Starting Dose for Rosuvastatin (Crestor)
The recommended starting dose for rosuvastatin (Crestor) is 10 mg once daily for most patients, with a dosage range of 5-40 mg daily depending on patient factors and treatment goals. 1
Standard Dosing Recommendations
- Initial dose: 10-20 mg once daily for standard therapy 2
- Dose range: 5-40 mg once daily 1
- Administration: Can be taken with or without food, at any time of day 1
Dose Adjustments Based on Patient Factors
Special Populations
- Asian patients: Start with 5 mg once daily 1
- Patients with severe renal impairment (CrCl <30 mL/min):
Drug Interactions
- Patients taking cyclosporine, tacrolimus, everolimus, or sirolimus:
Dosing Based on Treatment Intensity
| Intensity Level | LDL-C Reduction | Rosuvastatin Dose |
|---|---|---|
| High-Intensity | ≥50% | 20-40 mg daily |
| Moderate-Intensity | 30-49% | 5-10 mg daily |
Monitoring and Dose Titration
- Assess LDL-C response as early as 4 weeks after initiating therapy 1
- Adjust dosage if necessary based on lipid response and treatment goals
- For high-risk patients requiring >50% LDL-C reduction, consider starting with or titrating to 20-40 mg daily 2
Clinical Efficacy
Rosuvastatin demonstrates greater LDL-C reduction compared to other statins at equivalent doses:
- 10 mg rosuvastatin reduces LDL-C by approximately 49% 4
- This is significantly more effective than pravastatin 20 mg (28% reduction) and simvastatin 20 mg (37% reduction) 4
Safety Considerations
- Most common adverse events are mild to moderate: myalgia, constipation, asthenia, abdominal pain, and nausea 5
- Monitor for muscle symptoms, as with all statins
- Do not exceed 40 mg daily as this is considered the maximum therapeutic dose 2
Rosuvastatin's favorable pharmacologic profile includes selective uptake by hepatic cells and hydrophilic nature, contributing to its efficacy and safety profile 5.