Augmentin and Rosuvastatin in Elderly Patients: Safety Assessment
Yes, Augmentin (amoxicillin/clavulanate) can be safely prescribed to elderly patients taking rosuvastatin, as there are no clinically significant drug-drug interactions between these medications.
No Pharmacokinetic Interaction Between Augmentin and Rosuvastatin
Rosuvastatin has minimal metabolism via the cytochrome P450 system and exhibits high hydrophilicity and hepatoselectivity, making it less prone to drug-drug interactions compared to other statins 1, 2.
Augmentin (amoxicillin/clavulanate) is a beta-lactam antibiotic that does not interact with the cytochrome P450 enzyme system or affect organic anion transporter protein 1B1 (OATP1B1), which is the primary transporter responsible for rosuvastatin hepatic uptake 1.
The American Heart Association guidelines specifically note that digoxin coadministration with any statin, including rosuvastatin, is reasonable in elderly patients, demonstrating that statins can be safely combined with other medications when no metabolic pathway overlap exists 3.
Rosuvastatin's Favorable Safety Profile in Elderly Patients
Rosuvastatin is particularly advantageous in elderly patients taking multiple medications because it lacks clinically significant interactions with most drugs metabolized by cytochrome P450 enzyme 3A4 2.
At low starting doses (5-10 mg), rosuvastatin is highly efficacious in elderly patients and more likely to enable them to reach LDL-cholesterol goals without titration or combination therapy 2.
Rosuvastatin has shown efficacy in treating patients with comorbidities common in the elderly, including renal impairment and diabetes mellitus 2.
Key Monitoring Considerations in Elderly Patients on Rosuvastatin
While Augmentin itself poses no interaction risk, elderly patients on rosuvastatin require general vigilance for:
Polypharmacy risks: Elderly patients taking multiple medications are at increased risk for drug-drug interactions and adverse drug reactions, requiring careful medication review 4, 5.
Statin-associated symptoms: Monitor for musculoskeletal complaints, though these occur at similarly low rates with rosuvastatin as with other statins 1, 6.
Drugs that DO interact with rosuvastatin: Avoid or use caution with cyclosporine, gemfibrozil, and antiretroviral agents, which antagonize OATP1B1-mediated hepatic uptake and increase rosuvastatin toxicity risk 1.
Clinical Bottom Line
Prescribe Augmentin without dose adjustment or special precautions in elderly patients taking rosuvastatin. The combination is safe because these medications do not share metabolic pathways or transport mechanisms 1, 2. Continue rosuvastatin therapy during the antibiotic course, as there is no need for temporary discontinuation 3.