Fluid-lowering drug Crestor: instructions for use

width = Crestor - a medical product used to combat excess cholesterol of various types.

From the point of view of pharmacology, they are referred to the group of stanin funds. It is recommended to take the drug when diagnosing hypercholesterolemia of a homozygous family type, atherosclerosis, which requires a decrease in cholesterol.

The drug has lipid-lowering and hypocholesterolemic effect, which becomes noticeable within a week after the start of treatment. The crucifer is effective in diabetes mellitus and as an addition to a medical diet. The drug is well tolerated by the body, in comparison with analogues shows less toxic effect on the liver.

Clinical and pharmacological group

A hypolipidemic agent from the group of statins, an inhibitor of HMG-CoA reductase.

Conditions of leave from pharmacies

It is released on prescription.

Price list

How much does a Crestor cost? The average price in pharmacies is at the level of2 800 rubles.

Form of issue and composition

The drug Krestor is available in the form of tablets for oral use with a dosage of 5, 10, 20 and 40 mg, depending on the content of 1 tablet of the main active ingredient.

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In one tablet of the drug contains 5, 10, 20 or 40 mg of rosuvastatin calcium and additional substances (single crystal cellulose, crospovidone, lactose monohydrate, calcium phosphate, hypromellose, E171, E172, triacetate glycerol, magnesium stearate).

The drug is packed in blisters of 28 pieces in a cardboard pack (2 blisters with 14 tablets).

Pharmacological effect

A hypolipidemic drug, a selective competitive inhibitor of HMG-CoA reductase.

The crucifer reduces elevated concentrations of cholesterol-LDL (cholesterol-LDL-C), total cholesterol, triglycerides (TG), increases the concentration of high-density lipoprotein cholesterol (HDL-C), and also reduces the concentrations of apolipoprotein B (ApoB), cholesterol-non-HDL, cholesterol-VLDL, and VGL-TG and increases the content of apolipoprotein A-I (ApoA-I) (see Fig. Tables 1 and 2), reduces the ratio of LDL-C-HDL cholesterol, total cholesterol / cholesterol-HDL cholesterol and non-HDL / C-HDL cholesterol and the ApoB / ApoA-1 ratio.

The therapeutic effect becomes evident within 7 days after initiation of therapy. After 14 days of treatment, it reaches 90% of the maximum possible effect. Usually the maximum therapeutic effect is achieved by the 4th week of therapy.

Indications for use

What helps? The cross is shown in the following cases:

Hypertriglyceridemia (in addition to diet);
Family homozygous hypercholesterolemia (in addition to diet or other lipid-lowering therapy, or inadequate efficacy of the listed methods);
Mixed hypercholesterolemia or primary hypercholesterolemia (including familial heterozygous hypercholesterolemia), in addition to diet, when other non-pharmacological therapies are insufficient;
Primary prevention of stroke, heart attack and arterial revascularization in adult patients with an increased risk of developing coronary heart disease;
Delay in the progression of atherosclerosis (in addition to diet in patients with indications for therapy, aimed at reducing the concentration of total cholesterol and low-density lipoprotein cholesterol density).

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Contraindications

For tablets 40 mg:

patients of the Asian race;
simultaneous administration of cyclosporine;
excessive use of alcohol;
simultaneous reception of fibrates;
increased sensitivity to rosuvastatin or any of the components of the drug;
conditions that may lead to an increase in the plasma concentration of rosuvastatin;
in women: pregnancy, lactation, lack of adequate methods of contraception;
lactose intolerance, lactase deficiency or glucose-galactose malabsorption (the preparation contains lactose);
liver diseases in the active phase, including a persistent increase in serum transaminase activity and any increase in serum transaminase activity (more than 3-fold compared with IGN);
patients with risk factors for myopathy / rhabdomyolysis, namely: renal failure of moderate severity (CC less than 60 ml / min), hypothyroidism, personal or family anamnesis of muscle diseases, myotoxicity against the background of taking other HMG-CoA reductase inhibitors or fibrates in anamnesis.

For tablets 10 mg and 20 mg:

myopathy;
simultaneous administration of cyclosporine;
in women: pregnancy, lactation, lack of adequate methods of contraception;
patients who are predisposed to the development of myotoxic complications;
increased sensitivity to rosuvastatin or any of the components of the drug;
severe renal dysfunction (KK less than 30 ml / min);
lactose intolerance, lactase deficiency or glucose-galactose malabsorption (the preparation contains lactose);
liver diseases in the active phase, including a persistent increase in serum transaminase activity and any increase in serum transaminase activity (more than 3 times as compared with IGN)

Can be taken with caution:

For tablets of 10 mg and 20 mg: the presence of a risk of myopathy / rhabdomyolysis - renal failure, hypothyroidism, personal or family history of hereditary muscle diseases and previous history of muscle toxicity with other HMG-CoA reductase inhibitors or fibrates; excessive use of alcohol; age over 65 years; conditions in which there was an increase in the plasma concentration of rosuvastatin; race (Asian race); simultaneous appointment with fibrates (cf. section "Pharmacokinetics liver disease in history; sepsis; arterial hypotension; extensive surgical interventions, injuries; severe metabolic, endocrine or electrolyte disorders; uncontrolled convulsive seizures.

For tablets 40 mg: renal failure of low severity (QC more than 60 ml / min); age over 65; liver disease in history; sepsis; arterial hypotension; extensive surgical interventions, trauma; severe metabolic, endocrine or electrolyte disorders; uncontrolled convulsive seizures.

Use in pregnancy and lactation

The drug Krestor is contraindicated for use in women during pregnancy and breastfeeding.

Sexually mature women receiving therapy with this drug should pay attention to effective and adequate methods of protection from unplanned pregnancy. In case of unintended pregnancy on the background of therapy, the drug should be discontinued immediately and be sure to inform the doctor about the use of Rosuvastin.

Dosage and route of administration

The instructions for use indicate: The crucifer is taken orally, regardless of food intake and at any time of the day. Tablets must be swallowed whole (without crushing and not chewing), washed down with water.

Before the start of the course of treatment, you should follow the standard hypocholesterolemic diet (it should be continued throughout the therapy).

The doctor selects the dose of Crestor individually, it is determined by the goals of the treatment and the therapeutic response to treatment, taking into account the current recommendations on the target concentration of lipids.

The recommended initial daily dose for patients starting to take Krestor, or for those who are transferred with reception of other inhibitors of HMG-CoA reductase in patients should be 5 or 10 mg, the frequency of administration is 1 time in a day. When selecting the initial dose should be guided by individual concentration of cholesterol and take into account the possible risk of cardiovascular complications and side effects. If necessary, it is possible to increase the dose after 4 weeks.

Because of the high risk of side effects, an increase in the dose to 40 mg (after an additional dose above the recommended initial dose within 4 weeks of treatment) can be performed only in patients with severe hypercholesterolemia and a high risk of cardiovascular complications (especially in patients with familial hypercholesterolemia) who, when taking a dose of 20 mg, did not achieve the desired result, and who would be monitored doctor. Particularly careful observation is recommended for patients receiving Krestor in a dose of 40 mg.

The appointment of a daily dose of 40 mg is not recommended for patients who have not previously consulted a doctor. After 14-28 days of treatment and / or with an increase in the dose of the Crestor, it is necessary to monitor the lipid metabolism (if necessary, dose adjustment may be required).

Patients with severe renal failure (with creatinine clearance less than 30 ml per minute), the use of Crestor is contraindicated. Patients with renal insufficiency of mild or moderate severity do not need a dose adjustment. The use of a Crestor in a dose of 40 mg is contraindicated in patients with moderate impaired renal function (with creatinine clearance of 30-60 ml per minute). Patients with moderate functional renal impairment should take the drug in an initial dose of 5 mg.

When prescribing doses of 10 and 20 mg, the recommended initial dose for patients of the Mongoloid race, as well as for patients with predisposition to myopathy should not exceed 5 mg (application of a Crestor in a dose of 40 mg contraindicated).

The cruciate is contraindicated for patients with liver diseases that occur in the active phase.

Elderly patients do not need dose adjustment.

Side effects

As a rule, Krestor, according to reviews, causes side effects in rare cases. At the same time, most studies note their short-term and weakly expressed character.

So, with the use of Krestor, according to reviews. possible development:

Headache and dizziness (central nervous system);
Nausea, constipation and abdominal pain (gastrointestinal tract);
Rashes, itchy skin and urticaria (skin);
Hypersensitivity reactions, including angioedema development (immune system);
Diabetes mellitus type 2 (endocrine system);
Myalgia, myopathy, rhabdomyolysis (musculoskeletal system);
Proteinuria (urinary system).

According to the results of the post-marketing research, it is established that according to some reviews, Krestor can cause:

Polineuropathy and memory loss;
Peripheral edema;
Hematuria;
Jaundice and hepatitis;
Arthralgia;
Diarrhea;
Cough and shortness of breath;
Syndrome Stevens-Johnson.

In isolated cases, the use of Crestor led to the development of depression, nightmarish dreams, sleep disorders, sexual dysfunctions, insomnia.

Overdose

In case of accidental ingestion of large doses of the drug in patients, development of symptoms overdose, which are expressed in the oppression of the liver and kidneys, the development of violations by heart and blood vessels.

When such violations occur, the patient undergoes symptomatic treatment aimed at maintaining vital functions. Hemodialysis in an overdose is ineffective.

special instructions

Before you start using the drug, read the special instructions:

In a dose of 40 mg Crestor is not recommended for patients who have not previously consulted a doctor.
Prior to taking the drug and after 3 months of treatment, it is necessary to determine the indicators of liver function. If the activity of transaminases in the serum is 3 times higher than this with congenital adrenal hyperplasia, treatment should stop or reduce the dose of rosuvastatin.
After 2-4 weeks of treatment and / or with increasing the dose, it is necessary to monitor the lipid metabolism parameters, if necessary, to correct the dose of the drug.
When taking high doses of rosuvastatin, it is possible to develop tubular proteinuria (mostly transient), so patients receiving a drug at a dose of 40 mg need to monitor kidney function.
Patients with hypercholesterolemia who develop due to nephrotic syndrome or hypothyroidism before the appointment of Crestor should be treated with the underlying disease.
If you suspect a development of interstitial lung disease (shortness of breath, unproductive cough, worsening of overall health), treatment should be discontinued.
Patients should be warned that they should immediately consult a doctor in case of sudden spasms, muscle weakness or pain, especially when combined with fever and malaise. In such patients, it is necessary to determine the activity of creatine phosphokinase (CKF). If the baseline level of CK is significantly increased (5 times greater than with congenital adrenal hyperplasia), it is necessary to re-measure after 5-7 days. If a second test confirms high CPK activity or the symptoms are severe and cause discomfort, the drug should be stopped. If the symptoms disappear, and the activity of CPA returns to normal, consider the question of repeated administration of Crestor or other inhibitors of HMG-CoA reductase in smaller doses with careful medical observation.

The crest may cause dizziness, so care must be taken when driving means and performance of types of work requiring the speed of psychomotor reactions and high concentration of attention.

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Drug Interactions

When using the drug, it is necessary to take into account the interaction with other drugs:

Fibrates, gemfibrozil and lipid-lowering doses of vitamin PP increased the risk of myopathy, so with a simultaneous appointment, the recommended initial dose of rosuvastatin is 5 mg.
With the simultaneous use of rosuvastatin and antagonists of vitamin K, an increase in prothrombin time (MI), and when the dose is lowered or the drug is withdrawn, it decreases, so in such cases it is necessary to control PV.
Suspensions of antacids containing magnesium hydroxide and aluminum lead to a decrease in the plasma rosuvastatin concentration by about 50%. Erythromycin reduces the pharmacokinetic parameter of AUC by 20% and the concentration of rosuvastatin by 30%.
With the combined use of protease inhibitors and Krestor, a significant increase in the exposure of rosuvastatin is possible.
There was no clinically significant interaction with digoxin, fluconazole, ketoconazole, and itraconazole.

Reviews

We picked up some reviews of people taking the drug Krestor:

Lena. Crestor is the best drug from all the statins that exist at the moment. My mom only accepts the crucifix, already for, years. Excellent results. Full balance in the lipidogram. Her cardiologist is very pleased, but we even more so!
Tatyana. Krestor is one of the best statin drugs, my cardiologist is glad, as the indicators came back to normal after its application. But the price of the drug is high, you need to drink it for a long time so that the lipidogram indices are normal, and it hits the wallet. Now, while everything is fine, I want to switch to another analog preparation, but I have not yet chosen which one and look at the results, it can support my condition. In general, it is better not to save on health.
Jan. Myocardial infarction made me think and think about what I did with my health! Even went to the simulator. Painfully increased my cholesterol, here I was prescribed a strict diet, on boiled and paren only, I'm happy, you can eat fruit, forbid smoking, it's hard all this. Tried "Krestor" - on purpose I take, but did not observe allergic reactions. It became easier to breathe, plus I ran on the treadmill, practicing with the coach. Tablets help, but physical exercise is also good. I do not know, but I better cope with the pills, periodically, not to get used to, I stop the treatment.

Analogues

The most basic analogue of "Krestor" is the medicine "Rosuvastatin". However, the pharmaceutical market is able to offer other means, no less effective.

Excellent analogs of the original drug are medicines:

"Rosistark".
Rosart.
«Acorta».
"Mertenil."
"Tevastor".
The Rosacard.
"Roxer".
"Rosuvastatin calcium."
Rosicor.
"Rustor".
«Rosuvastatin-SZ».
"Rosulip".

Before using analogues, consult your doctor.

Storage conditions and shelf life

Keep the crossbow away from children's hands in a cool place. The room temperature can not rise above +29 degrees, so as not to weaken the impact and efficiency of the main component. Opening the blister absolutely does not affect the shelf life.

Since the production of the tablet should be used within 36 months.