Why is there a requirement for renal function when taking rosuvastatin, and what should I pay attention to?

A friend left a message asking Huazi, what precautions should be taken when taking rosuvastatin? Hua Zi said that rosuvastatin is one of the only two potent statins, and the other potent statin is atorvastatin. When taking rosuvastatin, care should be taken not to exceed the safe dose and the requirements for renal function.

There is a requirement for renal function when taking rosuvastatin, not because it will damage the kidney, but part of rosuvastatin needs to be excreted through the kidney. Poor function can easily cause the accumulation of rosuvastatin and increase the toxicity. In fact, rosuvastatin also has protective effects on the kidneys.

I. “Double Standard” of the largest dose at home and abroad

A friend who has lived abroad told Hua Zi that the maximum dose of rosuvastatin abroad can be taken at 40mg per day, but the maximum dose of rosuvastatin in China is 20mg per day. Why is the maximum dose of the same drug “double-standard” at home and abroad? Is it the reason for the drug?

Hua Zi said that this has nothing to do with drugs, but The constitution of Chinese people is different from that of foreigners, and their tolerance to statins is low . Rosuvastatin is particularly obvious. Under the same dose, the area under the drug concentration curve in Chinese is twice that of Europeans and Americans.

So in order to reduce adverse reactions, the maximum dose of rosuvastatin abroad is 40mg per day, while the maximum dose in China is reduced by half to 20mg per day.

Second, rosuvastatin with kidney-protecting effect

Because the drug insert says that it is forbidden for people with severe renal insufficiency, many people think that rosuvastatin has an effect on the kidneys. But this is a misunderstanding, Rosuvastatin is excreted by the kidneys in a small part, and people with severe renal insufficiency (creatinine clearance.

But for people with mild to moderate renal insufficiency, taking rosuvastatin will not affect drug excretion, and by reducing blood lipids, reducing renal atherosclerosis, and improving renal blood supply, Actually protects the kidneys.

In high-dose (40 mg daily) trials, transient, intermittent proteinuria was observed in most cases but was not considered a precursor to kidney disease.

Three, Rosuvastatin and Atorvastatin

Rosuvastatin can reduce the level of low-density lipoprotein cholesterol (LDL-C) by about 63% in foreign clinical trials, is the most powerful statin for lowering lipids Drugs. Atorvastatin can reduce LDL-C levels by up to about 55%.

However, rosuvastatin has a slightly higher incidence of adverse reactions than atorvastatin, so Atorvastatin is usually chosen for initial statin therapy, Rosuvastatin should be used only when it is intolerable or contraindicated.

Atorvastatin needs to be metabolized by liver drug enzymes and interacts with many drugs, while only a small part of rosuvastatin is metabolized by liver drug enzymes and has little interaction with other drugs . Rosuvastatin is more suitable for patients with coexisting multiple diseases who need multi-drug combination.

Fourth, pay attention to adverse reactions when using it

In the process of medication, pay attention to the effect on liver function. Although rosuvastatin is rarely metabolized by the liver, its “workplace” is in the liver cells, which may affect liver function. Therefore, Pay attention to the levels of transaminase (AST, ALT) during the treatment period. When it exceeds 3 times the upper limit of normal, it is recommended to stop the treatment.

Statins have side effects of muscle damage, including muscle soreness, fatigue, and the rare but fatal rhabdomyolysis. So Pay attention to creatine kinase (CK) during the medication period, and stop the medication when it exceeds 5 times the upper limit of normal.

RosuvalStatins may cause blood sugar abnormalities and increase the risk of new-onset diabetes. However, elevated blood sugar is not an indication for drug discontinuation, and it is recommended to combine hypoglycemic drugs to control blood sugar and maintain statin therapy as much as possible.

To sum up, rosuvastatin will not harm the kidneys, but in patients with severe renal insufficiency, it will affect the excretion of the drug and may cause accumulation poisoning. Rosuvastatin has fewer interactions with other drugs and is more suitable for multidrug use. Attention should be paid to adverse reactions during medication. It is recommended to review blood lipids, liver function, renal function, and creatine kinase in the first, third, and sixth months of medication to evaluate drug efficacy and prevent adverse reactions.

The medicine should be taken under the guidance of a doctor. If you have any doubts about the medicine, please consult your doctor or pharmacist. I am Huazi, a pharmacist. Welcome to follow me and share more health knowledge.