The Pharmaceutical Journal
Vol 272 No 7300 p632
22 May 2004

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Reports of rhabdomyolysis prompt prescribing reminder for Crestor

Four UK reports of rhabdomyolysis associated with rosuvastatin (Crestor) have prompted AstraZeneca to write to prescribers reminding them of the drug's start dose. All four cases involved patients who received start doses that were higher than the recommended 10mg and who had pre-existing risk factors for myopathy.

A spokeswoman for AstraZeneca told The Journal that a start dose of 10mg should be used in all patients, including those transferred to rosuvastatin from other statins, whatever the previous dose. The letter suggests that a dose adjustment up to 20mg can be made after four weeks but that 10mg is sufficient to provide control of lipid levels in most patients. It adds that a 40mg dose is rarely necessary.

The spokeswoman explained that data from large statin trials, such as the Heart Protection Study, had influenced prescribing patterns. She suggested that there was now a tendency for doctors to prescribe high doses of statins and to use rosuvastatin in the same way as simvastatin or atorvastatin.

AstraZeneca recommends that patients initiated on rosuvastatin at doses greater than 10mg should be reviewed at their next GP appointment and that a down titration of the dose should be considered.