Adults

The usual starting dose is 5 mg or 10 mg once daily. For primary prevention of cardiovascular events, the initial dose is typically 5 mg once daily. Dosage may be adjusted at 2-4 week intervals up to a maximum of 40 mg once daily.

Elderly

A starting dose of 5 mg is recommended for patients >70 years of age.

Renal_impairment

For patients with severe renal impairment (creatinine clearance < 30 mL/min/1.73 m²), the starting dose should be 5 mg once daily and should not exceed 10 mg once daily.

Onset

Significant lipid-lowering effects are observed within 1 week of initiation, with maximal effects achieved by 2-4 weeks.

Excretion

Excreted primarily in feces (approximately 90%) and to a lesser extent in urine (approximately 10%), mostly as unchanged drug.

Half life

Plasma elimination half-life is approximately 19 hours.

Absorption

Approximately 20% absolute bioavailability. Peak plasma concentrations (Tmax) occur 3 to 5 hours after oral administration.

Metabolism

Limited hepatic metabolism, primarily by CYP2C9 (approximately 10% of dose).

Niacin

Increased risk of muscle-related adverse events.

Warfarin

May enhance the anticoagulant effect of warfarin; monitor INR closely.

Gemfibrozil

Concurrent use increases rosuvastatin exposure; avoid co-administration if possible, or limit rosuvastatin dose to 10 mg daily.

Cyclosporine

Concurrent use significantly increases rosuvastatin exposure; co-administration is contraindicated.

Erythromycin

Decreases rosuvastatin exposure.

Protease Inhibitors (e.g., Lopinavir/Ritonavir, Atazanavir/Ritonavir)

Significantly increases rosuvastatin exposure; dosage adjustments and careful monitoring are needed.