Adults

Initial dose is typically 5 mg or 10 mg once daily. Dosage can be adjusted after 2-4 weeks, up to a maximum of 40 mg once daily, depending on lipid levels and therapeutic goals. For 5 mg tablet, it's usually the starting dose.

Elderly

No dose adjustment is necessary for patients >70 years old; however, a starting dose of 5 mg is recommended.

Renal_impairment

For patients with moderate renal impairment (CrCl < 60 mL/min), a starting dose of 5 mg once daily is recommended. The 40 mg dose is contraindicated in patients with severe renal impairment (CrCl < 30 mL/min).

Onset

Significant lipid-lowering effects observed within 1 week, with maximal effect usually achieved within 2-4 weeks of starting therapy.

Excretion

Approximately 90% is excreted in the feces, predominantly as unchanged drug. About 5% is excreted in the urine.

Half life

Approximately 19 hours.

Absorption

Rapidly absorbed after oral administration, with peak plasma concentrations occurring 3-5 hours post-dose. Absolute bioavailability is approximately 20%.

Metabolism

Limited metabolism, primarily by CYP2C9 (10%) and to a lesser extent CYP2D6. The major metabolite, N-desmethyl rosuvastatin, is about half as active as the parent drug.

Warfarin

May increase INR (International Normalized Ratio); monitor INR closely.

Gemfibrozil

Increases rosuvastatin exposure; co-administration is not recommended.

Cyclosporine

Concomitant use significantly increases rosuvastatin exposure; avoid this combination.

Erythromycin

Decreases rosuvastatin exposure.

Oral Contraceptives

May increase levels of ethinyl estradiol and norgestrel.