Rosuvastatin Calcium

ROSUVASTATIN CALCIUM- rosuvastatin calcium tablet, film coated
Golden State Medical Supply, Inc.

1 INDICATIONS AND USAGE

Pediatric use information for patients 7 to 17 years of age is approved for AstraZeneca’s CRESTOR (rosuvastatin calcium) tablets. However, due to AstraZeneca’s marketing exclusivity rights, this drug product is not labeled with that pediatric information.

1.3 Hypertriglyceridemia

Rosuvastatin is indicated as adjunctive therapy to diet for the treatment of adult patients with hypertriglyceridemia.

1.4 Primary Dysbetalipoproteinemia (Type III Hyperlipoproteinemia)

Rosuvastatin is indicated as an adjunct to diet for the treatment of adult patients with primary dysbetalipoproteinemia (Type III Hyperlipoproteinemia).

1.5 Adult Patients with Homozygous Familial Hypercholesterolemia

Rosuvastatin is indicated as adjunctive therapy to other lipid-lowering treatments (e.g., LDL apheresis) or alone if such treatments are unavailable to reduce LDL-C, Total-C, and ApoB in adult patients with homozygous familial hypercholesterolemia.

1.8 Limitations of Use

Rosuvastatin has not been studied in Fredrickson Type I and V dyslipidemias.

2 DOSAGE AND ADMINISTRATION

2.1 General Dosing Information

The dose range for rosuvastatin calcium tablets in adults is 5 to 40 mg orally once daily. The usual starting dose is 10 to 20 mg once daily. The usual starting dose in adult patients with homozygous familial hypercholesterolemia is 20 mg once daily.

The maximum rosuvastatin calcium tablets dose of 40 mg should be used only for those patients who have not achieved their LDL-C goal utilizing the 20 mg dose [see Warnings and Precautions (5.1)].

Rosuvastatin calcium tablets can be administered as a single dose at any time of day, with or without food. The tablet should be swallowed whole.

When initiating rosuvastatin therapy or switching from another HMG-CoA reductase inhibitor therapy, the appropriate rosuvastatin starting dose should first be utilized, and only then titrated according to the patient’s response and individualized goal of therapy.

After initiation or upon titration of rosuvastatin, lipid levels should be analyzed within 2 to 4 weeks and the dosage adjusted accordingly.

Pediatric use information for patients 7 to 17 years of age is approved for AstraZeneca’s CRESTOR (rosuvastatin calcium) tablets. However, due to AstraZeneca’s marketing exclusivity rights, this drug product is not labeled with that pediatric information.

2.3 Dosing in Asian Patients

In Asian patients, consider initiation of rosuvastatin therapy with 5 mg once daily due to increased rosuvastatin plasma concentrations. The increased systemic exposure should be taken into consideration when treating Asian patients not adequately controlled at doses up to 20 mg/day [see Use in Specific Populations (8.8) and Clinical Pharmacology (12.3)] .

2.4 Use with Concomitant Therapy

​ Patients taking cyclosporine and darolutamide

​ The dose of rosuvastatin should not exceed 5 mg once daily [see Warnings and Precautions (5.1) , Drug Interactions (7.1), Drug Interactions (7.4) and Clinical Pharmacology (12.3)] .

​ Patients taking gemfibrozil

​ Avoid concomitant use of rosuvastatin with gemfibrozil. If concomitant use cannot be avoided, initiate rosuvastatin at 5 mg once daily. The dose of rosuvastatin should not exceed 10 mg once daily. , . Avoid concomitant use of rosuvastatin with gemfibrozil. If concomitant use cannot be avoided, initiate rosuvastatin at 5 mg once daily. The dose of rosuvastatin should not exceed 10 mg once daily. [see Warnings and Precautions (5.1) , Drug Interactions (7.2) and Clinical Pharmacology (12.3) ].

​ Patients taking regorafenib

​ Concomitant use of rosuvastatin and regorafenib, the dose of rosuvastatin should not exceed 10 mg once daily. [see Warnings and Precautions (5.1) , Drug Interactions (7.5) and Clinical Pharmacology (12.3)].

​ Patients taking atazanavir and ritonavir, lopinavir and ritonavir, simeprevir or combination of dasabuvir/ombitasvir/paritaprevir/ritonavir, elbasvir/grazoprevir, sofosbuvir/velpatasvir and glecaprevir/pibrentasvir

​ Initiate rosuvastatin therapy with 5 mg once daily. The dose of rosuvastatin should not exceed 10 mg once daily , . Initiate rosuvastatin therapy with 5 mg once daily. The dose of rosuvastatin should not exceed 10 mg once daily [see Warnings and Precautions (5.1) , Drug Interactions (7.3) and Clinical Pharmacology (12.3)].

2.5 Dosing in Patients with Severe Renal Impairment

For patients with severe renal impairment (CL _cr <30 mL/min/1.73 m ²) not on hemodialysis, dosing of rosuvastatin should be started at 5 mg once daily and not exceed 10 mg once daily [see Use in Specific Populations (8.6) and Clinical Pharmacology (12.3)] .

3 DOSAGE FORMS AND STRENGTHS

5 mg: Pink, round, biconvex, coated tablets. Debossed as ‘CY’ on one side and ‘5’ on other side.

10 mg: Yellow, round, biconvex, coated tablets. Debossed as ‘CY’ on one side, and ‘10’ on other side.

20 mg: Yellow, round, biconvex, coated tablets. Debossed as ‘CY’ on one side, and ‘20’ on other side.

40 mg: Pink, round, biconvex, coated tablets. Debossed as ‘CY’ on one side, and ‘40’ on other side.

4 CONTRAINDICATIONS

Rosuvastatin is contraindicated in the following conditions:

• Patients with a known hypersensitivity to any component of this product. Hypersensitivity reactions including rash, pruritus, urticaria, and angioedema have been reported with rosuvastatin [see Adverse Reactions (6.1)] .

• Patients with active liver disease, which may include unexplained persistent elevations of hepatic transaminase levels [see Warnings and Precautions (5.2)] .

• Pregnancy [see Use in Specific Populations ( 8.1, 8.3)] .

• Lactation. Limited data indicate that rosuvastatin is present in human milk. Because statins have the potential for serious adverse reactions in nursing infants, women who require rosuvastatin treatment should not breastfeed their infants [see Use in Specific Populations (8.2)] .