FDA Soon To Approve New "Super
Statin" Crestor (rosuvastatin)
The Introductiuon of Crestor will trigger
another round of marketing wars and questions
about which statin is best. Watch for a lot of
claims. Find out the facts, which statin are best.
Potency. Crestor, Lipitor, and Zocor are the
most effective for lowering LDL...Crestor works
best for raising HDL. Crestor 10 mg lowers LDL
about 50%. It's at least as effective as Lipitor
20 mg or Zocor 80 mg.
Liver function tests. Testing recommendations
vary...but the risk of increased liver enzymes
is similar with all the statins.
Hepatotoxicity is rare, if it occurs at all.
Myopathy. The risk is similar for all statins...and
increases with higher doses or when combined with
gemfibrozil.
Renal monitoring. Crestor is the only statin
associated with kidney problems. Patients might
need to be monitored for proteinuria if they're
taking the highest dose... 40 mg/day.
Drug interactions. Interactions are most likely
with Zocor...Mevacor...and to a lesser extent,
Lipitor.
These statins are metabolized by CYP3A4 and can
interact with 3A4 inhibitors...ketoconazole, erythromycin,
grapefruit juice, etc.. Interactions are less
likely with Pravachol, or Crestor. Which are not
significantly metabolized by cytochrome P450 and
may be less likely to be involved in drug interactions.
Clinical benefit. So far Zocor and Pravachol
have the best evidence for improved outcomes.
But there's growing evidence that the others are
beneficial too.
Crestor at its highest does of 40mg, can reduce
LDL cholesterol 62% (Must monitor renal function
with the 40 mg dose). The next best is Lipitor
80mg which, reduced LDL by 54%. There's no proof
yet that Crestor improves outcomes...but studies
will be available shortly.
