What is Crestor?

Crestor belongs to a group of drugs called HMG CoA reductase inhibitors, or “statins.” Rosuvastatin is used together with diet to lower blood levels of “bad” cholesterol (low-density lipoprotein, or LDL), to increase levels of “good” cholesterol (high-density lipoprotein, or HDL), and to lower triglycerides (a type of fat in the blood).

Crestor is used in adults and children who are at least 8 years old to lower cholesterol and triglycerides in the blood.

Crestor is used in adults to slow the progression of atherosclerosis (a build-up of plaque in blood vessels that can block blood flow).

Crestor is used to lower the risk of stroke, heart attack, and certain other heart complications in men 50 years and older and women 60 years and older who have coronary heart disease or other risk factors.

Crestor is also used to treat hereditary forms of high cholesterol, including the heterozygous type (inherited from one parent) and the homozygous type (inherited from both parents). For the heterozygous type, Crestor can be used in children who are at least 8 years old. For the homozygous type, this medicine can be used in children as young as 7 years old.

Warnings

Crestor can harm an unborn baby or cause birth defects. Do not use rosuvastatin if you are pregnant.

Before taking Crestor, tell your doctor if you have ever had liver or kidney disease, diabetes, or a thyroid disorder, if you are of Chinese descent, or if you drink more than 2 alcoholic beverages daily.

In rare cases, Crestor can cause a condition that results in the breakdown of skeletal muscle tissue, leading to kidney failure. Call your doctor right away if you have unexplained muscle pain, tenderness, or weakness especially if you also have fever, unusual tiredness, and dark colored urine.

You should not take rosuvastatin if you have liver disease, or if you are breastfeeding a baby.

Avoid eating foods that are high in fat or cholesterol. Crestor will not be as effective in lowering your cholesterol if you do not follow a cholesterol-lowering diet plan.

There are many other drugs that can increase your risk of serious medical problems if you take them together with Crestor. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor. Keep a list of all your medicines and show it to any healthcare provider who treats you.

Crestor is only part of a complete program of treatment that also includes diet, exercise, and weight control. Follow your diet, medication, and exercise routines very closely.

Before taking this medicine

You should not take Crestor if you are allergic to rosuvastatin, or if you have:

• liver disease/high levels of liver enzymes in your blood; or
• if you are pregnant or breastfeeding.

Do not take Crestor if you are pregnant. Rosuvastatin could harm the unborn baby or cause birth defects. Stop taking this medicine and tell your doctor right away if you become pregnant. Use effective birth control to prevent pregnancy while you are taking this medicine.

Rosuvastatin may pass into breast milk and could harm a nursing baby. Do not breastfeed while you are taking this medicine.

To make sure Crestor is safe for you, tell your doctor if you have ever had:

• liver problems;
• kidney disease;
• a thyroid disorder;
• a habit of drinking more than 2 alcoholic beverages per day;
• if you are of Asian descent; or
• if you are 65 or older.

Crestor can cause the breakdown of muscle tissue, which can lead to kidney failure. This happens more often in women, in older adults, or people who have kidney disease or poorly controlled hypothyroidism (underactive thyroid).

People of Asian descent may absorb rosuvastatin at a higher rate than other people which may cause muscle weakness/dysfunction. Make sure your doctor knows if you are Asian. You may need a lower than normal starting dose.

How should I take Crestor?

Take Crestor exactly as prescribed by your doctor. Follow all directions on your prescription label. Your doctor may occasionally change your dose to make sure you get the best results. Do not take this medicine in larger or smaller amounts or for longer than recommended.

Crestor is usually taken once a day, with or without food. Take the medicine at the same time each day.

While using this medicine, you may need frequent blood tests.

Keep using this medicine as directed, even if you feel well. High cholesterol usually has no symptoms. You may need to take Crestor on a long-term basis.

You may need to stop using this medicine for a short time if you have:

• uncontrolled seizures;
• an electrolyte imbalance (such as high or low potassium levels in your blood);
• severely low blood pressure;
• a severe infection or illness;
• dehydration; or
• surgery or a medical emergency.

You should not stop using Crestor unless your doctor tells you to.

Crestor is only part of a treatment program that may also include diet, exercise, and weight control. Follow your doctor’s instructions very closely.

Store at room temperature away from moisture, heat, and light.

Dosing information

Usual Adult Dose for Hyperlipoproteinemia:

Initial dose: 5 mg to 10 mg once a day with or without food
Maintenance dose: 5 mg to 40 mg once a day with or without food

Usual Adult Dose for Hyperlipoproteinemia Type IIa (Elevated LDL):

Initial dose: 5 mg to 10 mg once a day with or without food
Maintenance dose: 5 mg to 40 mg once a day with or without food

Usual Adult Dose for Hyperlipoproteinemia Type IIb (Elevated LDL + VLDL):

Initial dose: 5 mg to 10 mg once a day with or without food
Maintenance dose: 5 mg to 40 mg once a day with or without food

Usual Adult Dose for Hyperlipoproteinemia Type IV (Elevated VLDL):

Initial dose: 5 mg to 10 mg once a day with or without food
Maintenance dose: 5 mg to 40 mg once a day with or without food

Usual Adult Dose for Atherosclerosis:

Initial dose: 5 mg to 10 mg once a day with or without food
Maintenance dose: 5 mg to 40 mg once a day with or without food

Usual Adult Dose for Homozygous Familial Hypercholesterolemia:

Initial dose: 20 mg once a day with or without food
Maintenance dose: 20 mg to 40 mg once a day with or without food

Usual Adult Dose for Prevention of Cardiovascular Disease:

Initial dose: 5 mg to 10 mg once a day with or without food Maintenance dose: 5 mg to 40 mg once a day with or without food

Response to therapy should be estimated from preapheresis LDL-C levels.

Usual Geriatric Dose for Hyperlipidemia:

Initial dose: 5 mg once a day with or without food
Maintenance dose: 5 mg to 20 mg once a day with or without food

Usual Pediatric Dose for Heterozygous Familial Hypercholesterolemia:

Pediatric patients 10 to 17 years of age:

Usual dose range: 5 to 20 mg orally once a day with or without food. Doses should be individualized according to the recommended goal of therapy. Adjustments should be made at intervals of 4 weeks or more.

Maximum dose: 20 mg orally once a day

What happens if I miss a dose?

Take the missed dose as soon as you remember. If you are more than 12 hours late, skip the missed dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line.

Avoid eating foods high in fat or cholesterol, or Crestor will not be as effective.

Avoid drinking alcohol. It can raise triglyceride levels and may increase your risk of liver damage.

Avoid using antacids without your doctor’s advice. Use only the type of antacid your doctor recommends, and do not take it within 2 hours after taking Crestor. Some antacids can make it harder for your body to absorb rosuvastatin.

Avoid eating foods that are high in fat or cholesterol. Crestor will not be as effective in lowering your cholesterol if you do not follow a cholesterol-lowering diet plan.

Crestor side effects

Get emergency medical help if you have any signs of an allergic reaction to Crestor: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

• unexplained muscle pain, tenderness, or weakness;
• muscle weakness in your hips, shoulders, neck, and back;
• trouble lifting your arms, trouble climbing or standing;
• confusion, memory problems; or
• liver problems – upper stomach pain, tiredness, loss of appetite, dark urine, jaundice (yellowing of the skin or eyes).

Common side effects may include:

• headache;
• weakness;
• muscle aches; or
• nausea, stomach pain.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects.

What other drugs will affect Crestor?

When you start or stop taking Crestor, your doctor may need to adjust the doses of any other medicines you take on a regular basis. Using certain medicines together with rosuvastatin can increase your risk of serious muscle problems. It is very important to tell your doctor about all medicines you use, and those you start or stop using during your treatment with Crestor, especially:

• colchicine;
• cyclosporine;
• another “statin” medicine – atorvastatin, lovastatin, simvastatin, Lipitor, Pravachol, Zocor, Vytorin, and others;
• antiviral medicine to treat HIV or hepatitis C – atazanavir, fosamprenavir, ledipasvir, lopinavir, ritonavir, simeprevir, sofosbuvir, tipranavir, Epclusa, Mavyret, Viekira, Vosevi, and others;
• a blood thinner – warfarin, Coumadin, Jantoven;
• cancer medicine – darolutamide, regorafenib;
• other cholesterol medications – fenofibrate, gemfibrozil; or
• medicines that contain niacin or nicotinic acid – vitamin B3, Advicor, Niaspan, Niacor, Simcor, Slo-Niacin, and others.

Clopidogrel is used to lower your risk of having a stroke, blood clot, or serious heart problem after you’ve had a heart attack, severe chest pain (angina), or circulation problems.

Clopidogrel may also be used for purposes not listed in this medication guide.

Clopidogrel side effects

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Clopidogrel increases your risk of bleeding, which can be severe or life-threatening. Call your doctor or seek emergency medical attention if you have bleeding that will not stop, if you have blood in your urine, black or bloody stools, or if you cough up blood or vomit that looks like coffee grounds.

Also call your doctor at once if you have:

• nosebleeds, pale skin, easy bruising, purple spots under your skin or in your mouth;
• jaundice (yellowing of your skin or eyes);
• fast heartbeats, shortness of breath;
• headache, fever, weakness, feeling tired;
• little or no urination;
• a seizure;
• low blood sugar–headache, hunger, sweating, irritability, dizziness, fast heart rate, and feeling anxious or shaky; or
• signs of a blood clot–sudden numbness or weakness, confusion, problems with vision or speech.

Common side effects of clopidogrel may include:

• bleeding.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects.

Warnings

You should not use clopidogrel if you have any active bleeding such as a stomach ulcer or bleeding in the brain.

Clopidogrel increases your risk of bleeding, which can be severe or life-threatening. Call your doctor or seek emergency medical attention if you have bleeding that will not stop, if you have blood in your urine, black or bloody stools, or if you cough up blood or vomit that looks like coffee grounds.

Do not stop taking clopidogrel without first talking to your doctor, even if you have signs of bleeding. Stopping clopidogrel may increase your risk of a heart attack or stroke.

Before taking this medicine

You should not use clopidogrel if you are allergic to it, or if you have:

• any active bleeding; or
• a stomach ulcer or bleeding in the brain (such as from a head injury).

Tell your doctor if you have ever had:

• an ulcer in your stomach or intestines; or
• a bleeding disorder or blood clotting disorder.

Clopidogrel may not work as well if you have certain genetic factors that affect the breakdown of this medicine in your body. Your doctor may perform a blood test to make sure clopidogrel is right for you.

This medicine is not expected to harm an unborn baby. However, taking clopidogrel within 1 week before childbirth can cause bleeding in the mother. Tell your doctor if you are pregnant or plan to become pregnant.

You should not breastfeed while using this medicine.

How should I take clopidogrel?

Follow all directions on your prescription label and read all medication guides or instruction sheets. Use these medicines exactly as directed.

Clopidogrel can be taken with or without food.

Clopidogrel is sometimes taken together with aspirin. Take aspirin only if your doctor tells you to.

Clopidogrel keeps your blood from coagulating (clotting) and can make it easier for you to bleed, even from a minor injury. Contact your doctor or seek emergency medical attention if you have any bleeding that will not stop.

You may need to stop using clopidogrel for a short time before a surgery, medical procedure, or dental work. Any healthcare provider who treats you should know that you are taking clopidogrel.

Do not stop taking clopidogrel without first talking to your doctor, even if you have signs of bleeding. Stopping the medicine could increase your risk of a heart attack or stroke.

Store at room temperature away from moisture and heat.

Clopidogrel dosing information

Usual Adult Dose for Acute Coronary Syndrome:

Unstable Angina (UA)/Non-ST-Elevation Myocardial Infarction (NSTEMI):
-Loading dose: 300 mg orally once
-Maintenance dose: 75 mg orally once a day
-Duration of therapy: Optimal duration unknown.

ST-Elevation Myocardial Infarction (STEMI):
-Loading dose: 300 mg orally once (OPTIONAL)
-Maintenance dose: 75 mg orally once a day, with or without thrombolytics
-Duration of therapy: Optimal duration unknown.

Comments:
-Administer this drug in combination with aspirin 75 mg to 325 mg orally once a day.
-The benefit of this drug for patients who undergo primary percutaneous coronary intervention is unknown.

Uses: Prevention of atherothrombotic events in patients with non-ST-segment elevation acute coronary syndrome (UA, NSTEMI, those who are to be managed medically, those who are to be managed with coronary revascularization) and STEMI.

Usual Adult Dose for Ischemic Stroke:

75 mg orally once a day

Uses: Prevention of atherothrombotic events in patients with a history of recent myocardial infarction, recent stroke, or established peripheral arterial disease.

Usual Adult Dose for Myocardial Infarction:

75 mg orally once a day

Uses: Prevention of atherothrombotic events in patients with a history of recent myocardial infarction, recent stroke, or established peripheral arterial disease.

Usual Adult Dose for Peripheral Arterial Disease:

75 mg orally once a day

Uses: Prevention of atherothrombotic events in patients with a history of recent myocardial infarction, recent stroke, or established peripheral arterial disease.

What happens if I miss a dose?

Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line . Overdose can cause excessive bleeding.

What should I avoid while taking clopidogrel?

Avoid alcohol. It can increase your risk of stomach bleeding.

Avoid activities that may increase your risk of bleeding or injury. Use extra care to prevent bleeding while shaving or brushing your teeth.

If you also take aspirin: Ask a doctor or pharmacist before using medicines for pain, fever, swelling, or cold/flu symptoms. They may contain ingredients similar to aspirin (such as salicylates, ibuprofen, ketoprofen, or naproxen). Taking these products together can increase your risk of bleeding.

What other drugs will affect clopidogrel?

Sometimes it is not safe to use certain medications at the same time. Some drugs can affect your blood levels of other drugs you take, which may increase side effects or make the medications less effective.

Tell your doctor about all your other medicines, especially:

• a stomach acid reducer such as omeprazole, Nexium, or Prilosec;
• an antidepressant such as citalopram, fluoxetine, sertraline, Cymbalta, Effexor, Lexapro, Pristiq, or Prozac;
• rifampin;
• a blood thinner–warfarin, Coumadin, Jantoven; or
• NSAIDs (nonsteroidal anti-inflammatory drugs)–aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib, diclofenac, indomethacin, meloxicam, and others.