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It is recommended that liver function tests be carried out prior to, and 3 monthsfollowing, the initiation of treatment. Eveness® should be discontinued or the dosereduced if the level of serum transminses is greater than 3 times the upper limit ofnormal. The reporting rate for serious hepatic events (consisting mainly of increasedhepatic transaminases) in post- marketing use is higher at the 40 mg dose. In patientswith secondary hypercholesterolaemia caused by hypothyroidism or nephriticsyndrome, the underlying diseases should be treated prior to initiating therapy withrosuvastatin .RacePharmacokinetic studies show an increase in exposure in Asian subjects comparedwith Caucasians .Protease inhibitorsThe concomitant use with protease inhibitors is not recommended .Drug interactionsCiclosporin: During concomitant treatment with Eveness® and cicloporin,rosuvastatin AUC values were on average 7 times higher than those observed inhealthy volunteers. Concomitant administration did not affect plasma concentration ofciclosporinVitamin K antagonists: As with other HMG-CoA reductase inhibitors, the initiation oftreatment or dosage up- titration of Eveness® in patients treated concomitantly withvitamin K antagonists (e.g. warfarin or another coumarin anticoagulants) may resultin an increase in international Normalized Ratio ( INR) . Discontinuation or downtitrationof Eveness® may result in a decrease in INR. Such is Desirable.Ezetimibe: concomitant use of Eveness® and ezetimibe resulted in no change to AUCor Cmax for either drug. However, a pharmacodynamic interaction, in terms ofadverse effects, between Eveness® and ezetimibe cannot be ruled out .Gemfibrozil and other lipid-loweing products: Concomitant use of Eveness® andgemfibrozil resulted in a 2- fold increase in rosuvastatin Cmax and AUC .Based on data from specific interaction studies no pharmacokinetic relevantinteraction with fenofibrate is expected, however a pharmacodynamic interaction mayoccur. Gemfibrozil fenofibrate, other fibrated and lipid loweing doses (>or equal to 1g/ day ) of niacin (nicotinic acid increase the risk of myopathy when givenconcomitantly with HMG-CoA reductast inhibitors, probably because they canproduce myopathy when given alone. The 40 mg dose is contraindicated withconcomitant use of a fibrate. These patients should also start with the 5 mg dose.Protease inhibitors: Although the exact mechanism of interaction is unknown,concomitant protease inhibitor use may strongly increase rosuvastatin exposure, in apharmacokikinetic study, co- administration of 20 mg rosuvastatin and combinationproduct of two protease inhibitors (400 mg lopinavir / 100mg ritonavir) in healthyvolunteers was associated with an approximately two –fold increase in rosuvastatinsteady-state AUC (0-24) and C max respectively. Therefore, concomitant use ofrosuvastatin in HIV patients receiving protease inhbitors is not recommended .Antacid: The simultaneous dosing of Eveness® with an antacid suspension containingaluminum and magnesium hydroxide resulted in a decrease in rosuvastatin plasmaconcentration of approximately 50%. This effect was mitigated when the antacid wasdosed 2 hours after Eveness®. The clinical relevance of this interaction has not beenstudied .