Which medicines and supplements can interact with Crestor?
Ask the doctor
Q. What medications, prescription and over the counter, especially vitamin B2, interact with Crestor (rosuvastatin)?
A. Rosuvastatin (Crestor) is one of the most commonly prescribed statin drugs prescribed to lower LDL cholesterol, reduce the risk of developing cardiovascular disease, and decrease the chance of having a heart attack or stroke.
There are no reported significant drug interactions with standard doses of vitamins and minerals.
Regarding over-the-counter products, antacids that contain magnesium or aluminum will decrease absorption of rosuvastatin if both are taken at the same time. It is best to wait two hours after taking an antacid before taking it.
The prescription medications that have major interactions with rosuvastatin include:
- Warfarin (Coumadin). Warfarin is an anti-clotting medicine. Taking rosuvastatin can increase the risk of bleeding. The warfarin dose usually needs to be decreased if rosuvastatin is prescribed.
- Cyclosporine (Sandimmune). Cyclosporine suppresses the immune system and is used to prevent rejection in patients who have had organ transplantation, and in the treatment of diseases caused by an overactive immune system. Crestor should not be used (or used only in very low doses) in people taking cyclosporine because of the high risk of muscle damage.
- Niacin, gemfibrozil, and fenofibrate. These drugs also treat abnormal blood lipid levels. When combined with rosuvastatin or other statins, the risk of muscle pain and weakness increases.
- Protease inhibitors, especially drugs that contain ritonavir. Ritonavir is an ingredient in Paxlovid used to treat COVID-19 and in Kaletra used to treat HIV infection. Ritonavir can significantly increase the blood levels if taken with rosuvastatin and greatly increase the risk of muscle and kidney damage. People prescribed Paxlovid for five days need to immediately stop taking rosuvastatin. They should ask the doctor when they can restart rosuvastatin. With Kaletra, the health care provider may switch to a different statin or make sure the rosuvastatin dose does not exceed 10 milligrams per day.
Image: © Catherine Delahaye/Getty Images
About the Author
Howard E. LeWine, MD, Chief Medical Editor, Harvard Health Publishing; Editorial Advisory Board Member, Harvard Health Publishing
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