A number of trials have demonstrated efficacy with alternate-day statin dosing,[11,12,13,14,15] including rosuvastatin; however, the study populations included patients without previous intolerance to statins. dIncludes 0-1 risk factors.  The doses of rosuvastatin used in our study were 2.5, 5, or 10 mg EOD (mean 5.6 mg). Please confirm that you would like to log out of Medscape. Possible explanations include the positive psychological effect of EOD treatment or lower plasma and muscle concentrations. Please enter a Recipient Address and/or check the Send me a copy checkbox. Dosing a statin (rosuvastatin) every other day (EOD) may provide significant lipoprotein changes while avoiding common adverse effects in this statin-intolerant population. In hypercholesterolemia patients, atorvastatin 10 mg every other day is safe and effective in lowering TC, TG, with LDL-c and a slight increase in HDL-c. View. James M Backes, PharmD; Carmelo V Venero, MD; Cheryl A Gibson, PhD; Janelle F Ruisinger, PharmD; Patricia A Howard, PharmD FCCP BCPS; Paul D Thompson, MD; Patrick M Moriarty, MD. You will receive email when new content is published. One method that practitioners use to help mitigate or lessen the side effects of Lipitor is to dose it every other day. Dosing a statin (rosuvastatin) every other day (EOD) may provide significant lipoprotein changes while avoiding common adverse effects in this statin-intolerant population. This dosing strategy may be useful in patients intolerant to once-daily statin dosing, although such an approach has not been documented to reduce cardiovascular events.  Atorvastatin also has a long half-life (~14 h) and has demonstrated effectiveness with EOD dosing. HDL-C = high-density lipoprotein cholesterol; LDL-C = low-density lipoprotein cholesterol; TC = total cholesterol; TG = triglycerides.  These factors produce the common clinical challenge of achieving an aggressive LDL-C goal in a high-risk patient intolerant to statin therapy. Please see our, 2001http://www.medscape.com/features/year-in-medicine/public/2014. Fifty-one patients were eligible for the analysis, which evaluated changes in the lipid profile, the number achieving their low-density lipoprotein cholesterol (LDL-C) goals, and the percent tolerating rosuvastatin EOD. dIncludes ≥2 risk factors, 10-y CHD risk 10-20%. an = 37. bAverage time to follow-up 4.1 ± 2.9 months. Click the topic below to receive emails when new articles are available.  reported that 43% of patients with previous statin-associated myopathy tolerated a different statin without a recurrence of symptoms. You've successfully added to your alerts. In another study involving the randomizing of participants into three groups, one taking 10 mg of atorvastatin (Lipitor) every other day, one taking 10 mg every day and the last taking 20 mg every other day over a period of six weeks, it was found that the reduction of LDL-C was lowest in patients taking 20 mg every other day, but this was complicated by the fact that those patients receiving 10 mg … cIncludes ≥2 risk factors, 10-y CHD risk <10%. eIncludes ≥2 risk factors, 10-y CHD risk <10%. 2008;42(3):341-346.  Also, lovastatin, simvastatin, and atorvastatin are largely metabolized by CYP3A4, which is responsible for the conversion of many lipid-soluble agents to their hydrophilic forms for clearance and is a primary isoenzyme involved in many common drug interactions.  Rosuvastatin, in contrast, is primarily cleared renally and is minimally metabolized (<10%) by the less common CYP2C9 isoenzyme, and thus is potentially less likely to be implicated in common drug interactions. All material on this website is protected by copyright, Copyright © 1994-2020 by WebMD LLC. Suggest treatment for side effects caused by Crestor . 2008;42(3):341-346. eIncludes ≥2 risk factors, 10-y CHD risk <10%. Objective: To determine the … 2008;42(3):341-346. © 2008 Harvey Whitney Books Company. fIncludes 0-1 risk factors. The following are 10 points to remember about alternate-day dosing with statins: 1. dIncludes ≥2 risk factors, 10-y CHD risk 10-20%. dIncludes 0-1 risk factors. To comment please, Comments on Medscape are moderated and should be professional in tone and on topic. aIncludes CHD or CHD risk equivalent, 10-y risk >20%. You've successfully added to your alerts.  Lastly, we reported mean LDL-C reductions of 29% and tolerance in 80% of subjects (n = 10) previously intolerant to statin therapy when given rosuvastatin (mean dose 10 mg) once weekly.. hIncludes plant stanol/sterols, policosanol, flaxseed oil.  The study reported here examined the effect and tolerance of EOD rosuvastatin therapy in a considerably larger cohort. I realize the pain could also have lessened just because I hadn't done a lot of stairs since then, too.
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