Crestor and Simeprevir

In the database of official manuals used in the service creation an interaction registered by statistical results of studies was found, which can either lead to negative consequences for the patient health or strengthen a mutual positive effect. A doctor should be consulted to address the issue of joint drug administration.

Talk to your doctor before using rosuvastatin together with simeprevir. Combining these medications may significantly increase the blood levels of rosuvastatin. This can increase the risk of side effects such as liver damage and a rare but serious condition called rhabdomyolysis that involves the breakdown of skeletal muscle tissue. In some cases, rhabdomyolysis can cause kidney damage and even death. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring to safely use both medications. Let your doctor know immediately if you have unexplained muscle pain, tenderness, or weakness during treatment with rosuvastatin or similar medications, especially if these symptoms are accompanied by fever or dark colored urine. You should also seek immediate medical attention if you develop fever, chills, joint pain or swelling, unusual bleeding or bruising, skin rash, itching, loss of appetite, fatigue, nausea, vomiting, dark colored urine, and/or yellowing of the skin or eyes, as these may be signs and symptoms of liver damage. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

ADJUST DOSE: Coadministration with simeprevir may significantly increase the plasma concentrations of rosuvastatin. The proposed mechanism is simeprevir inhibition of the hepatic uptake of rosuvastatin via organic anion transporting polypeptide 1B1 (OATP1B1). In 16 healthy study subjects, administration of a single 10 mg dose of rosuvastatin in combination with simeprevir 150 mg once daily for 7 days increased mean rosuvastatin peak plasma concentration (Cmax) by approximately 3.2-fold and systemic exposure (AUC) by 2.8-fold compared to rosuvastatin administered alone. High levels of HMG-CoA reductase inhibitory activity in plasma is associated with an increased risk of musculoskeletal toxicity. Myopathy manifested as muscle pain and/or weakness associated with grossly elevated creatine kinase exceeding ten times the upper limit of normal has been reported occasionally. Rhabdomyolysis has also occurred rarely, which may be accompanied by acute renal failure secondary to myoglobinuria and may result in death.

MANAGEMENT: Rosuvastatin therapy should be initiated at a dosage of 5 mg once daily, and not exceed a dosage of 10 mg daily, when prescribed with simeprevir. Alternatively, fluvastatin may be substituted, as it has been shown to have no significant interaction with simeprevir. All patients receiving statin therapy should be advised to promptly report any unexplained muscle pain, tenderness or weakness, particularly if accompanied by fever, malaise and/or dark colored urine. Therapy should be discontinued if creatine kinase is markedly elevated in the absence of strenuous exercise or if myopathy is otherwise suspected or diagnosed.

Crestor

Generic Name: rosuvastatin

Brand name: Crestor, Ezallor Sprinkle

Synonyms: n.a.

What is Crestor?

Simeprevir

Generic Name: simeprevir

Brand name: Olysio

Synonyms: n.a.

What is Simeprevir?