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Alternate Day Rosuvastatin Therapy

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Alternate Day Rosuvastatin Therapy

Alternate day rosuvastatin therapy may be an option for patients who are intolerant to daily statin dosing. This type of rosuvastatin therapy may reduce the risk of statin-associated side effects like myalgia and hepatotoxicity while providing comparable lipid lowering effectiveness as newer statins.

Studies have confirmed the effectiveness of alternate day dosing of rosuvastatin for lipid lowering effects, side effects and patient compliance. When comparing daily and alternate day rosuvastatin dosages, researchers were able to discern a difference in terms of efficacy, side effects and patient compliance with each method.

In a study of 506 patients with coronary artery disease, an alternate day rosuvastatin regimen proved similar to daily treatment in terms of its lipid-lowering effectiveness and side effect profile. However, the incidence of hepatotoxicity was significantly lower (7% vs 15%) for this dosing group.

Another study assessed the lipid-reducing effectiveness of an alternate day rosuvastatin dose in patients with prior statin intolerance. Randomly assigned patients received either the EOD rosuvastatin regimen or a control group that received the same daily atorvastatin dosage for six weeks.

For patients who were able to tolerate an alternate day rosuvastatin dose regimen, LDL-C decreased by 34.5% versus 16.1% when on a daily dose; thus, about 50% of patients achieved their LDL-C goals. Triglyceride levels also declined, dropping 27.7% versus 10.3% in the daily rosuvastatin dose group and HDL cholesterol dropped 13.4% versus 14.9% with the alternate day rosuvastatin dosage group.

Although alternate day dosing of statins was less effective than daily dosing, it remains an option for patients who are intolerant to daily doses. Furthermore, this regimen offers a cost-saving advantage over more potent daily regimens while still producing similar lipid reducing efficacy.

Patients with a history of statin intolerance often do not experience adverse events or reduced LDL-C reduction when switching to alternate day rosuvastatin, possibly because it is metabolized more slowly than daily statins.

A randomized, multicenter, double-blind study assessed the lipid lowering efficacy and tolerance of an alternate day rosuvastatin dosing regimen in 51 patients who had previously experienced statin intolerance. In this experiment, 51 patients who were intolerant to daily statin regimen were randomly assigned to take either alternate day rosuvastatin or an alternate day control group that received 10 mg atorvastatin daily for six weeks. Fasting bloodwork on either the alternate day that rosuvastatin was taken was assessed through fasting bloodwork on that alternate day of administration of rosuvastatin.

Rosuvastatin alternate day dosing was well tolerated by the majority of patients, reducing the incidence of adverse events and improving adherence to the regimen. The most frequent adverse events reported were myalgias and increased transaminase levels. Furthermore, LDL-C, triglyceride, and total cholesterol levels were significantly lower on this alternate regimen than on daily dosing; moreover, more patients who could tolerated it achieved their new target of LDL-C below 2.0 mmol/L.

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