The drug "Rosuvastatin" has been known since 2003 and is offered as a IV generation statin. It is a modern and high-quality gamma-methylglutaryl-CoA reductase inhibitor. This enzyme is responsible for the synthesis of cholesterol in the human body. Its inhibition leads to a decrease in endogenous cholesterol and a decrease in the risk of developing heart disease.
In addition to Rosuvastatin, there are several more class analogues that are part of the statin group. These are Simvastatin, Pravastatin, Cerivastatin, Lovastatin, Fluvastatin, Atorvastatin, Pitavastatin. In terms of clinical efficacy and the rate of reduction of total and low-density cholesterol, Rosuvastatin is second only to Pitavastatin, which is not yet widely used due to a less accumulated clinical research base.
To dateAtorvastatin is used more than other statins due to the fact that it has the most comprehensive research evidence base for its clinical efficacy. He and his generics are also much cheaper than Rosuvastatin. But since the effect of the latter (normalization of the lipid profile of blood plasma) occurs faster, then it begins to be used more widely. This is really a quality drug that you should pay for its price.
Place of Rosuvastatin in pharmacotherapy
The use of Rosuvastatin, despite the presence of class analogues, is quite wide. It is determined by indications and limited by contraindications. Almost all types of hypercholesterolemia and disorders of fat metabolism are present in the indications. At the same time, a decrease in atherogenic lipid fractions has a positive effect on the body. Because of this, the likelihood of developing atherosclerotic lesions is reduced, and life expectancy (and its quality) is somewhat increased.
Rozuvastatin can be used both for the prevention of cardiovascular diseases and for their treatment. The last niche of pharmacotherapy exists due to the inhibition of atherosclerosis processes and stabilization of the endothelium over the plaque. Since cerebral and cardiac infarcts develop due to acute thrombosis of the adductor arteries, this clinical effect really helps to prevent acute coronary events.
Instructions for use
Instructions attached to the drug "Rozuvastatin"for use (there are no analogues of such documentation) contains a narrow range of indications for use. However, it does not contain information for the patient that it is required to determine the cholesterol fraction before use. In the future, their change will allow us to evaluate the clinical effectiveness of treatment at a certain dosage. The instructions also contain information about precautions and treatment features, contraindications and the most common and important side effects.
Indications for use
Among all diseases associated with an increase in plasma lipid fractions, some clinical indications have been identified:
- hereditary heterozygous (familial) hypercholesterolemia;
- Fredrickson-classified polygenic hypercholesterolemia type IIa;
- combined dyslipidemia classified by Fredrickson as IIb;
- homozygous hereditary (familial) hypercholesterolemia;
- coronary, cerebral or renal atherosclerosis occluding the lumen of the artery;
- atherosclerosis of the arteries of the lower extremities, including Leriche's syndrome;
- hypertriglyceridemia (Fredrickson type IV);
- treatment of myocardial and cerebral infarction, starting from the acute period;
- prevention of myocardial infarction and stroke.
Contraindications
Any cheap analogue of Rosuvastatin has the same number of side effects as the original Crestor. Based on them, a spectrum is formedcontraindications that look like this:
- liver disease with hepatocyte cytolysis syndrome and more than threefold increase in transaminase concentration;
- liver failure, cirrhosis with a Child-Pugh score of 9;
- chronic renal failure with creatinine clearance below 30 ml/min;
- myopathy of any origin;
- allergic reactions to components of the dosage form or to Rosuvastatin.
There is a group of additional contraindications for the 40mg dosage:
- chronic renal failure with a creatinine clearance of at least 60 ml/min.;
- any hereditary myopathies;
- simultaneous reception with fibrates;
- alcoholism;
- mongoloid race;
- using a statin for the first time.
Features of taking the drug
All "Rozuvastatins" are drugs, analogues of which are widely presented on the market. And, choosing a certain trade name, the patient must continue to take this medicine. That is, changing the medicine to another is unreasonable. The drug itself is taken regardless of food and at any time of the day. There are slightly different recommendations from specialists who have previously worked with first-generation statins. They contain information that statins should be taken before bed. Although this is not of fundamental importance, the main thing is that the medicine is taken at about the same time and constantly.
You need to constantly monitor your own condition while taking Rosuvastatin (analogues). Feedback from experts allows you to develop the optimal tactics of observation. In particular, after establishing the presence of hypercholesterolemia, you need to start taking the drug in a fixed dose. After 2 months, control is carried out - the lipid profile is repeated and the activity of aminotransferases is assessed.
If there is a normalization of the lipid profile of the blood plasma, it is required to continue taking it at the same dose. If total cholesterol remains high and low-density cholesterol decreases slightly, an increase in dose is required. If transaminases increase three times, the abolition of statins is required. It should be especially noted that Rosuvastatin has the least tendency to cause cytolysis of all statins. Analogues (Ukraine is also gradually moving from Atorvastatin to Rozuvastatin) are less safe in terms of class. And Pitavastatin remains the least studied.
Analogues of "Rozuvastatin"
As analogues of "Rozuvastatin" ("Crestor"), more than 10 drugs are already offered today. Among them are "Akorta", "Mertenil", "Rozart", "Rozistark", "Rozuvastatin Canon", "Rozuvastatin SOTEKS", "Rozuvastatin SZ", "Rozulip", "Rozucard", "Roxera", "Rustor", " Tevastor". The cost of their treatment is different, as well as the effectiveness. According to the price, these drugs can be divided intothree categories:
- low prices (from 250 to 650 rubles): Rosuvastatin SZ, Rosuvastatin Canon, Akorta, Rosuvastatin SOTEX;
- average prices (from 400 to 900 rubles): "Mertenil", "Rozart", "Roxera", "Rozucard", "Tevastor", "Rozulip";
- high prices (from 1100 to 2200 rubles): Crestor.
Analysis of prices was carried out on the basis of a comparison of the cost of drugs, the mass of the active substance in which was 10 mg. The price range reflects the cost of a monthly course of hypocholesterolemic therapy. The cheapest analogue of "Rozuvastatin" is produced by the company "Northern Star". Rosuvastatin Canon and Akorta also differ slightly in price. Their value fluctuates the least with currency fluctuations.
Overview of cheap Crestor generics
The Rosuvastatin drug produced by Astrazeneca is called Crestor. It is the original medicine against which all others must be compared. The same applies to reviews: the characteristics of a certain generic should be based on its comparison with Crestor. But due to its relatively high cost, many patients immediately start treatment for hypercholesterolemia with cheaper generics.
Objective information in reviews can only be provided by specialists who often encounterthe use of both Rosuvastatin generics and the original Crestor. And the instructions for use attached to the Rosuvastatin preparation, patient reviews and clinical experience will allow other patients to decide on the choice of a specific trade name.
Expert reviews of Crestor and generics
Comparison of "Crestor" was carried out only by specialists of the All-Russian Society of Cardiology. This information is often published in the journal Rational Pharmacotherapy in Cardiology. In particular, it touches upon the issues of bioequivalence of generics to Crestor. Based on the results of pharmacoeconomic studies, it was found that the drugs "Mertenil", "Rozart", "Roxera", "Rozucard" and "Rozulip" are bioequivalent to "Crestor".
This means that any indicated Rosuvastatin analogue has a therapeutic effect similar to the original drug, has the same number and severity of side effects. So far, the drugs "Rozuvastatin SZ", "Rozuvastatin Canon", "Rozuvastatin SOTEKS" and "Akorta" are not involved in such tests. Since these statistical studies are not funded by pharmacological companies, the information obtained is objective and corresponds to the clinical features of the treatment of hypercholesterolemia. However, the results are only for foreign generics.
Specialist reviews of cheapgenerics "Rosuvastatin"
Modern cheap analogue of Rosuvastatin must prove its bioequivalence to Crestor, after which it automatically receives the respect of professionals. Without bioequivalence studies, specialists can only note the clinical features of the application. One of them is this: with the constant use of cheap analogues of Rosuvastatin (drugs listed above), the frequency of side effects is comparable to that observed with the use of generics bioequivalent to Crestor.
Fluctuations in the plasma concentration of "Rosuvastatin", arising from the use of a solid dosage form with a different composition, are considered insignificant in this case. Therefore, the cheap Russian analogue of "Rozuvastatin" can really replace the original drug "Crestor" and its generics for the treatment of hypercholesterolemia.
Characterization of patient reviews
According to the feedback of patients who share their impressions about the use of drugs with their doctor, several logical conclusions can be distinguished. First, patients' judgments about the quality of the drug are biased. Secondly, due to the clinical effect imperceptible to the patient, adherence to therapy is low, although treatment is necessary to prevent the risks of acute coronary events. Thirdly, patients tend to exaggerate the importance of side effects and underestimate the dynamics of plasma lipid profiles.
