by Nicole Evans M.D.

Created on: April 03, 2010   Last Updated: April 05, 2010

Crestor is a prescription medication that is widely used for lowering cholesterol levels.  Crestor is the brand name for the medication Rosuvastatin.  This medication belongs to the class of drugs that are HMG-CoA reductase inhibitors and are commonly known as “statins”.

Crestor is an effective cholesterol lowering agent able to decrease elevated total cholesterol, LDL (low density lipoproteins), and TG (triglycerides).  Crestor is associated with many side effects, as well as specific contraindications for use in people with certain medical conditions.

The most common adverse effect of Crestor is muscle pain, technically called myalgia.  Muscle pain occurs in up to 13% of people who take this medication.  Joint pain, also called arthralgia, is also common with Crestor, occurring in 4% to 10% of individuals.  Muscle weakness occurs in about 3% of Crestor users.

Muscle pain and weakness are forms of myopathy.  The risk of myopathy is a special concern for the Asian population.  Some people of Asian descent appear to be at an increased risk of rosuvastatin-associated myopathy and may require dose adjustment.

Elderly patients are also predisposed to muscle pain and weakness due to changes in metabolism and organ function that are associated with old age.  Crestor, and all statins, should be used with caution in patients with advanced age.

Some people taking statins have developed a severe side effect, rhabdomyolysis, with acute renal failure and/or myopathy.  It is known that the risk of rhabdomyolysis is related to the dose of Crestor used.  The risk is also increased by the concurrent use of other cholesterol lowering medications.

There are conditions and medications that can predispose an individual to myopathy, requiring that Crestor or other statins be used with caution.  These include renal impairment, inadequately treated hypothyroidism, and medicines such as colchicine. 

Other side effects of Crestor that occur with significant frequency include headache, dizziness, nausea, abdominal pain and constipation.  These adverse events occur in 2% to 10% of people on Crestor.

All statins can cause an increase in liver enzymes.  In 2% of people on Crestor, the specific  liver enzyme ALT becomes elevated to levels greater than three times the upper limit of normal. Post-marketing data on the use of Crestor has also revealed that the enzymes alkaline phosphatase, AST, and GGT become increased in 2% of people.  Bilirubin also increases in a small percentage of patients.

Because Crestor can cause significant elevations of liver enzymes, this medication should be used with caution in individuals with impaired liver function and in individuals who are heavy alcohol users.

Patients should always report unexplained muscle pain, muscle tenderness, weakness, yellowing skin and/or eyes, and dark or tea-colored urine.  All individuals who are taking Crestor should request that their physician fully inform them of the risks of this medication. 

Source: Lexi-Comp Online. Accessed Apr 3, 2010.

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