Stravas Special Precautions

Renal Effects: Proteinuria (dipstick) was observed in patients treated at high doses, especially 40mg. Proteinuria was mostly derived from renal tubules and in most cases was transient or intermittent. Proteinuria is not considered as a precursor of acute or progressive nephropathy.
Skeletal Muscle Effects: Effects on skeletal muscle have been reported in patients receiving a variety of doses of Rosuvastatin, such as myalgia, myopathy, and rare rhabdomyolysis, especially at doses greater than 20 mg.
Creatine kinase testing: Creatine kinase testing should not be done after strenuous exercise or when there is a plausible cause of an increase in creatine kinase (CK), which could confuse interpretation of the results. If the basal value of creatine kinase was significantly increased (<5×ULN), should be tested within 5-7 days for confirmation. If repeated tests confirm the patient's basal creatine kinase value >5×ULN, treatment should not be initiated.
Liver effects: As with other HMG-CoA reductase inhibitors, Rosuvastatin should be used with caution in heavy alcohol consumption and/or with a history of liver disease. Liver function testing is recommended before and 3 months after initiation of treatment. If the increase of serum transaminase is more than 3 times the upper limit of normal value, Rosuvastatin should be discontinued or the dose should be reduced. In cases of hypercholesterolemia secondary to hypothyroidism or nephrotic syndrome, the primary disease should be treated before starting to treat with Rosuvastatin.
Lactose intolerance: Patients with rare hereditary galactose intolerance, lactase deficiency, or malabsorption of glucose-galactose should not take Rosuvastatin.
Interstitial pulmonary disease: Rare cases of interstitial pulmonary disease have been reported in some statin therapy, especially in those on long-term treatment. Symptoms include difficulty breathing, dry cough without phlegm, and general decline in health (fatigue, weight loss, and fever). Statin therapy should be discontinued in patients with suspected interstitial pulmonary disease.
Diabetes: According to some reports, use of HMG-CoA reductase inhibitors (including Rosuvastatin) and Glycated haemoglobin A1C, HbA1c) was associated with elevated fasting serum glucose levels. Patients at risk (FBG: 5.6 ~ 6.9 mmol/L, BMI >30 kg/m², elevated triglycerides, hypertension) should be monitored clinically and biochemically in accordance with relevant guidelines.