Surotin Drug Interactions

Rosuvastatin is minimally (approximately 10%) metabolized by cytochrome P-450 (CYP), isoenzyme 2C9. Clearance of Rosuvastatin is not dependent on metabolism by CYP3A4 to a clinically important extent.
Antacid: Administration of Rosuvastatin and an antacid containing aluminum hydroxide and magnesium hydroxide decreased Rosuvastatin peak plasma concentration by 50%, such effect was considered clinically important. Therefore, if Rosuvastatin and an aluminum hydroxide and magnesium hydroxide are used concomitantly, the antacid should be administered at least 2 hours after Rosuvastatin.
Cyclosporine: Concomitant use of Rosuvastatin and cyclosporine may increase the risk of myopathy. Following concomitant use of Rosuvastatin and cyclosporine, Rosuvastatin peak plasma concentration was clinically significantly increased. If used concomitantly with cyclosporin, dosage of Rosuvastatin should be limited to 5 mg once daily.
HIV Protease Inhibitors: Concomitant use of Rosuvastatin with certain ritonavir-boosted HIV protease inhibitors (e.g., atazanavir, fosamprenavir, lopinavir) would increase peak plasma concentration of Rosuvastatin. Caution and dose adjustment are advised if Rosuvastatin is used concomitantly with ritonavir-boosted HIV protease inhibitors.
Fibric acid derivative: Fenofibrate: Concomitant use of Rosuvastatin and fenofibrate may increase the risk of myopathy. Following concomitant use of Rosuvastatin and fenofibrate, Rosuvastatin peak plasma concentration was increased; such effect was not considered clinically important. However, caution is advised if Rosuvastatin is used concomitantly with fenofibrate.
Gemfibrozil: Concomitant use of Rosuvastatin and gemfibrozil may increase the risk of myopathy. Following concomitant use of Rosuvastatin and gemfibrozil, Rosuvastatin peak plasma concentration was increased by approximate 2 fold, such effect considered clinically important. Concomitant use should be avoided, if used concomitantly with gemfibrozil; dosage of Rosuvastatin should not exceed 10 mg once daily.
Oral contraceptive: Concomitant use of Rosuvastatin and oral contraceptive (ethinyl estradiol, norgestrel) resulted of increase ethinyl estradiol, norgestrel peak plasma concentration.
Warfarin: Concomitant use of Rosuvastatin and coumarin derivative anticoagulants e.g., Warfarin has been shown to substantially increase international normalised ratio (INR). If Rosuvastatin is used concomitantly with coumarin derivative anticoagulants, INR should be stable prior to initiating Rosuvastatin and should be monitored frequently enough during early therapy to ensure that no substantial alteration in INR occurs.
Other drugs: Niacin: Concomitant use of Rosuvastatin and niacin may increase the risk of myopathy. Caution is advised if Rosuvastatin is used concomitantly with antilipemic dosage of niacin.
Erythromycin: Concomitant use of Rosuvastatin and erythromycin decreased plasma concentrations of Rosuvastatin.
Azole antifungal: Concomitant use of Rosuvastatin and azole antifungal (i.e., fluconazole, itraconazole) increase plasma concentrations of Rosuvastatin but concomitant use Rosuvastatin and ketoconazole may decreased plasma concentrations of Rosuvastatin.
Digoxin: Concomitant use of Rosuvastatin and digoxin increase plasma concentrations of digoxin by 4%.