The drug "Rosuvastatin" is known since 2003 and is offered as a fourth-generation statin. It is a modern and high-quality inhibitor of gamma-methylglutaryl-CoA reductase. 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 clinical efficacy and in the rate of decrease in total and low-density cholesterol, Rosuvastatin is second only to Pitavastatin, which is not yet widely used due to the less accumulated base of clinical trials.
To date, Atorvastatin is used more often than other statins due to the fact that it has the most comprehensive research base of evidence of its clinical effectiveness. 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 applied more widely. This is a really high-quality drug, for which its price should be paid.
Place "Rosuvastatin" in pharmacotherapy
The drug "Rosuvastatin" application, despite the presence of class analogues, is quite wide. It is determined by indications and limited to contraindications. Almost all types of hypercholesterolemia and fat metabolism disorders 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 decreases, and life expectancy (and its quality) increases slightly.
The drug "Rosuvastatin" 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 and stabilization of the endothelium over the plaque. Since heart and brain infarctions develop due to acute adrenal artery thrombosis, this clinical effect does prevent acute coronary events.
Instructions for use
The instructions for use attached to the Rosuvastatin preparation (there are no analogues of such documentation) contain a narrow range of indications for use. However, it does not contain information for the patient that cholesterol fractions must be determined before use. In the future, their change will allow us to evaluate the clinical effectiveness of treatment in a specific dosage. Also, the instruction contains information about precautions and treatment features, about contraindications and the most frequent and important side effects.
Indications for use
Among all diseases associated with an increase in plasma lipid fractions, some clinical indications are highlighted:
- 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, occlusive artery lumen;
- atherosclerosis of the arteries of the lower extremities, including Lerish syndrome;
- hypertriglyceridemia (type IV according to Fredrickson);
- treatment of myocardial infarction and brain, starting from the acute period;
- prevention of myocardial infarction and stroke.
Contraindications
Any cheap analogue of Rosuvastatin has the same amount of side effects as the original Crestor. Based on them, a spectrum of contraindications is formed, which are as follows:
- liver diseases with hepatocyte cytolysis syndrome and a more than three-fold increase in transaminase concentration;
- liver failure, cirrhosis of the liver with 9 points on the Child-Pugh scale;
- chronic renal failure with creatinine clearance below 30 ml / min .;
- myopathy of any origin;
- allergic reactions to the components of the dosage form or to "Rosuvastatin".
There is a group of additional contraindications for a dosage of 40 mg:
- chronic renal failure with creatinine clearance not lower than 60 ml / min .;
- any hereditary myopathies;
- concomitant use with fibrates;
- alcoholism;
- Mongoloid race;
- using statin for the first time.
Features of the drug
All "Rosuvastatins" are drugs whose analogues are widely available on the market. And, choosing a specific trade name, the patient should take this medicine further. 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 previously worked with statins of the first generations. They contain information that statins should be taken before bedtime. 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 "Rosuvastatin" (analogues) is taken. Experts' feedback allows us to develop the optimal observation tactics. 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 evaluated.
If normalization of the lipid profile of blood plasma is observed, it is required to continue taking it at the same dose. If total cholesterol remains high, and the amount of low-density cholesterol decreases slightly, a dose increase is required. If transaminases increase three times, statin withdrawal is required. It is especially worth noting that the least tendency to cause cytolysis of all statins is "Rosuvastatin." Analogs (Ukraine is also gradually moving from Atorvastatin to Rosuvastatin) are less safe in class. And the least studied is Pitavastatin.
Analogues of "Rosuvastatin"
As analogues of "Rosuvastatin" ("Crestor") today more than 10 drugs are offered. Among them are “Akorta”, “Mertenil”, “Rosart”, “Rosistark”, “Rosuvastatin Canon”, “Rosuvastatin SOTEX”, “Rosuvastatin SZ”, “Rosulip”, “Rosucard”, “Roxer”, “Rustor”, “ Tevastor. " The cost of their treatment is different, as is the effectiveness. At a price these drugs can be divided into three categories:
- low prices (from 250 to 650 rubles): Rosuvastatin SZ, Rosuvastatin Canon, Akorta, Rosuvastatin SOTEKS;
- average prices (from 400 to 900 rubles): Mertenil, Rosart, Roxer, Rosucard, Tevastor, Rosulip;
- high prices (from 1100 to 2200 rubles): Krestor.
The price analysis was carried out based on a comparison of the cost of drugs, the weight 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 Rosuvastatin is manufactured by Severnaya Zvezda. Rosuvastatin Canon and Akorta also vary slightly in price. Their value least of all varies depending on fluctuations in exchange rates.
General overview of cheap generic "Crestor"
The drug "Rosuvastatin", released by Astrazeneca, is called "Crestor." This is an original medicine with which everyone else should be compared. The same applies to reviews: the characteristic of a particular generic should be based on its comparison with the "Crestor". But due to its relatively high cost, many patients immediately begin treatment for hypercholesterolemia with cheaper generics.
Objective information in reviews can only be provided by specialists who often encounter the use of both generic Rosuvastatin 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.
Reviews of specialists about the "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 addresses the bioequivalence of generics to the Crestor drug. According to the results of pharmacoeconomic studies, it was found that the preparations Mertenil, Rosart, Roxer, Rosucard and Rosulip are bioequivalent to Crestor.
This means that any of the specified analogue of "Rosuvastatin" has a therapeutic effect similar to the original drug, has the same number and severity of side effects. So far, the medicines Rosuvastatin SZ, Rosuvastatin Canon, Rosuvastatin SOTEX and Akorta are not involved in such tests. Since these statistical studies are not funded by pharmacological companies, the information obtained is objective and consistent with the clinical features of the treatment of hypercholesterolemia. However, the results are only for foreign generics.
Reviews of specialists about cheap generic "Rosuvastatin"
The modern cheap analogue of Rosuvastatin should prove its bioequivalence to Krestor, after which it automatically gains 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 analogs of Rosuvastatin (the drugs are indicated above), the frequency of side effects is comparable to that observed with the use of generic drugs that are bioequivalent to Crestor.
Fluctuations in the plasma concentration of "Rosuvastatin" resulting from the use of a solid dosage form with a different composition, in this case are considered insignificant. Therefore, the cheap Russian analogue of Rosuvastatin can really replace the original drug Krestor and its generics for the treatment of hypercholesterolemia.
Characteristics of Patient Reviews
According to the reviews of patients who share their impressions about the use of drugs with the attending physician, several logical conclusions can be made. First, patients' judgments about the quality of the drug are biased. Secondly, due to the clinical effect invisible 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 profile.