Cholestor Drug Interactions

Antacids: Potential pharmacokinetic interaction (decreased plasma rosuvastatin concentrations with concomitant aluminum-magnesium hydroxide antacid). Administer antacids 2 hours after rosuvastatin.
Bile Acid Sequestrants: Potential pharmacodynamic interaction (enhanced effect on total and LDL-cholesterol) with concomitant bile acid sequestrant.
Cyclosporine: Potential pharmacokinetic interaction (clinically important increases in peak plasma rosuvastatin concentration and AUC with concomitant cyclosporine); limit dosage of rosuvastatin to 5 mg daily with such concomitant therapy.
Digoxin: Pharmacokinetic interaction unlikely (no change in plasma digoxin concentrations with concomitant rosuvastatin).
Drugs Affecting Hepatic Microsomal Enzymes: Pharmacokinetic interaction unlikely (rosuvastatin clearance not dependent on metabolism by cytochrome P-450 isoenzyme 3A4). Interactions (e.g., increases or decreases in AUC of rosuvastatin) between rosuvastatin and ketoconazole, erythromycin, itraconazole, or fluconazole not deemed clinically important.
Fenofibrate: Pharmacokinetic interaction unlikely (no changes in rosuvastatin or fenofibrate plasma concentrations with concomitant administration).
Gemfibrozil: Increased risk of adverse musculoskeletal effects (i.e., increased CK, myoglobinuria, rhabdomyolysis) with concomitant use. Avoid concomitant use unless potential benefit outweighs risk.
Oral Contraceptives: Potential pharmacokinetic interaction (increased plasma concentrations of ethinyl estradiol and norgestrel) with concomitant rosuvastatin.
Warfarin: Potential pharmacodynamic interaction (clinically important increase in international normalized ratio [INR]) when rosuvastatin (40 mg) given concomitantly with warfarin (25 mg); plasma warfarin concentrations unchanged. Determine INR prior to initiating rosuvastatin and following any change in dosage and then frequently enough thereafter until stable INR is documented, then at usually recommended intervals.