rosuvastatin
4 interactions related to rosuvastatin
rosuvastatin + coq10
Rosuvastatin blocks HMG-CoA reductase, an enzyme required for both cholesterol and coenzyme Q10 synthesis. Although the CoQ10 depletion is generally smaller than with lipophilic statins, mitochondrial impairment is still one proposed mechanism for statin-associated muscle symptoms.
rosuvastatin + berberine
Rosuvastatin is taken into liver cells by the OATP1B1 transporter, and berberine has been shown to upregulate OATP1B1 in hepatocyte studies, increasing hepatic uptake of rosuvastatin. The clinical net effect (more LDL lowering vs. higher muscle/liver risk) is not well established in humans.
pomegranate + statins
Pomegranate juice inhibits intestinal CYP3A4, the main enzyme that metabolizes simvastatin, atorvastatin, and lovastatin. A published case report links pomegranate juice consumption to rhabdomyolysis in a patient stable on rosuvastatin, and the same enzyme inhibition can raise the systemic exposure and muscle toxicity risk of CYP3A4-metabolized statins.
alcohol + statins
Statins and alcohol are both metabolized by the liver and can independently raise transaminases; combined heavy use increases the risk of hepatotoxicity and, in some cases, myopathy or rhabdomyolysis. Atorvastatin plasma levels rise sharply in patients with alcoholic liver disease.