Concerns About Common Cholesterol Rx Abound

Cholesterol medication rosuvastatin, or Crestor, tied to diabetes risk and other health concerns

(RxWiki News) Patients like to think medications will simply make them better, but often, side effect risks are involved. Some experts are expressing concerns that these risks are too great for a common cholesterol medication.

In a new article, a US doctor suggested that the benefits may not outweigh the risks for patients taking rosuvastatin (sold under the brand name Crestor).

"Last year, rosuvastatin (Crestor) was the most prescribed brand name drug in the US, with 22.3 million prescriptions filled and $5.8 [billion] in sales," explained article author Sidney Wolfe, MD, senior adviser to the Health Research Group at Public Citizen, a Washington DC-based consumer rights advocacy group.

Robert Phipps, RPh, owner of Fowlerville Pharmacy in Fowlerville, MI, told dailyRx News that, in most cases, rosuvastatin should be used as a last resort, after other medications and lifestyle changes to lower cholesterol.

Patients who are taking rosuvastatin should receive "follow up blood work and patient evaluation, especially in regards to liver enzymes, kidney function, and blood sugar" to see the health effects of the medication. This is important with any statin, Phipps said, but especially for those taking rosuvastatin.

Rosuvastatin works to lower high cholesterol, a fat-like substance that can build up and block blood flow through the arteries. High cholesterol is a risk factor for problems like heart disease and stroke.

Rosuvastatin, along with other statins in the same family, aim to slow the body's production of cholesterol, hopefully limiting the amount that can build up and cause heart troubles.

In this new article, Dr. Wolfe cited a number of studies in which the medication has been tied to health risks like diabetes.

One of the studies was the JUPITER trial — a large study that was the basis for rosuvastatin's initial approval. Dr. Wolfe noted that in this trial, patients in the rosuvastatin group had a 26 percent higher rate of new onset diabetes than those who received a placebo (fake pill).

The article also cited a review of 17 trials with over 100,000 patients in which those on rosuvastatin has a 25 percent higher risk of developing diabetes than those using other statins.

Also, Public Citizen opposed the US Food and Drug Administration's 2003 approval of the medication and asked that it be banned in 2004 due to concerns about ties to kidney problems and a muscle condition called rhabdomyolysis.

Despite these concerns, Dr. Wolfe did point out that rosuvastatin does lower cholesterol. Dr. Wolfe provided this as an answer to the question of why this medication is used despite questions about its safety.

"The short answer is that of statins still on the market, the milligram for milligram cholesterol lowering potency of rosuvastatin exceeds all others, a fact exploited in advertising campaigns," Dr. Wolfe wrote.

Dr. Wolfe warned that in 2016, the patent for rosuvastatin will expire, likely leading to cheaper, generic versions of the drug and an increase in prescriptions.

"But for the sake of the public's health, we must hope that the drug's disadvantages will lead to a sharp decline in its use before next year," Dr. Wolfe wrote.

Patients should discuss the risks and benefits of their medications with a doctor or pharmacist.

The article was published March 17 in The BMJ. Dr. Wolfe is also the founder of Public Citizen.

Review Date: 
March 15, 2015