Starez Drug Interactions

Concurrent use of fibrates may cause severe myositis and myoglobinuria.
Gemfibrozil, fibrate and niacin: Gemfibrozil increases the risk of myopathy when given concomitantly with some HMG-CoA reductase inhibitors. Therefore, the combination of rosuvastatin and gemfibrozil is not recommended. The benefit of further alteration in lipid levels by the combined use of rosuvastatin with fibrates or niacin should be carefully weighed against the potential risks of such combinations.
Certain protease inhibitors: Rosuvastatin is a substrate of various transporter proteins (e.g. OATP1B1 and BCRP). The risk of myopathy (including rhabdomyolysis) is increased when rosuvastatin is administered concomitantly with certain medicinal products that may increase the plasma concentration of rosuvastatin due to interactions with these transporter proteins (e.g. certain protease inhibitors including combinations of ritonavir with atazanavir, lopinavir, and/or tipanavir). Whenever possible, alternative medications should be considered, and if necessary, consider temporarily discontinuing Starez 10 therapy. In situations where co-administration of these medicinal products with rosuvastatin is unavoidable, the benefit and the risk of concurent treatment and rosuvastatin dosing adjustments should be carefully considered.
Coumarin Anticoagulants: In patients taking coumarin anticoagulants with Rosuvastatin concomitantly, INR should be determined before starting Rosuvastatin and frequently enough during early therapy to ensure that no significant alteration of INR occurs.
Niacin: The risk of skeletal muscle effects may be enhanced when Rosuvastatin is used in combination with niacin, a reduction in Rosuvastatin dosage should be considered in this setting.