Roswin Drug Interactions

Ciclosporin: Significantly increased rosuvastatin exposure. Rosuvastatin dose should be limited to 5 mg once a day if rosuvastatin is coadministered with ciclosporin.
Gemfibrozil: Significantly increased rosuvastatin exposure; thus, combination therapy with rosuvastatin and gemfibrozil should be avoided. If used, do not exceed rosuvastatin 10 mg once a day.
Protease Inhibitors: Protease inhibitor combinations lopinavir/ritonavir and atazanavir/ritonavir increase rosuvastatin AUC up to 3-fold. For these combinations, rosuvastatin dose should be limited to 10 mg once a day.
Coumarin Anticoagulants: Rosuvastatin significantly increased International Normalized Ratio (INR) in patients receiving coumarin anticoagulants. In patients taking coumarin anticoagulants and rosuvastatin concomitantly, determine INR before starting rosuvastatin and after any change in dosage and then regularly thereafter until no significant alteration of INR occurs.
Niacin (≥1 g/day): Increased risk of skeletal muscle effects. Exercise caution when prescribing with rosuvastatin.
Fenofibrate: No clinically significant increase in the AUC of rosuvastatin or fenofibrate was observed. Exercise caution when prescribing fenofibrates with rosuvastatin due to the increased risk of myopathy during treatment with HMG-CoA reductase inhibitors with concomitant use of fenofibrates.
Antacid (Aluminum and Magnesium hydroxide): Decreased rosuvastatin plasma concentrations of about 50%. However, this effect was mitigated when the antacid was given 2 hours after rosuvastatin.
Erythromycin: Decreased rosuvastatin's AUC_0-24 and C_max by 20% and 30%, respectively. This is due to the increase in gut motility caused by erythromycin.
Oral Contraceptives/Hormone Replacement Therapy (HRT): Increased plasma concentrations of ethinyl estradiol and norgestrel by 26% and 34%, respectively. These increased plasma levels should be considered when selecting oral contraceptive doses.
Cytochrome P450 Enzymes: Results from in vitro and in vivo studies show that rosuvastatin is neither an inhibitor nor an inducer of cytochrome P450 isoenzymes. In addition, rosuvastatin is a poor substrate for these isoenzymes. No clinically relevant interactions have been observed between rosuvastatin, and either fluconazole or ketoconazole. Coadministration of itraconazole and rosuvastatin increased rosuvastatin AUC by 28%, however, this is not clinically significant.
Other Medications: There were no clinically significant interactions with antihypertensive agents, antidiabetic agents, digoxin and ezetimibe.