Rosuvastatin is a substrate for certain transporter proteins including the hepatic uptake transporter organic anion-transporting polyprotein 1B1 (OATP1B1) and efflux transporter breast cancer resistance protein (BCRP). Concomitant administration of rosuvastatin with medical products that are inhibitors of these transporter proteins may result in increased rosuvastatin plasma concentrations and an increased risk of myopathy (see table as follows). (See table.)
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The simultaneous dosing of rosuvastatin with an antacid suspension containing aluminum and magnesium hydroxide resulted in a decrease in rosuvastatin plasma concentration of approximately 50%. This effect was mitigated when rosuvastatin is administered at least 2 hours after the antacid.
Coadministration of rosuvastatin and warfarin may result in a rise in INR compared to warfarin alone. Initiate INR monitoring prior to taking rosuvastatin, cessation and dosage adjustment of rosuvastatin therapy.