Statins can effectively lower blood lipids, regulate the vascular endothelial environment, anti-inflammatory, anti-oxidant and stabilize blood clots, and are the basic drugs for cardiovascular and cerebrovascular diseases. At present, 7 drugs have been put into use, and three generations are in the same house, of which there are 3 third-generation drugs, namely atorvastatin, rosuvastatin, and pitavastatin, which are used more frequently in clinical practice.
Statins can reduce scorbability and increase blood lipids, be a good "vascular garbage cleaner", and internally carry out a "skill competition" with each other, there are 4 main indicators, all of which are rosuvastatin winners, namely:
1. In terms of advanced research and development, rosuvastatin was the first to develop a 5mg specification. The significance is that the starting dose of statins is 20mg, which is suitable for the white physique, but it is not friendly to the yellow race, so under the premise of not affecting the efficacy, rosuvastatin takes the lead in "reducing the dose and slimming", and the adapted population has increased significantly.
2. In terms of drug tolerance, rosuvastatin is relatively longer. The significance is that statins are chemical drugs, and they have their own suitable populations, as well as intolerant patients, and when intolerance occurs, bad cholesterol lowers slowly, and cardiovascular and cerebrovascular accidents rise much more. From the perspective of long-term clinical monitoring, rosuvastatin is better tolerated by the patient population.
3. In terms of drug safety, rosuvastatin is more outstanding. The significance is that the structure of statins is water-soluble, fat-soluble, and water-lipid bisoluble, and only water-soluble causes the least side effects. Rosuvastatin is one of these categories, and it interacts less with other drugs, avoiding many of the adverse consequences.
4. In terms of lipid-lowering effectiveness, rosuvastatin has more advantages. The significance is that the main task of statins is to lower lipids and regulate lipids, and the specification of rosuvastatin 20mg can strongly reduce bad cholesterol by more than 50%, especially for patients with cerebral infarction, angina, coronary heart disease, and cardiac stents, doctors usually recommend rosuvastatin.
These 4 main indicators, rosuvastatin wins, but also adds 4 "halos" to the drug, which is more widely used.
However, medication is risky, and the more drugs are used, the more they should be paid attention to. Rosuvastatin has its own side effects that are also cause for concern.
Clinical results show that rosuvastatin side effects are concentrated in 4 ways:
1. There is a risk of liver injury. Most of the human blood lipids are synthesized in the liver, which determines that the main place of work of statins is in the liver. At the same time, it will also affect liver function, which is an inherent feature of statins, that is, all statins have varying degrees of damage to the liver, and the main indicator is increased aminotransferases.
Rosuvastatin is a "hydrophilic" statin, which is theoretically more friendly to liver function, and clinically it is indeed more conducive to the use of people with poor liver function, but there is still a risk of liver damage, especially some domestic patients have bad drug Xi, and there are problems such as indiscriminate use, mixed use, and multi-use.
Therefore, if the resuvastatin is taken to regularly review the liver function, it is clinically recommended to be carried out after one month, and if the aminotransferase is higher than 3 times the normal value, it should be stopped, and the cause should be identified. Patients with pre-existing liver disease should follow the doctor's instructions to use it, and do not mix hepatoprotective drugs at will in order to protect the liver.
2. There is a risk of kidney injury. Statins are excreted by the kidneys and can also interfere with kidney function. Because rosuvastatin contains sulfonamide genes in its chemical structure, it may increase proteinuria, and to cause concern, long-term medication must check kidney function.
Compared with lipophilic statins, rosuvastatin, a hydrophilic statin, is more likely to enter the kidneys, and it is clinically clear that rosuvastatin cannot be used if renal insufficiency and the glomerular filtration rate is less than 30.
3. There is a risk of elevated blood sugar. Rosuvastatin will affect the work of glycosylated hemoglobin when lowering lipids and regulating the endothelial environment, resulting in blood sugar fluctuations, and since 2012, domestic and foreign drug regulatory departments have issued relevant reminders.
Rosuvastatin may cause new diabetes, so should it be taken or not? If you find that your blood sugar is abnormally elevated, you should go to the hospital in time and let the doctor decide whether to stop the drug. If rosuvastatin is used in diabetic patients, it is also up to the doctor to weigh the effects of the two.
4. There is a risk of muscle damage. Statins interfere with creatine phosphokinase, allowing calcium ions to "slip away", causing muscle pain and inflammation, and in some cases of rhabdomyolysis.
Rosuvastatin should be monitored for muscle enzymes during use, and if there is general fatigue and muscle pain for a certain period of time, it is necessary to see a doctor promptly.
In addition, rosuvastatin has 6 contraindications that need to be paid attention to and avoided.
One is the unique contraindication of statins, which cannot be eaten with grapefruit and citrus, and avoid foods such as red yeast rice and oats that cause increased drug concentrations.
The second is patients who are allergic to rosuvastatin components, which are common in hypersensitivity reactions.
Third, rosuvastatin is contraindicated when the liver disease is in the onset period and is not controlled, that is, when the liver disease is active.
Fourth, it is forbidden for pregnant and lactating women, because it may have an impact on the fetus or baby.
Fifth, patients with severe renal insufficiency and continuously elevated muscle enzymes cannot be used.
Sixth, it should not be used in combination with cyclosporine drugs, which will cause drug interactions.
In short, if you take rosuvastatin for a long time, you should focus on the side effects, avoid extraneous branches, and at the same time keep in mind the types of contraindications, and do not use them indiscriminately or mixed.