Archive for the ‘Crestor’ Category

Crestor

Friday, September 7th, 2007

Crestor Cholesterol-lowering drug, also known as rosuvastatin, is a drug in a class of medications called HMG-CoA reductase inhibitors or more commonly referred to as statins. Crestor Cholesterol-lowering drug works to inhibit the production of an enzyme in the liver that causes cholesterol.

A factor that distinguishes Crestor Cholesterol-lowering drug (rosuvastatin) from the other five statins on the market is that Crestor’s potential to cause kidney toxicity is far greater. AstraZeneca halted clinical trials after reports of kidney damage and muscle weakness became known in patients taking 80 milligrams of Crestor per day. (Muscle weakness is an early symptom of rhabdomyolysis.) The FDA’s review noted that in contrast to currently approved statins, rosuvastatin (Crestor) was also associated with renal [kidney] findings not previously reported with other statins.However, according to AstraZeneca’s documentation of Crestor – it tells another story: Crestor Cholesterol-lowering drug is generally well tolerated. Adverse reactions have usually been mild and transient. In clinical trials of 10,275 patients, the most commonly reported treatment-related adverse events were myalgia, constipation, asthenia, abdominal pain, and nausea. Crestor Cholesterol-lowering drug is contraindicated in patients with active liver disease or unexplained persistent elevations of serum transaminases and in women who are pregnant or may become pregnant, and in nursing mothers.So long as Crestor is taken according the proper prescribing instructions, there is nothing wrong with the product, according to counsel for AstraZeneca. In a letter to this firm, they believe, and we agree, that patients should not be discouraged from following the advice of their physicians.

We agree with AstraZeneca’s attorney that patients should follow the “advice of their physicians that they use FDA-approved therapies.” Further, according to AstraZeneca’s attorney “[f]or persons taking Crestor on their physicians’ advice,” they should not “stop taking the drug without the knowledge of their physician” as this “may result in serious complications and injury.” We agree with AstraZeneca that it is important that the medical community maintain the “ability to convey accurate information to patients and to provide needed professional medical assistance.” Please consult your physician regarding any questions or concerns that you have regarding medications and medical treatment.

Crestor

Monday, March 5th, 2007

FDA Public Health Advisory for Crestor (rosuvastatin)

Astra-Zeneca Pharmaceuticals today released a revised package insert for Crestor (rosuvastatin) for use in the 22 member states of the European Union (EU). The changes to the European labeling are in response to postmarketing spontaneous adverse event reports in patients receiving Crestor and highlight certain patient populations who may be at an increased risk for serious muscle toxicity (myopathy) associated with Crestor use, especially at the highest approved dose of 40 mg. These risk factors and many of the recommendations for how to minimize the risk of myopathy are already captured in the FDA approved labeling for Crestor in the U.S. FDA is alerting physicians to the need to carefully read the Crestor product label and follow the recommendations for starting doses, dose adjustments, and maximum daily doses to minimize the risk of myopathy in individual patients.

Crestor, a member of a class of cholesterol-lowering drugs commonly referred to as “statins”, was approved in the U.S. in August 2003, based on review of an extensive clinical database involving approximately 12,000 patients. At that time, the FDA identified in the WARNINGS section of the product label those patients whose increased baseline risk for myopathy warranted more careful monitoring when prescribed Crestor. The U.S. approved labeling included a specific section titled, “Myopathy/Rhabdomyolysis”, which states that patients who are of advanced age (³ 65 years), have hypothyroidism, and/or renal insufficiency should be considered to have a greater risk for developing myopathy while receiving a statin. Physicians are warned to prescribe Crestor with caution in these patients, particularly at higher doses, as the risk of myopathy increases with higher drug levels.

In addition, the U.S. approved labeling for Crestor states that increased rosuvastatin drug levels were observed in certain sub-populations of patients (e.g., subgroups of Asians, patients concomitantly using cyclosporine and gemfibrozil), conferring increased risk of myopathy. Because of these findings, the FDA required Astra-Zeneca to make available in the U.S. a 5-mg dose that could be used in patients requiring less aggressive cholesterol-lowering or who were taking concurrent cyclosporine. The maximum recommended dose in the FDA-approved label is limited to 10 mg daily in patients with severe renal impairment or who are also taking gemfibrozil.

FDA has received reports of rhabdomyolysis in association with Crestor, as it has with other drugs in the statin class. In ongoing fashion, we are evaluating these reports of adverse muscle effects with regard to clinical severity and apparent relationship to the drug. FDA is comparing the frequency of reporting of muscle injury with Crestor to that with other statins, given differences in prescribing rates for the different drugs. Pending the evaluation of the recent Crestor safety experience, FDA is not proposing to change the US labeling for Crestor, but does want to re-emphasize to physicians to the importance of carefully following the recommendations in the current product label. Analysis of accumulating safety data in the U.S. and worldwide will be considered in any future labeling changes for Crestor, and to make recommendations on risk management plans for Crestor.

Healthcare professionals prescribing Crestor are reminded of the following key safety messages from the Crestor label: start doses and maintenance doses of drug should be based on individual cholesterol goals and apparent risks for side-effects; all patients should be informed that statins can cause muscle injury, which in rare, severe cases, can cause kidney damage and other organ failure that are potentially life-threatening; and patients should be told to promptly report to their physician signs or symptoms of muscle pain and weakness, malaise, fever, dark urine, nausea, or vomiting.