Rosuvastatin oral tablet interactions: Alcohol, medications, and other factors

Rosuvastatin interactions with other drugs

Before you start treatment with rosuvastatin, tell your doctor and pharmacist about any prescription, over-the-counter, and other medications you take. By sharing this information with them, you may help prevent possible interactions.

To learn whether rosuvastatin interacts with supplements, herbs, or vitamins, see the “Rosuvastatin and other interactions” section.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Here’s a table of drugs that can interact with rosuvastatin. Keep in mind this table doesn’t include all drugs that may interact with rosuvastatin. Some of these interactions are described in detail in “Drug interactions in depth.”

When to avoid rosuvastatin  

In some cases, factors or conditions could prevent your doctor from prescribing rosuvastatin due to the risk of harm. These are known as contraindications. Below are the contraindications of rosuvastatin.

Note: Before you start treatment with rosuvastatin, it’s important to tell your doctor if these contraindications apply to you. They can determine whether to prescribe rosuvastatin.

Having certain types of liver disease

Doctors typically won’t prescribe rosuvastatin for people with certain types of liver disease, including acute liver failure and decompensated cirrhosis. This is because rosuvastatin may cause liver damage, which can worsen liver disease.

If you have liver disease, talk with your doctor before taking rosuvastatin. Depending on your specific liver condition, your doctor may prescribe a treatment other than rosuvastatin.

Having had an allergic reaction to rosuvastatin or any of its ingredients

If you have had an allergic reaction to rosuvastatin or any of its ingredients, your doctor will likely not prescribe rosuvastatin. Taking the drug could cause another allergic reaction. You can ask them about other treatments that may be better choices for you.

Rosuvastatin interaction with alcohol 

If you drink alcohol, your doctor may advise you to avoid or limit it during rosuvastatin treatment.

Consuming large amounts of alcohol can cause liver damage. Rosuvastatin may also cause liver damage as a side effect. This means that drinking alcohol during rosuvastatin treatment may increase the risk of liver problems.

Alcohol can also worsen the condition you’re receiving rosuvastatin to treat. For example, drinking too much alcohol can worsen high cholesterol or raise your risk of heart disease.

If you consume alcohol during rosuvastatin treatment, these side effects may be more likely to occur. If you have questions about drinking alcohol while taking rosuvastatin, talk with your doctor.

Drug interactions in depth 

Here’s a closer look at certain drug interactions of rosuvastatin.

Antacids

Rosuvastatin can interact with antacids, which are used to treat heartburn symptoms.

If taken at the same time, antacids can decrease how much rosuvastatin your body absorbs. This can make rosuvastatin less effective, so it may not work as well to lower your cholesterol or lower your risk of heart disease or certain heart procedures.

Here are some antacids that may interact with rosuvastatin:

• magnesium trisilicate (Gaviscon)
• magnesium hydroxide/calcium carbonate (Rolaids)
• aluminum hydroxide/magnesium hydroxide (Mylanta, others)

Antacids containing aluminum or magnesium are known to interfere with the absorption of rosuvastatin. It’s not clear whether other antacids also have this interaction. For example, it’s not known if calcium-only antacids, such as calcium carbonate (Tums), also affect rosuvastatin’s absorption. But to be safe, it’s best to take the precautions described below with taking any antacid if you’re prescribed rosuvastatin.

Steps you or your doctor may take

Although rosuvastatin and antacids can interact, you can minimize this interaction by taking rosuvastatin at least 2 hours after taking an antacid dose. Separating doses helps prevent antacids from affecting rosuvastatin’s absorption.

Talk with your doctor or pharmacist if you have additional questions about interactions between rosuvastatin and antacids.

Fibrates

Rosuvastatin has interactions with fibrates, which are a class of medications used to treat high triglycerides. Fibrates may also be used for treating certain types of dyslipidemia and to lower certain risks related to heart disease.

Used on their own, both rosuvastatin and fibrates can cause myopathy and rhabdomyolysis as a side effect. Taking these medications together further raises the risks of these side effects, which can be severe.

Here are some fibrate medications that may interact with rosuvastatin:

• fenofibrate (Antara, others)
• gemfibrozil (Lopid)

Steps you or your doctor may take

Using gemfibrozil and rosuvastatin together typically isn’t recommended. If you and your doctor decide this combination is the best treatment for you, your doctor will likely prescribe a lower rosuvastatin dosage to you. They’ll also monitor you closely for signs and symptoms of myopathy or rhabdomyolysis. This may involve ordering frequent lab tests to check for certain substances in your blood that may increase this risk.

The interaction between rosuvastatin and fenofibrate is moderate compared with gemfibrozil but still has risks. If your doctor prescribes fenofibrate and rosuvastatin to you, they may periodically order lab tests to check for certain substances in your blood that may increase this risk.

Immediately contact your doctor if you develop symptoms such as unexplained muscle pain, tenderness, or weakness while taking rosuvastatin with fenofibrate.

Certain antivirals

Rosuvastatin has interactions with certain antiviral medications, which are used to treat infections caused by viruses. Specifically, many antivirals for treating hepatitis C and antivirals for HIV have been reported to interact with rosuvastatin.

Here are some antiviral medications that may interact with rosuvastatin:

• sofosbuvir/velpatasvir/voxilaprevir (Vosevi)
• ledipasvir/sofosbuvir (Harvoni)
• glecaprevir/pibrentasvir (Mavyret)
• sofosbuvir/velpatasvir (Epclusa)
• lopinavir/ritonavir (Kaletra)

Steps you or your doctor may take

The severity of this interaction and what your doctor may do depends on the specific antiviral you’re taking.

For example, using rosuvastatin with ledipasvir/sofosbuvir (Harvoni) or sofosbuvir/velpatasvir/voxilaprevir (Vosevi) is not recommended. Instead, your doctor may prescribe a different medication besides rosuvastatin. Or, they may wait for you to finish treatment with Harvoni or Vosevi before prescribing rosuvastatin.

For interactions with other antivirals, your doctor will likely prescribe a lower rosuvastatin dosage to you. They may also want to periodically order lab tests to check for certain substances in your blood that may be early signs of myopathy or rhabdomyolysis.

Rosuvastatin and other interactions

Rosuvastatin may have other interactions, such as with supplements, foods, vaccines, or lab tests.

Here are some potential interactions with rosuvastatin. Keep in mind that the following information does not include all other possible rosuvastatin interactions.

Rosuvastatin interactions with supplements

Before you start treatment with rosuvastatin, tell your doctor and pharmacist about any supplements, herbs, and vitamins you take. By sharing this information with them, you may help prevent possible interactions.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Note: In addition to the interactions described below, rosuvastatin may interact with sodium bicarbonate used as a supplement. Sodium bicarbonate is also used as an antacid, and antacids containing magnesium and aluminum have been shown to interact with rosuvastatin.

It’s not clear whether sodium bicarbonate used as an antacid or as a supplement will also have this interaction. But to be safe, you can minimize this interaction by separating doses of rosuvastatin and sodium bicarbonate by at least 2 hours.

Rosuvastatin interactions with herbs

It’s possible for rosuvastatin to interact with an herb called red yeast rice. Some people take this herb to support healthy cholesterol levels. But red yeast rice works in a manner that’s very similar to statins such as rosuvastatin. If you take red yeast rice during rosuvastatin treatment, it may increase the risk of myopathy and rhabdomyolysis as a side effect of rosuvastatin.

If you take any red yeast rice supplements, talk with your doctor before starting rosuvastatin treatment. They’ll likely advise you to stop taking the supplements.

Rosuvastatin interactions with vitamins

There are no specific reports of vitamins interacting with rosuvastatin. However, that doesn’t mean vitamin interactions won’t occur or be recognized in the future. Because of this, you should talk with your doctor or pharmacist before taking any vitamin product with rosuvastatin.

Note that although rosuvastatin interacts with antacids that contain magnesium, interactions with the mineral magnesium found in supplements such as multivitamins haven’t been reported.

Rosuvastatin interactions with food

Although sodium bicarbonate (baking soda) antacids or supplements may interact with rosuvastatin, there were no reports of food interactions with the drug.

The amount of baking soda in food, such as baked goods, is usually small. The food is also often divided into multiple servings. The quantity of baking soda would be much less than in a sodium bicarbonate supplement.

If you have additional questions or want more information about eating certain foods during rosuvastatin treatment, talk with your doctor.

Rosuvastatin interactions with vaccines

There aren’t any known interactions between rosuvastatin and vaccines. Talk with your doctor or pharmacist to check whether you’re due for any vaccines.

Rosuvastatin interactions with lab tests

Rosuvastatin isn’t known to interact with lab tests. If you have concerns about this medication interacting with lab tests, talk with your doctor.

ROSUVASTATIN INTERACTION WITH CANNABIS OR CBD

Cannabis (often called marijuana) and cannabis products, such as cannabidiol (CBD), have not been specifically reported to interact with rosuvastatin. However, as with any drug or supplement, talk with your doctor before using cannabis in combination with rosuvastatin. The impact of cannabis may affect how well you stick to your rosuvastatin treatment plan.

Note: Cannabis is illegal at a federal level but is legal in many states to varying degrees.

Rosuvastatin and health-related interactions

Certain medical conditions and other factors may increase the risk of interactions with rosuvastatin. Before you take this drug, be sure to talk with your doctor about your health history. Rosuvastatin may not be the right treatment option if you have certain medical conditions or other factors affecting your health.

Health conditions or factors that might interact with rosuvastatin include:

• Asian descent: People of Asian descent may metabolize (break down) rosuvastatin differently. This can raise your risk of myopathy as a side effect if you take rosuvastatin. Due to this, your doctor may prescribe a lower rosuvastatin dosage if you are of Asian descent. Your doctor can provide more information on whether you should receive a lower rosuvastatin dosage based on your background.
• Kidney condition: Having a kidney condition, such as chronic kidney disease (CKD), may raise your risk of myopathy as a side effect if you take rosuvastatin. Due to this, your doctor may monitor you more closely for signs of myopathy, including ordering blood tests to check for certain substances in your blood. If you have severe kidney disease or receive kidney dialysis, your doctor will likely prescribe a lower rosuvastatin dosage to you.
• Liver condition: Your doctor may not prescribe rosuvastatin if you have certain liver conditions. To learn more, see “When to avoid rosuvastatin.” If you have a mild liver condition and your doctor prescribes rosuvastatin to you, they may prescribe a lower starting dosage. They’ll also likely order liver function tests (a type of blood test) before prescribing rosuvastatin and throughout your treatment.
• Hypothyroidism: Having hypothyroidism (underactive thyroid) that isn’t treated raises your risk of myopathy as a side effect if you take rosuvastatin. And rosuvastatin can affect your thyroid function as a side effect. Your doctor can determine whether rosuvastatin is safe for you to take based on your thyroid health. They may want to closely monitor your thyroid health using blood tests if they prescribe rosuvastatin. They’ll also want to make sure your hypothyroidism is being treated before prescribing rosuvastatin.
• Allergic reaction: If you’ve had an allergic reaction to rosuvastatin or any of its ingredients, your doctor will likely not prescribe rosuvastatin. Taking the drug could cause another allergic reaction. You can ask them about other treatments that may be a better option for you.
• Breastfeeding: Breastfeeding while taking rosuvastatin is not recommended. The drug passes into breast milk, and it’s not clear what effects, if any, rosuvastatin may have on a child who is breastfed. If you’re breastfeeding or planning to, talk with your doctor before using rosuvastatin. They can talk with you about treatment options and ways to feed a child other than breastfeeding.
• Pregnancy: Your doctor likely won’t prescribe rosuvastatin if you are pregnant. And they’ll likely have you stop taking it if you become pregnant during treatment. There haven’t been enough clinical trials to determine whether rosuvastatin is safe to use while pregnant. Based on how the drug works, it’s thought rosuvastatin and other statins could cause harm if used during pregnancy. Observational data over several decades have not proven there is a risk of using statins during pregnancy, but we also can’t say for certain that the drug is safe to take during pregnancy. If you’re planning to become pregnant, tell your doctor before starting rosuvastatin. They can advise you on the right treatment plan for you.

FAQ about rosuvastatin and interactions 

Here are some frequently asked questions about rosuvastatin and possible interactions.

What pain reliever can I take with rosuvastatin?

Common over-the-counter (OTC) pain relievers, such as ibuprofen (Advil, Motrin) or acetaminophen (Tylenol), are usually safe to take with rosuvastatin. There aren’t reported interactions between rosuvastatin and ibuprofen or other nonsteroidal anti-inflammatory drugs (NSAIDs), such as naproxen.

Rosuvastatin and acetaminophen also aren’t reported to interact. That said, both medications can cause liver damage as a side effect. This usually isn’t a concern when considering if rosuvastatin and acetaminophen can be taken together. But if you already have a liver condition, your doctor may suggest avoiding this combination or limiting the amount of acetaminophen you take.

That said, acetaminophen and NSAIDs such as ibuprofen have their own interactions. So you should still check with your doctor or pharmacist before using an OTC pain reliever.

Prescription pain relievers, including opioids and prescription NSAIDs, also aren’t known to interact with rosuvastatin. But like OTC pain relievers, prescription medications for pain have their own interactions that your doctor or pharmacist can check for before you begin treatment.

Talk with your doctor or pharmacist if you have additional questions about taking rosuvastatin with pain relievers.

Does rosuvastatin interact with grapefruit or grapefruit juice?

No, there aren’t reported interactions between rosuvastatin and grapefruit or grapefruit juice.

Many statins do interact with grapefruit and grapefruit juice, but rosuvastatin does not. So your doctor may prefer prescribing rosuvastatin over other statins if you enjoy grapefruit.

Ask your doctor or pharmacist if you have questions about rosuvastatin and the foods you consume.

Preventing interactions  

You can take certain steps to help prevent interactions with rosuvastatin. Your doctor and pharmacist are key resources, so reach out to them before starting treatment. For example, you should plan to do the following:

• Let them know if you drink alcohol or use cannabis.
• Tell them about any other medications you take, as well as any supplements, herbs, and vitamins.
• Create a medication list, which your doctor and pharmacist can help you fill out.

It’s also important to read the rosuvastatin label and other paperwork that may come with the drug. The label may have colored stickers that mention an interaction. The paperwork, sometimes called the medication guide or patient package insert, may contain details about interactions.

If rosuvastatin doesn’t come with paperwork, you can ask your pharmacist to print a copy. If you need help reading or understanding this information, ask your doctor or pharmacist.

You can also help prevent interactions with rosuvastatin by taking it exactly as your doctor prescribes.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.