Rosuvastatin: Risks, Benefits, and Monitoring for Myalgias and Hepatic Toxicity in Lipid Control Therapy

Rosuvastatin is one of the most widely used potent statins in the treatment of dyslipidemia, aimed at reducing cardiovascular risk. Its efficacy in lowering LDL cholesterol levels and its ability to improve the lipid profile have been extensively documented. However, as with any pharmacological treatment, it is crucial to consider both the benefits and the risks associated with its use, as well as the need for adequate monitoring of adverse reactions.

Diving Deeper into the Use of Rosuvastatin

Rosuvastatin has proven effective not only in reducing LDL cholesterol levels but also in decreasing major cardiovascular events in high-risk patients, even in those with normal LDL levels but elevated high-sensitivity C-reactive protein (hsCRP) levels [1]. However, its use is not without side effects. Among the most common are myalgias, which, although generally mild, can lead to treatment discontinuation in some patients [2].

Additionally, there is concern regarding hepatic toxicity associated with statin use. While asymptomatic elevations in liver transaminases are common, a direct correlation with significant liver damage has not been demonstrated [3]. Regular monitoring of liver enzymes is important, especially in patients with a history of liver disease.

Another aspect to consider is the risk of new-onset diabetes associated with statin use, including rosuvastatin. Although the risk is low, it is more pronounced in patients with pre-existing risk factors for diabetes [4]. Despite these risks, the cardiovascular benefits of rosuvastatin generally outweigh the potential adverse effects.

Conclusions

Rosuvastatin remains a valuable option in lipid control and the prevention of cardiovascular diseases. Its safety profile is comparable to that of other potent statins, and the benefits in reducing cardiovascular risk are significant. Nevertheless, it is essential for physicians to carefully monitor patients, watching for possible adverse reactions such as myalgias and hepatic toxicity. The decision to initiate treatment should be based on a careful assessment of individual risks and benefits, ensuring that patients are adequately informed and monitored.

Referencias

• [1] Rosuvastatin: a review of its use in the prevention of cardiovascular disease in apparently healthy women or men with normal LDL-C levels and elevated hsCRP levels.
• [2] Effect of statin therapy on muscle symptoms: an individual participant data meta-analysis of large-scale, randomised, double-blind trials.
• [3] Safety of statins.
• [4] Statin-associated incident diabetes: a literature review.

Created 6/1/2025