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Rosuvastatin in CKD — GPhC CRA MCQ

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HardRenal Dose AdjustmentRosuvastatin in CKDGPhC CRA

A 70-year-old man with CKD stage 4 (eGFR 20 mL/min/1.73m2) presents with a new prescription for rosuvastatin 20 mg daily. The pharmacist notes that his previous statin was atorvastatin 20 mg. What is the most appropriate action?

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Correct answer: A — Contact the prescriber as rosuvastatin at doses above 5 mg requires caution in patients with an eGFR below 30 mL/min/1.73m2

The BNF advises that rosuvastatin doses above 5 mg should be avoided in patients with severe renal impairment (eGFR below 30 mL/min/1.73m2) due to increased systemic exposure and the risk of adverse effects including myopathy. The prescriber should be contacted to discuss a dose reduction or return to atorvastatin, which does not require dose adjustment in renal impairment.

Reference: BNF; Rosuvastatin SmPC