What is the most serious side effect of rosuvastatin
Pro Research Analysisby 
Searched over 200M research papers
Consensus Meter
The Most Serious Side Effect of Rosuvastatin
Introduction to Rosuvastatin Side Effects
Rosuvastatin, a potent statin used for lowering low-density lipoprotein cholesterol (LDL-C), is generally well-tolerated but can cause several adverse effects. These side effects range from mild to severe, impacting various organ systems. Understanding the most serious side effect is crucial for clinicians and patients to manage risks effectively.
Myopathy and Rhabdomyolysis: The Most Serious Side Effects
Myopathy is the most commonly reported adverse effect of statins, including rosuvastatin. This condition involves muscle pain, weakness, and elevated levels of creatine kinase (CK). While most cases are mild, severe myopathy can progress to rhabdomyolysis, a life-threatening condition characterized by extensive muscle breakdown, leading to acute kidney injury and severe hyperkalemia. In a reported case, a patient developed severe rhabdomyolysis within a month of starting rosuvastatin, necessitating temporary dialysis.
Renal Impairment and Failure
Although concerns have been raised about the potential renal side effects of rosuvastatin, extensive studies have shown that intensive LDL-C lowering with rosuvastatin does not significantly increase the risk of renal impairment or renal failure in patients without pre-existing advanced renal disease. The relative risk for serious renal adverse events was found to be minimal, indicating that while renal issues can occur, they are not the most serious side effect compared to myopathy and rhabdomyolysis.
Hepatotoxicity and Mitochondrial Dysfunction
High doses of rosuvastatin can also lead to hepatotoxicity, particularly affecting the mitochondria in liver cells. Studies in hypercholesterolemic mice have shown that high doses of rosuvastatin can cause significant morphological and functional alterations in hepatocyte mitochondria, potentially leading to liver damage. However, these effects are dose-dependent and less common at therapeutic doses used in humans.
Other Notable Adverse Effects
Other adverse effects of rosuvastatin include dizziness and pruritus, which are generally mild and resolve upon discontinuation of the drug. Rare but serious side effects such as ischemic colitis have also been reported, though these are extremely uncommon.
Conclusion
While rosuvastatin is effective in lowering LDL-C and generally well-tolerated, the most serious side effect is rhabdomyolysis, a severe form of myopathy that can lead to acute kidney injury and other life-threatening complications. Clinicians should monitor patients closely for signs of muscle pain and weakness, especially during the initial months of therapy, to mitigate this risk.
Sources and full results
Most relevant research papers on this topic