Crestor
Crestor: instructions for use and reviews
- 1. Release form and composition
- 2. Pharmacological properties
- 3. Indications for use
- 4. Contraindications
- 5. Method of application and dosage
- 6. Side effects
- 7. Overdose
- 8. Special instructions
- 9. Application during pregnancy and lactation
- 10. Use in childhood
- 11. In case of impaired renal function
- 12. For violations of liver function
- 13. Use in the elderly
- 14. Drug interactions
- 15. Analogs
- 16. Terms and conditions of storage
- 17. Terms of dispensing from pharmacies
- 18. Reviews
- 19. Price in pharmacies
Latin name: Crestor
ATX code: C10AA07
Active ingredient: rosuvastatin (rosuvastatin)
Producer: IPR Pharmaceuticals Inc. (Puerto Rico)
Description and photo update: 2019-19-08
Prices in pharmacies: from 1100 rubles.
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Crestor is a drug with hypolipidemic action.
Release form and composition
Krestor is produced in the form of tablets: biconvex; 5 mg each: round, yellow, with an engraved inscription "ZD4522 5" on one side; 10 mg each: round, pink, with an engraved inscription "ZD4522 10" on one side; 20 mg each: round, pink, with an engraved inscription "ZD4522 20" on one side; 40 mg each: oval, pink, with an engraved inscription "ZD4522" on one side, on the other - "40" (7 or 14 pcs. in blisters, 1, 2 or 4 blisters in a cardboard box).
The composition of 1 tablet includes:
- Active ingredient: rosuvastatin - 5, 10, 20 or 40 mg (in the form of rosuvastatin calcium);
- Auxiliary components (for tablets of 5/10/20/40 mg, respectively): lactose monohydrate - 93.08 / 89.5 / 179 / 164.72 mg, microcrystalline cellulose - 31.02 / 29.82 / 59.64 / 54.92 mg, calcium phosphate - 11.32 / 10.9 / 21.8 / 20 mg, crospovidone - 7.5 / 7.5 / 15/15 mg, magnesium stearate - 1.88 / 1.88 / 3, 76 / 3.76 mg.
The composition of the film shell: lactose monohydrate - 1.8 / 1.8 / 3.6 / 3.6 mg, hypromellose - 1.26 / 1.26 / 2.52 / 2.52 mg, glycerol triacetate (triacetin) - 0.036 / 0.36 / 0.72 / 0.72 mg, titanium dioxide - 0.9 / 1.06 / 2.11 / 2.11 mg, dye iron oxide yellow - 0.18 mg (for tablets of 5 mg), dye iron oxide red (for tablets of 10/20/40 mg) - 0.02 / 0.05 / 0.05 mg.
Pharmacological properties
Pharmacodynamics
The active ingredient of Crestor, rosuvastatin, is a lipid-lowering agent, a selective competitive inhibitor of HMG-CoA reductase.
The drug reduces elevated concentrations of total cholesterol (HC), low-density lipoprotein cholesterol (LDL-C) and triglycerides (TG), and also increases the concentration of high-density lipoprotein cholesterol (HDL-C). Crestor also increases the concentration of apolipoprotein AI (ApoA-I), reduces the concentration of triglycerides of very low density lipoproteins (TG-VLDL), very low density lipoprotein cholesterol (VLDL-C), cholesterol not associated with high-density lipoproteins (HDL-free cholesterol), and apolipoprotein B (ApoB). It also reduces the ratio of cholesterol to HDL-C, LDL-C to HDL-C, non-HDL cholesterol to HDL-C, ApoB to ApoA-1. Changes in these parameters in primary hypercholesterolemia (type IIa and IIb according to Fredrickson) and hypertriglyceridemia (type IIb and IV according to Fredrickson) has a dose-dependent effect.
The lipid-lowering effect develops within one week after the start of taking Crestor. After 2 weeks, approximately 90% of the greatest possible effect is achieved. The maximum therapeutic effect is usually observed by the 4th week of treatment and remains with regular administration of the drug.
Crestor is effective in adult patients with hypercholesterolemia, including those accompanied by hypertriglyceridemia, regardless of age, gender and race, including patients with concomitant diabetes mellitus and familial hypercholesterolemia.
In 80% of patients with hypercholesterolemia of types IIa and IIb according to Fredrickson (with an average initial concentration of LDL-C of ~ 4.8 mmol / L) when taking Crestor in a daily dose of 10 mg, the level of LDL-C reaches values less than 3 mmol / L.
In studies of patients with heterozygous familial hypercholesterolemia (with the participation of 435 people), a positive dynamics of lipid profile parameters is observed when Crestor is taken in the dose range from 20 to 80 mg. After titration to a daily dose of 40 mg (therapy for 12 weeks), the concentration of LDL-C decreases by 53%. The level of cholesterol-LDL up to values less than 3 mmol / l is achieved in 33% of patients.
In patients with homozygous familial hypercholesterolemia, receiving the drug in doses of 20 and 40 mg, the decrease in the concentration of LDL-C on average is 22%.
With hypertriglyceridemia in patients with an initial TG concentration in the range of 273-817 mg / dL, taking rosuvastatin in the dose range of 5-40 mg 1 time per day for 6 weeks, there was a significant decrease in the TG concentration in the blood plasma.
With the additional appointment of fenofibrate, an additive effect is noted in relation to the concentration of TG, with the combined administration of nicotinic acid in lipid-lowering doses - in relation to the level of HDL-C.
The METEOR studies involved 984 patients aged 45 to 70 years with an average LDL-C concentration of 4.0 mmol / L (154.5 mg / dL), a low risk of developing coronary heart disease (10-year risk according to the Framingham scale was less than 10%) and subclinical atherosclerosis (assessed by the thickness of the intima-media complex of the carotid arteries - TCIM). The aim of the study was to study the effect of rosuvastatin on TCIM. Patients received rosuvastatin in a daily dose of 40 mg or placebo for two years. In the rosuvastatin group, there was a slowdown in the rate of progression of the maximum IMT for 12 carotid artery segments compared with placebo with a difference of -0.0145 mm / year [95% CI ranged from -0.0196 to -0.0093; p <0.001]. A direct relationship between a decrease in IMT and a decrease in the risk of cardiovascular complications has not yet been demonstrated. The METEOR study was conducted in patients with a low risk of coronary heart disease for whom a 40 mg Crestor dose is not recommended. At a dose of 40 mg, Crestor should be prescribed to patients with severe hypercholesterolemia and a high risk of cardiovascular complications.
The JUPITER studies (Justification of statin use for primary prevention: an interventional study evaluating rosuvastatin) enrolled 17 802 patients. According to the results, it was found that rosuvastatin significantly reduced the risk of cardiovascular complications [142 compared with 252 in the placebo group (p <0.001)], reducing the relative risk was 44%. The effectiveness of the treatment was assessed after 6 months of regular administration of the drug. There was also a statistically significant decrease in the combined criterion, which included stroke, heart attack and death from cardiovascular causes, by 48% (hazard ratio - 0.52; 95% confidence interval - 0.4–0.68; p <0.001), occurrence of non-fatal or fatal myocardial infarction - by 54% (risk ratio - 0.46; 95% confidence interval - 0.3-0.7),nonfatal or fatal stroke - by 48%, overall mortality - by 20% (risk ratio - 0.8; 95% confidence interval - 0.67-0.97; p = 0.02). The safety profile of rosuvastatin 20 mg is generally similar to that of placebo.
Pharmacokinetics
After oral administration, the maximum plasma concentration of rosuvastatin reaches approximately within 5 hours. Its absolute bioavailability is about 20%.
The drug is metabolized mainly by the liver, an organ that is the main site for cholesterol synthesis and low density lipoprotein cholesterol metabolism. The volume of distribution is ~ 134 liters. Communication with plasma proteins (mainly albumin) ~ 90%.
About 10% of rosuvastatin undergoes limited metabolism. In its metabolism, the CYP2C9 isoenzyme is most involved, to a lesser extent - the CYP3A4, CYP2C19, CYP2D6 isoenzymes.
The main identified metabolites of the drug are N-desmethylrosuvastatin and lactone metabolites. The first is about half less active than rosuvastatin, the rest are pharmacologically inactive. At least 90% of the pharmacological activity in relation to the inhibition of circulating HMG-CoA reductase is accounted for by rosuvastatin, the rest is its metabolites.
About 90% of the taken dose of rosuvastatin (including the absorbed and unabsorbed substance) is excreted unchanged through the intestines, the rest - by the kidneys.
Half-life (T ½) ~ 19 hours. Its duration does not change if the dose is increased.
Geometric mean plasma clearance ~ 50 l / h (coefficient of variation 21.7%). In the process of hepatic uptake of rosuvastatin, a membrane cholesterol transporter is involved, which plays an important role in hepatic elimination of the drug.
The systemic exposure of rosuvastatin increases in proportion to the dose. With daily intake, pharmacokinetic parameters do not change.
Pharmacokinetics in special clinical situations:
- age and gender: no clinically significant changes in the pharmacokinetics of rosuvastatin were observed;
- race: Asian patients (Koreans, Chinese, Japanese, Vietnamese, Filipinos) showed an approximately twofold increase in the area under the concentration-time curve (AUC) and the maximum concentration of rosuvastatin; in Indian patients, these indicators were increased by 1.3 times compared to Europeans. There were no significant differences in the pharmacokinetics of the drug between Caucasian and Negroid patients;
- genetic polymorphism: rosuvastatin binds to transport proteins OATP1B1 and BCRP. Carriers of the SLCO1B1 (OATP1B1) c.521CC and ABCG2 (BCRP) c.421AA genes showed an increase in AUC by 1.6 and 2.4 times, respectively, compared with carriers of the SLCO1B1 c.521TT and ABCG2 c.421СС genotypes;
- liver failure: in liver failure with a score of ≤ 7 on the Child-Pugh scale, an increase in T ½ was not detected. Two patients with scores of 8 and 9 on the Child-Pugh scale had at least a twofold increase in T ½. Patients with scores> 9 on the Child-Pugh scale have no experience with rosuvastatin;
- renal failure: with mild to moderate renal failure, the plasma levels of rosuvastatin and its main metabolite did not change significantly. In patients with severe renal impairment (creatinine clearance <30 ml / min), the plasma concentration of rosuvastatin increased 3 times, N-desmethylrosuvastatin - 9 times compared with healthy volunteers. In hemodialysis patients, the plasma level of rosuvastatin is about 50% higher than in healthy subjects.
Indications for use
- Primary hypercholesterolemia (increased serum cholesterol) according to Fredrickson (type IIa, including familial heterozygous hypercholesterolemia) or mixed hypercholesterolemia (type IIb) - as adjunctive therapy to diet in cases where diet and other non-drug treatments (eg, exercise, reduction body weight) are insufficient;
- Familial homozygous hypercholesterolemia - as an adjunct therapy to diet and other lipid-lowering therapy (eg, LDL apheresis) or when such treatment is insufficient;
- Hypertriglyceridemia (according to Fredrickson - type IV) - as an addition to the diet;
- Atherosclerosis (to slow the progression) - as an addition to the diet in patients with indications for therapy to lower the concentration of total cholesterol (cholesterol) and LDL cholesterol (low density lipoprotein cholesterol);
- The main cardiovascular complications, including arterial revascularization, heart attack, stroke (primary prevention) in adult patients without clinical symptoms of ischemic heart disease, but with a high risk of its development (for men age - from 50 years, for women - from 60 years, increased concentration of C-reactive protein (≥2 mg / L) in the presence of at least one of the additional risk factors: arterial hypertension, low concentration of HDL-C, smoking, family history of early onset of coronary heart disease).
Contraindications
- Liver diseases occurring in the active phase, including a persistent increase in serum transaminase activity and any increase in serum transaminase activity (more than 3 times in comparison with the upper limit of the norm);
- Simultaneous reception with cyclosporine;
- Lactase deficiency, lactose intolerance or glucose-galactose malabsorption (lactose is part of the Crestor);
- Age under 18;
- Pregnancy, period of breastfeeding (lactation), lack of adequate methods of contraception in women;
- Hypersensitivity to Crestor components.
Additional contraindications for a daily dose of 5, 10 or 20 mg are:
- Pronounced functional impairment of the kidneys (creatinine clearance less than 30 ml per minute);
- Myopathy;
- Predisposition to the occurrence of myotoxic complications.
Contraindications for a daily dose of 40 mg are (optional):
- Excessive alcohol consumption;
- Presence of risk factors for rhabdomyolysis / myopathy, namely: moderate renal failure (creatinine clearance less than 60 ml per minute), hypothyroidism, family or personal history of muscle diseases, myotoxicity with the use of fibrates or other inhibitors of HMG-CoA reductase in history;
- Conditions in which the plasma concentration of rosuvastatin may increase;
- Simultaneous reception with fibrates;
- Belonging to the Mongoloid race.
In the presence of the conditions / diseases described above, Crestor in a daily dose of 5, 10 and 20 mg should be taken with caution (under medical supervision).
According to the instructions, Crestor in all dosages should be taken with caution in the presence of the following conditions / diseases:
- Uncontrolled seizures;
- History of liver disease;
- Arterial hypotension;
- Sepsis;
- Endocrine, metabolic or electrolyte disturbances that are severe;
- Injuries, major surgical interventions;
- Age from 65 years.
Crestor in a daily dose of 40 mg with a mild degree of renal failure (creatinine clearance greater than 60 ml per minute) should be taken with caution.
There is no experience of using Crestor in patients with hepatic insufficiency and with more than 9 points on the Child-Pugh scale.
Instructions for the use of Crestor: method and dosage
Crestor is taken orally, regardless of food intake and at any time of the day. The tablets must be swallowed whole (without crushing or chewing) with water.
Before starting the course of treatment, you must follow the standard cholesterol-lowering diet (it should be continued throughout therapy).
The doctor selects the dose of Crestor individually, it is determined by the goals of the treatment and the therapeutic response to treatment, taking into account the current recommendations for the target lipid concentration.
The recommended initial daily dose for patients starting to take Crestor, or for patients transferred from taking other HMG-CoA reductase inhibitors, should be 5 or 10 mg, the frequency of administration is 1 time per day. When choosing an initial dose, one should be guided by the individual concentration of cholesterol and take into account the possible risk of developing cardiovascular complications and side effects. If necessary, the dose may be increased after 4 weeks.
Due to the high risk of side effects, an increase in the dose to 40 mg (after taking an additional dose higher than the recommended initial dose for 4 weeks of treatment) can only be performed in patients with severe hypercholesterolemia and a high risk of developing cardiovascular complications (especially in patients with familial hypercholesterolemia), in which the desired result was not achieved when taking a dose of 20 mg, and who will be under medical supervision. Particularly careful monitoring is recommended for patients receiving Crestor at a dose of 40 mg.
The appointment of a daily dose of 40 mg is not recommended for patients who have not previously consulted a doctor. After 14-28 days of treatment and / or with an increase in the dose of Crestor, it is necessary to monitor the parameters of lipid metabolism (if necessary, a dose adjustment may be required).
In patients with severe renal failure (with creatinine clearance less than 30 ml per minute), the use of Crestor is contraindicated. No dose adjustment is required in patients with mild or moderate renal impairment. The use of Crestor at a dose of 40 mg is contraindicated in patients with moderate renal impairment (with creatinine clearance of 30-60 ml per minute). Patients with moderate functional impairment of the kidneys are recommended to take the drug in an initial dose of 5 mg.
Crestor is contraindicated for patients with liver diseases occurring in the active phase.
Elderly patients do not need dose adjustment.
When prescribing doses of 10 and 20 mg, the recommended initial dose for patients of the Mongoloid race, as well as for patients with a predisposition to myopathy, should not exceed 5 mg (the use of Crestor at a dose of 40 mg is contraindicated).
Side effects
Side effects arising from the use of Crestor, as a rule, are mild and transient. As with the use of other inhibitors of HMG-CoA reductase, the frequency of their development is mainly dose-dependent (> 1/100, 1/1000, 1/10000, <1/1000 - rarely; <1/10000, including individual cases - rarely):
- Central nervous system: often - dizziness, headache;
- Immune system: rarely - hypersensitivity reactions, including the development of angioedema;
- Urinary system: proteinuria (changes in the amount of protein in the urine are observed in less than 1% of patients receiving 10-20 mg of Crestor, and about 3% of patients receiving 40 mg). As a rule, proteinuria diminishes or disappears during therapy, and the occurrence of acute or progression of existing kidney disease does not mean;
- Endocrine system: often - type 2 diabetes mellitus;
- Digestive tract: often - nausea, constipation, abdominal pain; rarely - pancreatitis;
- Musculoskeletal system: myalgia, myopathy, including myositis (when using Crestor in all dosages and, especially, when taking doses greater than 20 mg); in rare cases, rhabdomyolysis with or without acute renal failure; in a small number of patients - a dose-dependent increase in the activity of creatine phosphokinase (insignificant, asymptomatic and temporary; with an increase of more than 5 times compared with the higher limit of the norm, therapy is interrupted);
- Liver: in a small number of patients - a dose-dependent increase in the activity of hepatic transaminases (insignificant, asymptomatic and temporary);
- Skin: infrequently - rash, pruritus, urticaria;
- Laboratory indicators: an increase in the concentration of bilirubin, glucose, the activity of gamma-glutamyltransferase, alkaline phosphatase, symptoms of thyroid dysfunction;
- Others: often - asthenic syndrome.
During post-marketing studies, there were reports of the development of the following side effects:
- Central nervous system: very rarely - memory loss, polyneuropathy;
- Respiratory system: unspecified frequency - shortness of breath, cough;
- Digestive tract: very rarely - jaundice, hepatitis; rarely - an increase in the activity of hepatic transaminases; with unspecified frequency - diarrhea;
- Urinary system: very rarely - hematuria;
- Reproductive system and mammary glands: unspecified frequency - gynecomastia;
- Skin and subcutaneous fat: with unspecified frequency - Stevens-Johnson syndrome;
- Musculoskeletal system: very rarely - arthralgia; with unspecified frequency - immune-mediated necrotizing myopathy;
- Others: with unspecified frequency - peripheral edema.
During the use of some statins, there have been reports of the development of the following side effects: depression, sexual dysfunction, sleep disturbances, including nightmares and insomnia. Reported isolated cases of interstitial lung disease, especially with prolonged therapy.
Overdose
The pharmacokinetic parameters of rosuvastatin do not change even with the simultaneous administration of several daily doses.
In case of overdose, symptomatic and supportive treatment is indicated. There are no recommendations for specific overdose therapy. It is necessary to monitor liver function and creatine phosphokinase levels, monitor the activity of vital organs and systems. Hemodialysis is unlikely to be effective.
special instructions
In patients receiving high doses (mainly 40 mg) of Crestor, the development of tubular proteinuria was noted, which, as a rule, was transient and did not indicate acute kidney disease or progression of kidney disease. When prescribing the drug at a dose of 40 mg during treatment, it is recommended to monitor the indicators of renal function.
When using Crestor in all dosages (especially above 20 mg), myalgia, myopathy, and in rare cases rhabdomyolysis may develop.
If the initial level of creatine phosphokinase is significantly increased (5 times higher than the upper limit of the norm), a second measurement should be performed after 5-7 days. If a second test confirms the baseline level, therapy cannot be started. After intense physical exertion or in the presence of other possible reasons for the increase in creatine phosphokinase, its determination should not be carried out, since this may lead to an incorrect interpretation of the results obtained.
If there are risk factors for myopathy / rhabdomyolysis, Crestor can be taken with caution after assessing the balance of benefits with possible risks.
If you suddenly develop muscle pain, muscle weakness, or spasms, especially in combination with fever and malaise, you should see your doctor. The possibility of continuing therapy is determined by the severity of muscle pain and the level of creatine phosphokinase. After the normalization of the level of creatine phosphokinase, it is possible to consider the issue of re-prescribing Crestor in smaller doses with careful monitoring of the patient's condition.
2-4 weeks after starting therapy and / or increasing the dose, it is necessary to monitor the parameters of lipid metabolism (the dose is adjusted if necessary).
Before starting to take Crestor and 3 months after starting treatment, it is recommended to determine the functional parameters of the liver. If the level of transaminase activity in the blood serum is 3 times higher than the upper limit of normal, the dose is reduced or therapy is canceled.
In case of hypercholesterolemia associated with hypothyroidism or nephrotic syndrome, the treatment of the underlying diseases should be carried out before the use of Crestor.
With the use of some statins, especially for a long time, there have been reports of isolated cases of the development of interstitial lung disease, manifested by such symptoms as an unproductive cough, shortness of breath, and a deterioration in general well-being (weight loss, fever and weakness). In these cases, therapy is canceled.
At a glucose concentration of 5.6-6.9 mmol / L, the use of Crestor was associated with an increased risk of developing type 2 diabetes mellitus.
Influence on the ability to drive vehicles and complex mechanisms
During treatment, when driving or performing work associated with increased concentration of attention and requiring the speed of psychomotor reactions, care must be taken (there is a possibility of dizziness).
Application during pregnancy and lactation
Cholesterol and other products of its biosynthesis are important for the correct intrauterine development of the fetus, therefore the potential risk of inhibition of HMG-CoA reductase outweighs the benefits of using rosuvastatin in pregnant women. In this regard, Crestor is strictly contraindicated during pregnancy. Moreover, women of reproductive age need to use reliable methods of contraception while taking the drug. If pregnancy occurs during the period of lipid-lowering therapy, treatment should be stopped immediately.
Whether rosuvastatin is excreted in breast milk has not been reliably established, therefore Crestor is contraindicated for breastfeeding mothers.
Pediatric use
The efficacy and safety of rosuvastatin in children has not been established. The experience of using the drug in pediatric practice is very limited. For this reason, Crestor is currently not recommended for the treatment of children and adolescents under the age of 18.
With impaired renal function
No dose adjustment is required for patients with mild to moderate renal impairment.
Crestor is contraindicated in patients with severe renal insufficiency (creatinine clearance <30 ml / min).
At a dose of 40 mg, the drug should not be used in patients with moderate renal impairment (creatinine clearance 30-60 ml / min). The recommended starting dose for this category of patients is 5 mg.
For violations of liver function
Crestor is contraindicated in case of concomitant liver diseases, if they are in the active phase.
Use in the elderly
Care must be taken when treating elderly patients. There is no need to adjust the dose of Crestor.
Drug interactions
With the simultaneous use of Crestor with some drugs, the following effects may occur (AUC is the total concentration of the drug in the blood plasma; C max is the maximum concentration of the drug in the blood):
- Cyclosporine: a significant increase in the AUC of rosuvastatin (the combination of drugs is contraindicated);
- Vitamin K antagonists: increased INR (international normalized ratio);
- Gemfibrozil and other lipid-lowering drugs: an increase in C max and AUC of rosuvastatin, possibly a pharmacodynamic interaction;
- Fenofibrate, gemfibrozil and other fibrates and lipid-lowering doses of nicotinic acid: increased risk of myopathy (the recommended initial dose of Crestor is 5 mg);
- Protease inhibitors: significant increase in rosuvastatin exposure;
- Antacids: a significant decrease in the plasma concentration of rosuvastatin (this effect is less pronounced in cases where antacids are used 2 hours after taking rosuvastatin);
- Erythromycin: decrease in AUC and C max of rosuvastatin;
- Hormone replacement therapy / oral contraceptives: an increase in their AUC (to be taken into account when selecting doses of oral contraceptives).
Analogs
The analogues of Crestor are: Rosucard, Rosuvastatin Canon, Rosuvastatin Sandoz, Roxera, Tevastor, Cleivas, Rovix, Romazik, Rosvator, Fastrong, Rosulip, Rosart, Mertenil, Astin, Atorvasterol, Atormak, Vabadin, Vazoklin, Livzaxol Zosta, Tor, Lipimaks, Liprimar, Lovastatin, Simvakard, Etset, Simgal, Tolevas, Torvakard, Tulip, Torvazin, Simstat, Simvakor, Pravapres, Litorva, Lipodemin, Limistin, Livazo, Cardak, Zokor, Vazilip, Atotex, Atotex.
Terms and conditions of storage
Keep out of reach of children at temperatures up to 30 ° C.
The shelf life is 3 years.
Terms of dispensing from pharmacies
Dispensed by prescription.
Reviews about Crestor
Since the drug has appeared relatively recently, there are still few reviews of Crestor from patients. Doctors recommend this remedy for the treatment of hyperlipidemia, especially for patients who have had a stroke or heart attack. Among the most common side effects are headaches and sleep disturbances.
Price for Crestor in pharmacies
Prices for Crestor can vary significantly depending on the region and the pharmacy chain. Approximate price range:
- tablets 5 mg: 14 pcs. in the package - 655–770 rubles; 28 pcs. in the package - 1220-2320 rubles; 98 pcs. in the package - 4640–6190 rubles;
- tablets 10 mg: 14 pcs. in the package - 930-1100 rubles; 28 pcs. in the package - 1415–3455 rubles; 98 pcs. in the package - 4200-9200 rubles;
- tablets 20 mg: 28 pcs. in the package - 2700-5255 rubles;
- tablets 40 mg: 28 pcs. in the package - 4500–6570 rubles.
Crestor: prices in online pharmacies
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Drug name Price Pharmacy |
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Crestor 10 mg film-coated tablets 28 pcs. RUB 1100 Buy |
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Crestor 5 mg film-coated tablets 28 pcs. 1686 RUB Buy |
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Crestor tablets p.p. 10mg 28 pcs. 1723 RUB Buy |
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Crestor 20 mg film-coated tablets 28 pcs. RUB 3000 Buy |
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Crestor 10 mg film-coated tablets 126 pcs. 4282 RUB Buy |
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Crestor 40 mg film-coated tablets 28 pcs. RUB 4854 Buy |
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Crestor tablets p.o. 10mg 126 pcs. RUB 5387 Buy |
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Crestor tablets p.o. 40mg 28 Pcs. RUB 6160 Buy |
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Maria Kulkes Medical journalist About the author
Education: First Moscow State Medical University named after I. M. Sechenov, specialty "General Medicine".
Information about the drug is generalized, provided for informational purposes only and does not replace the official instructions. Self-medication is hazardous to health!
