Monday, Wednesday, and Friday Dosing of Rosuvastatin in Patients Previously Intolerant to Statin Therapy

Alternate-day versus daily atorvastatin in coronary artery disease: a randomized study

“…Many previous studies have attempted to use the alternate-day dosing regimen of statin administration in patients with hypercholesterolemia (12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24). Results, however, have been controversial; being discouraging for short-half-life statins: lovastatin, fluvastatin, pravastatin, and simvastatin (12-14, 19, 20).…”

Efficacy and tolerability of once-weekly rosuvastatin in patients with previous statin intolerance

“…This may be evident by the observation that the absolute magnitude of the percentage reduction in LDL seen with once-weekly rosuvastatin in the current study is smaller than reductions reported in previous literature that have investigated a once-weekly rosuvastatin dosing regimen (23-29% vs. 12.2% LDL reduction, previous literature vs. current study, respectively). [7][8][9][10][11] Although these previous reports excluded patients with changes in other lipid-lowering medications and identified no significant difference in LDL reductions seen for patients with lipid panels drawn 1-3 days vs. 4-7 days after their last dose (P 5 .714), 8 they did not account for changes in nonpharmacologic therapies, including diet and exercise, that may have biased the results. In addition, there was no use of placebo controls to help account for confounding variables.…”

“…6 Reports have emerged from the literature that have identified improved lipid control with trials of alternative statin dosing in patients with hyperlipidemia who were previously labeled ''intolerant'' of statins. [7][8][9][10][11][12][13][14] In many of these studies the authors investigated alternative rosuvastatin dosing (every other day, twice per week, and three times per week). The selection of rosuvastatin for these studies was most likely because of the relatively long half life and high LDL-lowering potency of rosuvastatin, which theoretically affords this statin the best chance of attaining therapeutic effects with an infrequent dosing schedule.…”

Expert opinion: the therapeutic challenges faced by statin intolerance

“…If re-challenge is ineffective, then alternate day (33)(34)(35), once weekly (36-39), or twice weekly dosing (39,40) are preferable management alternatives. Within limitations (small size, retrospective, open label, or non-randomized design), these studies (mainly with atorvastatin and rosuvastatin) have demonstrated a reduction in LDL-C of 20-43% (highest achieved by daily dosing) and, importantly, statin tolerance.…”