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Assumere Rosuvastatina a stomaco pieno migliora la tollerabilità?

Nella pratica clinica è abbastanza classica la domanda da parte del paziente se il farmaco che si sta consigliando deve essere assunto a stomaco pieno o a digiuno.
In questo studio gli autori hanno valutato se la somministrazione di rosuvastatina con il pasto possa in qualche modo modificare la sua efficacia terapeutica. Precedenti dati in individui cinesi sani avevano dimostrato che la concentrazione sistemica di rosuvastatina era inferiore quando assunta con il cibo, per un minore assorbimento a livello intestinale ed una maggiore eliminazione epatica.

Food Effect on Rosuvastatin Disposition and Low-Density Lipoprotein Cholesterol

McLean CC, Teft WA, Morse BL, Gryn SE, Hegele RA, Kim RB

Clinical Pharmacology & Therapeutics 2017 Epub Dec 8

ABSTRACT: Rosuvastatin is commonly prescribed for the treatment of hypercholesterolemia and hepatic transporter-mediated accumulation in the liver enhances its efficacy. Current guidelines indicate no preference for fed or fasted rosuvastatin administration. We investigated the association between food intake and rosuvastatin disposition in healthy subjects and low-density lipoprotein cholesterol (LDL-C)-lowering effects among patients taking rosuvastatin. We demonstrate that administration with food resulted in a near 40% reduction of rosuvastatin exposure in healthy Asian (n?=?12) and Caucasian (n?=?11) subjects. Higher rosuvastatin concentrations in Asian subjects also correlated with higher allele frequency of ABCG2 c.421C>A. In mice, a greater rosuvastatin liver:plasma ratio was noted when administered with food. Among rosuvastatin patients (n?=?156), there was no difference in dose needed to reach target LDL-C, measured LDL-C, or lathosterol concentrations, when administered in a fed or fasting state. Therefore, taking rosuvastatin with food could reduce systemic concentrations, and subsequent myopathy risk, without compromising LDL-C-lowering benefit.

Clinical Pharmacology & Therapeutics 2017 Epub Dec 8