Efficacy of alternate day versus everyday dosing of rosuvastatin in hyperlipidemia

Chandrashekar Panchavarthi, Ushasree Takkela Shankara, Vijayakrishna Pakanati, Shirisha Siddamshetty, Jaya Prakash Konda, Sai kumar Gowlikar


Background: Hyperlipidemia is one of the common risk factor for cardiovascular disease. Statins are well established in treatment for lowering LDL-C, triglycerides, TC and improving HDL-C levels. Rosuvastatin is long acting and more efficacious than other statins in lesser dosages with good safety profile.

Methods: In this prospective open label study, 42 patients with plasma LDL cholesterol of more than 130 mg/dl and total cholesterol more than 200 mg/dl were selected. After baseline tests they were randomly allocated to two groups. Oral 10 mg of rosuvastatin was given to group-A daily and group-B on alternative day for six weeks. Fasting plasma lipid profile was measured on 0 day, 4th and 6th week and serums ALT, AST were estimated in both the groups on 0 day, 6th week.

Results: Statistical analysis was done with Student paired t-test. There was significant reduction in total cholesterol, LDL-C, triglycerides and elevation of HDL after 4 weeks and 6weeks of the treatment in both the groups compared to baseline. The mean percentage change of TC-24%and 21.60%; LDL- 33.50% and 31%; HDL-19.89% and 17.09%; TG - 36.70%and 41.33%in once daily group and alternate day group respectively p<0.0001***. No significant elevation of the mean serum ALT and AST levels at any point of study.

Conclusions: Rosuvastatin 10 mg on alternate days has similar efficacy in decreasing lipid levels and raising HDL levels compared to daily dose. The decrease in triglyceride levels was more significant than daily doses. Hence alternate day dosing of rosuvastatin may be an alternate regime and cost effective without a major decrease in therapeutic benefits and also decrease in adverse events in patients with hyperlipidemia.


Rosuvastatin, Dyslipidaemia, HMG-CoA reductase inhibitors, cost-effectiveness

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Mukherjee AK. Prediction of coronary heart disease using risk factor categories. J Indian Med Assoc. 1995;93;312-5.

Gupta R, Joshi P, Mohan V, Reddy KS, Yousuf S. Epidemiology and causation of coronary heart disease and stroke in India. Heart. 2008;94;16-26.

Lloyd Johns DM, O`Donnell CJ ,D`Agostino RB, Massaro J, Silbershatz H, Wilson PW. Applicability of cholesterol lowering primary prevention trials to a General population. The Framingham Heart study. Arch intern Med. 2001;161;949-54.

Williams D, Feely J. Pharmacokinetic-pharmacodynamic drug interaction with HMG CoA reductase inhibitors. Clin Pharmacokinet. 2002;41;343-70.

Ghirlanda G, Oradie A, Manto A, Lippa S, Uccioli L, Caputo S, et al. Evidence of plasma CoQ 10 lowering effect by HMG CoA reductase inhibitors; a double blind placebo- controlled study. J clin Pharmacol. 1993;33;226-9.

Baigent C, Keech A, Kearney PM, Blackwell L, Buck G, Pollicino C. Efficacy and safety of cholesterol lowering treatment. Prospective meta-analysis of data from 90056 participants in 14 randomised trials of statins. Lancet. 2005;366;1267-78.

Bersot PT. Drug therapy for hypercholesterolemia and dyslipidemia. In Bruton LL, editor. Goodman and Gillman manual of pharmacology and Therapeutics. 12th edition New York; McGraw- Hill; 2010:893.

Lennernas H. Clinical pharmacokinetics of atorvostatin. Clin Pharmocokinet. 2003;42;1141-60.

WHO collobarating centre for drug statistic and methodology. ATC classification index with DDDs; 2011.

Park K. Epidemiology of chronic non communicable diseases and conditions, In; Park K, editor. Parks textbook of preventive and social medicine. 20th ed. Jabalpur. Bhanot; 2009:316.

Bakes JM, Venoro CV, Gibson CA, Ruisinger JF, Howard PA, Thompson PD, et al. Effectiveness and tolerability of every other day rosuvastatin in patient with prior statin intolerance. Ann Pharmacother. 2008;2(3):341-6.

Wongwiwatthananukit S, Sansanayudh N, Dhummauppakorn R, Kitiyadisai C. The efficacy and safety of rosuvastatin every other day compared with once daily in patient with hypercholesterolemia. The Annals of pharmacotherapy. 2006;40(11):1917-23.

Clearfield MB, Amerena J, Bassand JP, Hernández García HR, Miller SS, Sosef FF, et al. Comparison of efficacy and safety of rosuvastatin 10 mg and Atorvastatin 20 mg in high risk patients with hypercholesterolemia. Prospective study to evaluate the use of low doses of the statins atorvastatin and rosuvastatin (PULSAR). Trials. 2006;7:35.