Moderate
Established
Descripción
Rosuvastatin increases warfarin plasma concentrations through inhibition of CYP2C9, potentially leading to supratherapeutic INR values.
Mecanismo
Rosuvastatin inhibits CYP2C9, the principal enzyme for S-warfarin metabolism, resulting in reduced clearance and elevated warfarin levels.
Relevancia clínica
INR increases of approximately 10–20% have been observed in pharmacokinetic studies; clinically significant bleeding has been reported.
Manejo clínico
Monitor INR when initiating or adjusting rosuvastatin dose; the FDA label specifically warns about this interaction.