Alternate day rosuvastatin, an underutilized option in statin intolerant hyperlipidemic patients: a case report and literature review.

Statin agents have proven effective in primary and secondary prevention of cardiovascular disease. Approximately 10-15 percent of patients on statin agents discontinue these agents because of myalgia. We report a patient with a remote history of a transient ischemic attack, significant hyperlipidemia and a positive family history of vascular disease and intolerance to multiple lipid lowering agents, including several statin agents. The patient was started on 5 mg rosuvastatin every other day with no adverse symptoms. The dose was increased to 20 mg rosuvastatin every other day over approximately four months resulting in a 39-percent decrease in LDL levels and a 14-percent improvement in HDL levels with excellent tolerability. The long half-life of rosuvastatin along with its high potency make it a good candidate for alternate-day administration. While few studies have evaluated the efficacy of the described alternate-day statin therapy, the failure to address significant hyperlipidemia is associated with adverse health outcomes and costs. Alternate-day statin agent use remains an underutilized option in patients intolerant of daily statin administration. While significant cost benefits also may occur with an alternate-day regimen, prospective studies are needed to confirm the long-term safety and efficacy of this mode of administration.