Crestor would be more than a few spots down on my list of "Statins to have patients on" Nearly everyone should be started on Pravastatin. It is one of the most lipophobic, and has a novel mechanism of metabolism. Both of these features lend it to not crossing the BBB, where statins can mess with the brains own internal cholesterol system (which is separate from the one in the liver that services the rest of the body due to the nature of the BBB), having a far lower rate of rhabdomyolysis, and it does not carry the risk of increasing the chance of Type II diabetes as all the lipophilic statins do. The only time I suggest starting somewhere else is if the person has had an MI, CVA, PVD, etc... and needs aggressive cholesterol management. In that case I'd go for Atorvastatin as its the only one proven to decrease the risk of MI and CVA related to dyslipidemia in the context of established cardiovascular disease.cathyf wrote:...Another example that my boss and I were talking about yesterday. His cardiologist insists that he has to take Crestor for his cholesterol. My boss keeps begging to try a cheap generic statin and see if it works well enough, because the Crestor costs over $100/month. The doc insists that it has to be Crestor, "because Crestor has worked so well for you!" This is just a frighteningly stupid thing to say! The only cholesterol drug he's even taken is the Crestor, and so nobody knows whether Crestor is the best thing, or whether something else would work as well or even better. You don't have to know anything about cholesterol or statins or any other drugs to realize that the doc is claiming something he doesn't know and can't know -- all you have to know is the question "so well" compared to what?!?...
I'm amazed that guy hasn't switched cardiologists. The reasoning he is using to justify Crestor as a drug of choice is just scary.