Myrosor (Ezetimibe, Rosuvastatin)

Myrosor acts on lipid metabolism disorders and is indicated for the following conditions:

• Primary hypercholesterolemia: lowers LDL‑cholesterol and total cholesterol levels.
• Mixed dyslipidemia: improves overall lipid profile by reducing triglycerides and LDL‑cholesterol while raising HDL‑cholesterol.
• High cardiovascular risk patients: provides additional LDL‑cholesterol reduction when statin monotherapy is insufficient.

• Ezetimibe selectively inhibits the Niemann‑Pick C1‑like 1 (NPC1L1) transporter in the intestinal brush border, reducing absorption of dietary and biliary cholesterol. Rosuvastatin competitively inhibits HMG‑CoA reductase, the rate‑limiting enzyme in hepatic cholesterol synthesis, leading to up‑regulation of LDL receptors and increased clearance of LDL particles from circulation.

Common Side Effects

• Headache: mild to moderate intensity.
• Abdominal pain: discomfort in the stomach area.
• Diarrhea: loose stools occurring intermittently.
• Myalgia: muscle aches without weakness.
• Elevated liver enzymes: increased ALT/AST levels.
• Nausea: feeling of sickness.

Serious or Rare Side Effects

• Rhabdomyolysis: severe muscle breakdown with potential kidney injury.
• Severe liver injury: marked elevation of hepatic enzymes or jaundice.
• Allergic reactions: rash, pruritus, or angioedema.
• Myopathy: muscle weakness with elevated CK.
• Pancreatitis: inflammation of the pancreas.
• Acute renal failure: sudden loss of kidney function.

Before initiating therapy, consider the following precautions:

• Liver function monitoring: assess baseline and periodic ALT/AST.
• Renal function assessment: evaluate creatinine clearance, especially in elderly.
• Muscle symptom evaluation: inquire about unexplained muscle pain or weakness.
• Active liver disease: avoid use in patients with ongoing hepatic impairment.
• Concomitant medication review: adjust doses of drugs that increase statin exposure.
• Store at room temperature: keep in the original pack, protect from moisture.

Myrosor may interact with several medications. Review the following interaction categories:

Major Interactions (Avoid)

• Strong CYP3A4 inhibitors (e.g., clarithromycin, itraconazole): increase rosuvastatin exposure.
• Gemfibrozil: heightened risk of myopathy.
• Cyclosporine: elevated statin plasma levels.
• High‑dose niacin: increased risk of muscle toxicity.
• Cholestyramine or colestipol: reduce ezetimibe absorption.

Moderate Interactions (Monitor Closely)

• Other statins: cumulative statin effect.
• Fibrates (e.g., fenofibrate): monitor for muscle symptoms.
• Warfarin: potential alteration of INR.
• Digoxin: possible increased serum levels.
• Antidiabetic agents: monitor glucose control.