Drug Detail:Ezallor sprinkle (Rosuvastatin [ roe-soo-va-sta-tin ])
Generic Name: ROSUVASTATIN CALCIUM 5mg
Dosage Form: capsule
Drug Class: Statins
General Dosing Information
The dose range for EZALLOR Sprinkle in adults is 5 mg to 40 mg orally once daily. The usual starting dose is 10 mg to 20 mg once daily. The usual starting dose in adult patients with homozygous familial hypercholesterolemia is 20 mg once daily. The maximum EZALLOR Sprinkle dose of 40 mg should be used only for those patients who have not achieved their LDL-C goal utilizing the 20 mg dose [see Warnings and Precautions (5.1)].
EZALLOR Sprinkle can be administered as a single dose at any time of day, with or without food. Swallow capsules whole. Do not crush or chew. For patients who cannot swallow capsules, the capsules can be opened for administration [see Dosage and Administration (2.5)].
When initiating EZALLOR Sprinkle therapy or switching from another HMG-CoA reductase inhibitor therapy, the appropriate EZALLOR Sprinkle starting dose should first be utilized, and only then titrated according to the patient’s response and individualized goal of therapy.
After initiation or upon titration of EZALLOR Sprinkle, lipid levels should be analyzed within 2 to 4 weeks and the dosage adjusted accordingly.
Pediatric use information for patients 7 to 17 years of age is approved for AstraZeneca’s CRESTOR (rosuvastatin calcium) tablets. However, due to AstraZeneca’s marketing exclusivity rights, this drug product is not labeled with that pediatric information.
Dosing in Asian Patients
In Asian patients, consider initiation of EZALLOR Sprinkle therapy with 5 mg once daily due to increased rosuvastatin plasma concentrations. The increased systemic exposure should be taken into consideration when treating Asian patients not adequately controlled at doses up to 20 mg once daily [see Use in Specific Populations (8.8) and Clinical Pharmacology (12.3)].
Use with Concomitant Therapy
Patients taking cyclosporine and darolutamide
The dose of EZALLOR Sprinkle should not exceed 5 mg once daily [see Warnings and Precautions (5.1), Drug Interactions (7.1), Drug Interactions (7.4) and Clinical Pharmacology (12.3)].
Patients taking gemfibrozil
Avoid concomitant use of EZALLOR Sprinkle with gemfibrozil. If concomitant use cannot be avoided, initiate EZALLOR Sprinkle at 5 mg once daily. The dose of EZALLOR Sprinkle should not exceed 10 mg once daily [see Warnings and Precautions (5.1), Drug Interactions (7.5) and Clinical Pharmacology (12.3)].
Patients taking regorafenib
Concomitant use of EZALLOR Sprinkle and regorafenib, the dose of EZALLOR Sprinkle should not exceed 10 mg once daily. [see Warnings and Precautions (5.1), Drug Interactions (7.5) and Clinical Pharmacology (12.3)].
Patients taking atazanavir and ritonavir, lopinavir and ritonavir, simeprevir or combination of dasabuvir/ombitasvir/paritaprevir/ritonavir, elbasvir/grazoprevir, sofosbuvir/velpatasvir and glecaprevir/pibrentasvir
Initiate EZALLOR Sprinkle therapy with 5 mg once daily. The dose of EZALLOR Sprinkle should not exceed 10 mg once daily [see Warnings and Precautions (5.1), Drug Interactions (7.3) and Clinical Pharmacology (12.3)].
Dosing in Patients with Severe Renal Impairment
For patients with severe renal impairment (CLcr < 30 mL/min/1.73 m2) not on hemodialysis, dosing of EZALLOR Sprinkle should be started at 5 mg once daily and not exceed 10 mg once daily [see Use in Specific Populations (8.6) and Clinical Pharmacology (12.3)].
Administration Options
EZALLOR Sprinkle capsule should be swallowed whole. For patients unable to swallow an intact capsule, alternative administration options are available.
Oral Administration
Directions for use with soft food (applesauce or pudding)
For patients with swallowing difficulty, EZALLOR Sprinkle capsule can be opened and contents can be sprinkled over soft food. The contents of the capsules should be swallowed along with a small amount (teaspoonful) of soft food (such as applesauce or chocolate/vanilla flavored pudding). The drug/food mixture should be swallowed within 60 minutes and not be stored for future use. If it is not used in its entirety, the remaining contents should be discarded immediately.
Nasogastric Tube (≥16 French) Administration
For patients who have a nasogastric tube in place, the EZALLOR Sprinkle capsule can be opened and the intact granules emptied into a 60 mL catheter tipped syringe and add 40 mL of water. Replace the plunger and shake the syringe vigorously for 15 seconds. The granules in EZALLOR Sprinkle capsule may start dissolving which is acceptable. Attach the syringe to a nasogastric tube (≥16-French) and deliver the contents of the syringe through the nasogastric tube into the stomach. After administering the granules, the nasogastric tube should be flushed with 20 mL of additional water. The mixture must be used immediately after preparation and not be stored for future use. If it is not used in its entirety, the remaining mixture should be discarded immediately. Use with any other liquids is not recommended.