i would but i have 20mg tabs, so I was planning 10mg EOD
Makes sense and is probably fine if you tolerate rosuvastatin at all. When you exhaust your supply, maybe plan for a smaller dose if you're getting the LDL reduction you're looking for.
The lower the peak serum concentration, the less likelihood of side effects. It is a deviation from the standard of care, but my general recommendation for lipid management is to keep statin doses low and pair it with ezetimibe and bempedoic acid to achieve the desired LDL lowering effect.
Statins are great, but as an unfortunate byproduct of the approval process, the dosing guidelines are egregiously high. By that I mean, the clinical trials were focused on very high risk populations that would be most likely to show positive outcomes in which anything but the maximal dose would be unethical.
I feel comfortable with this guidance because the ACC is fucking out to lunch. They define the standard of care for such things and are *still* pushing statin mono-therapy.
In their view, "preventative" intervention should start once the 10 year MESA risk exceeds 10% which blows my fucking mind. To be clear, when there's a MACE (major adverse cardiac event), the most likely presentation of that is fucking death, for which there's 50% probability. So, if we do the math, they consider *beginning* preventative intervention when there's a 10% chance of a MACE in the next 10 years and if you hit that, a 50/50 chance of dying, with the final calculated risk of death at 5%.
So, roll a d20.
pmc.ncbi.nlm.nih.gov
