Drug Interactions, Kratom Guides

Can Kratom & Rosuvastatin Be Used Together?

Does Kratom Interact With Rosuvastatin?

Kratom and rosuvastatin have a low chance of causing an adverse reaction but always check with your doctor before combining medications of any kind. These two can interact in the following ways:

A. Kratom May Increase the Risk of Rosuvastatin Toxicity

In theory, there is a risk of adverse drug reactions when kratom and statins are taken together. One possible interaction between the two drugs is that the statins are metabolized significantly by CYP isoenzymes, and kratom is a CYP inhibitor.

Thus, it can lead to a high blood concentration of statins and increase the risk for severe events like rhabdomyolysis. However, to date, there are no reports of serious adverse events in patients taking regular statins and kratom together.

Other drugs (e.g., atorvastatin) in this group are substantially metabolized by the CYP enzymes in the liver. However, rosuvastatin is the most active form of the drug, and only about 10% of it undergoes hepatic metabolism via CYP450 enzymes.

Rosuvastatin is unlikely to cause significant metabolically mediated drug-drug interactions with other CYP inhibitors like kratom.

B. Kratom & Rosuvastatin Can Have a Synergistic Effect on Lipid Profiles

There is another possible indirect way by which rosuvastatin and kratom may interact. This interaction is, however, possibly positive as some studies have shown kratom has beneficial effects on serum lipid profile. It has been associated with an elevation in the HDL level and a drop in triglyceride levels, which can lead to an additive effect on the lipid profile.

Is It Safe To Take Kratom With Rosuvastatin?

Kratom and rosuvastatin have entirely different mechanisms of action and, thus, different effects on the body’s physiology. One possible way both drugs can interact is during metabolism in the liver. However, only a small portion of rosuvastatin is hepatically metabolized.

We can thus conclude that it is relatively safe to take the two drugs simultaneously from a pharmacokinetic point of view. But, it is still advisable to take full opinion from one’s physician before taking the two drugs together.

What Is Rosuvastatin?

Rosuvastatin is a synthetic lipid-lowering agent used as a first-line drug for primary and secondary prevention of atherosclerotic cardiovascular diseases. It is also indicated for various dyslipidemias. It is a member of the ‘HMG-CoA reductase inhibitor’ group of drugs and works by inhibiting the hepatic HMG-CoA reductase, the rate-limiting enzyme for cholesterol synthesis.

Additionally, it has anti-inflammatory, anti-oxidant, and anti-thrombotic properties. The relatively high efficacy and better safety profile make rosuvastatin an attractive choice. It is mainly excreted via the bile into the feces.

The drug is available in tablets or capsules of 5-40 mg and is taken once daily. It has a good safety profile, with pharyngitis, headache, flu syndrome, and myalgia being the more commonly seen adverse effects. However, it can rarely be responsible for myopathy, rhabdomyolysis, and liver toxicity.

Rosuvastatin Details & Specifications

Drug NameRosuvastatin
Trade NamesCrestor, Ezallor
ClassificationStatins
CYP MetabolismLimited (~10%)
Active MetabolitesMinor
SolubilityHydrophilic
Protein Binding90%
Optimal Time Of DosingAny time of the day
Interaction With KratomIndirect
Risk Of InteractionMinimal
Renal Excretion10%

What Is Rosuvastatin Used for?

Following are the few clinical indications where rosuvastatin has proven efficacy:

Mild To Moderate Hypercholesterolemia

Rosuvastatin taken regularly in the usual dose leads to a significant reduction in the low-density lipoprotein cholesterol (LDL-C) and triglycerides (TG) levels, as well as an increase in the high-density lipoprotein cholesterol (HDL-C) levels. Rosuvastatin has greater efficacy when compared to other statins like atorvastatin, simvastatin, and pravastatin.

Familial Hypercholesterolemia

Familial hypercholesterolemia is an inherited lipid metabolism disorder resulting in high blood cholesterol levels. Rosuvastatin has demonstrated efficacy in lowering LDL-C and total cholesterol in patients with familial hypercholesterolemia.

Hypertriglyceridemia

Rosuvastatin has shown up to a 40% reduction in TG levels in patients with hypertriglyceridemia and a substantial decrease in other atherogenic lipid components.

Metabolic Syndrome

Regular use of rosuvastatin in patients with metabolic syndrome can result in consistent improvement in several lipid parameters like LDL, non-HDL, and HDL.

What Is the Proper Dose of Rosuvastatin?

Rosuvastatin is prescribed in the daily dose range of 10 to 40 mg. It attains a maximum plasma level 5 hours after the administration.

What Are the Side Effects of Rosuvastatin?

Rosuvastatin can cause the following side effects:

Musculoskeletal Events

Various musculoskeletal adverse effects are associated with the regular use of rosuvastatin. These include myalgia, limb pain, cramp, myositis with elevated creatine kinase (CK), muscle weakness, muscular spasms, and myopathy.

The exact mechanism of muscular injury is not yet confirmed, but the reduction in coenzyme Q10 concentrations leading to altered mitochondrial energy metabolism is a possible explanation.

These adverse effects are frequently reported and are the most common cause of patients’ discontinuation of the drug. Muscular symptoms are the most common side effects seen with rosuvastatin; rhabdomyolysis is unheard of.

Hepatic Events

Rosuvastatin can cause liver injury ranging from asymptomatic abnormal liver function tests (LFTs) to hepatitis. The increase in transaminase level occurs in a dose-dependent manner. Rosuvastatin’s highly selective uptake by hepatocytes can explain how it possibly causes hepatotoxicity. Also, some case reports have linked the development of autoimmune hepatitis to the use of rosuvastatin.

Renal Events

Rosuvastatin can cause elevation of urea/creatinine levels, hematuria, proteinuria, and, very rarely, renal failure.

Other Adverse Effects

Some of the other adverse effects seen with rosuvastatin use are listed below:

  • Abdominal pain
  • Acute Pancreatitis
  • Flu-like syndrome
  • Nausea

What Is Kratom?

Kratom, also known as Mitragyna speciosa, is a herb belonging to the Rubiaceae or the coffee family. It is cultivated in Southeast Asian countries like Indonesia, Malaysia, and Thailand for medicinal and recreational purposes.

Recently, the use of kratom has increased significantly in western countries, leading to concerns regarding its safety. The drug enforcement agency (DEA) in the United States has kept it on the list of “drugs of concern,” though this is mainly due to misinformation.

In western countries, kratom is used for various purposes like chronic pain relief, mood elevation, sleep promotion, and preventing withdrawal symptoms of multiple drugs.

The primary active substrates of kratom are alkaloids mitragynine and 7-hydroxymitragynine. They bind to opioid receptors and exhibit anti-nociceptive properties. Stimulation of the postsynaptic α-2 adrenergic receptor is responsible for mood elevation and countering withdrawal symptoms.

Mitragynine is also a cyclooxygenase-2 inhibitor and thus has analgesic and anti-inflammatory properties. The adverse effect profile of kratom is benign, especially when compared to opioids, and therefore, patients favor the use of kratom to mitigate the withdrawal symptoms of opioids.

Related: Making Sense of Kratom Research

What Is Kratom Used for?

Kratom has been used in traditional medicine for a long time. Some of the everyday purposes of its usage are listed as follows:

What Is the Appropriate Dose of Kratom?

Kratom is most commonly available in capsules, tablets, and powder. Although there is no proven dose range for kratom, a daily dose range of 1-12 grams is considered safe for a healthy adult.

A dose equal to 1-5 grams produces stimulating effects, and a dose of 5-12 grams of raw leaves has opioid-like effects.

What Are the Side Effects of Kratom?

Very few reports of acute toxicity with kratom use are available. Even among the reported cases, most have been due to using kratom with other substances like cocaine, opioids, barbiturates, and other drugs.

The more significant concern regarding kratom use is its potential to induce addiction and dependence without proper use. Hence, anyone using or wanting to use kratom must discuss the risk-benefit of kratom use with a healthcare provider.

Despite some side effects, kratom is well-tolerated and doesn’t cause many issues.

Some of the reported short-term adverse effects include:

Reported long-term effects are as follows:

  • Anorexia
  • Anxiety
  • Dehydration and excessive thirst
  • Hyperpigmentation
  • Hypothyroidism
  • Poor concentration
  • Weight-loss
  • Withdrawal symptoms like aggressive behavior, sweating, anxiety, tremor, muscle aches, jerky movements of the limbs, etc.

What Are the Different Types of Kratom?

Kratom is classified into three types based on the color of the stem and vein of its leaf. These include:

The color of the vein represents the age of the leaves. Red vein kratom is the most mature and also the most potent. The potency differs because of the variability in the concentration of mitragynine and 7-hydroxymitragynine. Thus, different strains have varying clinical effects on the patient. Even the same-colored kratom can vary depending on the harvesting technique, weather, location, etc.

The white vein kratom is energizing and used for improved mood and concentration.

The green veins are more balanced, offering a little bit of everything without leaning too strongly in either direction.

Key Takeaways: Does Kratom Interact With Rosuvastatin?

After studying rosuvastatin and kratom’s properties, there is a slight possibility of harmful interaction when both drugs are used simultaneously. However, further studies and clinical trials are required to reach any definite conclusion regarding the safety of their co-administration. Consequently, consult your physician before initiating kratom use.

References

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