Supplements and Rosuvastatin calcium.
Rosuvastatin calcium, sold under the brand names Crestor, Ezallor Sprinkle, is a statin: it lowers LDL cholesterol by inhibiting HMG-CoA reductase. Statins are the most-prescribed class in the UK.
Rosuvastatin is the most potent statin per milligram, and the one with the lowest CYP3A4 dependence. It is primarily excreted unchanged via the kidneys and biliary tract, with only minor CYP2C9 involvement. That means the CYP3A4 supplement interactions that hit simvastatin (and to a lesser extent atorvastatin) barely apply here. Rosuvastatin is the statin of choice when a patient needs strong LDL reduction with minimal drug interaction concern. It is often the switch destination from simvastatin in older patients on polypharmacy. Two supplement interactions matter. Additive lipid lowering (berberine, plant sterols, red yeast rice carry small additive effects). And additive myopathy risk with niacin at high doses. Rosuvastatin shows a slightly higher diabetes incidence signal in long observational data than other statins. CARDS and JUPITER are the relevant evidence base. The standard clinical move with new statin myalgia is dose reduction, switch, or check vitamin D, which has a small reproducible effect on statin-tolerability data.
Below are the 4 documented pairs we have explicitly assessed against Rosuvastatin calcium in the Distil database: 2 amber and 2 green. The pairs cluster around 3 mechanisms: Additive HMG-CoA reductase inhibition, OATP transporter inhibition (reduced absorption), and Additive lipid lowering. Every call is cited to either a clinical reference (PMID) or the British National Formulary. Anything not on this list is either still to be assessed or beyond our database scope. The checker beneath surfaces assessments by supplement, and the missing-item form at the bottom of the page routes any uncatalogued supplement into our next curation pass.
Documented interactions
Additive HMG-CoA reductase inhibition
Bergamot's active flavonoids lower LDL cholesterol through the same liver pathway rosuvastatin acts on, so combining them adds to the cholesterol-lowering effect. A clinical trial showed bergamot added to rosuvastatin lowered LDL more than rosuvastatin alone. This can be intentional under medical supervision, but tell your GP before combining so your dose and cholesterol levels can be reviewed together rather than the two effects stacking unplanned.
OATP transporter inhibition (reduced absorption)
Green tea extract can lower the amount of rosuvastatin in your bloodstream by interfering with the transporter that moves the drug into cells. In a study of healthy volunteers, a concentrated green tea extract reduced rosuvastatin levels by about a fifth. It is not certain whether this changes how well rosuvastatin lowers cholesterol, so the sensible approach is to keep your green tea extract intake steady and let your prescriber know you take it, especially around a cholesterol check.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Other
Statins do reduce plasma CoQ10 levels, but the best-quality randomised trials show that taking CoQ10 alongside a statin does not reliably reduce muscle pain or improve other statin side effects. We treat the pair as safe to combine. If you find it helps you personally that is fine, but the evidence for routine use is weak.
Additive lipid lowering
Oat beta-glucan lowers LDL cholesterol by trapping bile acids in the gut, a different route from how a statin works. Taking the two together is complementary, not a harmful clash, and the small extra cholesterol reduction is a benefit. We treat this pair as safe to combine.
What this list does not say. Pairs not flagged here are not implicitly safe. They are either not yet in our database, or fall outside our inclusion scope (food-supplement interactions only; for drug-drug interactions, the BNF is authoritative). Use the checker below to surface any supplement, and submit a missing item if you take something we have not catalogued.
How we grade severity, choose what's in scope, and what we exclude.
Every call on this page is reasoned. We publish the full rubric for severity tiers, the medication inclusion logic, the evidence grades we accept, and what we deliberately leave out. About three thousand words. Worth reading once if you use this tool more than occasionally.
Read the full methodologyWant this checked across everything you take?
This page checks the pairs you enter. The personalised Distil report goes further:
- the same graded, cited interaction check across your whole stack, not just the pairs you thought to type in
- where your current routine may be leaving you short of your goals
- the evidence-backed compounds worth adding, and the ones worth dropping
It's a paid report: £79, or £49 for the first 25 customers. The interactions check is one section of it, and you can read a real one in full before you buy.
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