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Supplements and Rosuvastatin calcium.

Every documented pair, every citation. Below: 4 documented pairs grouped by mechanism.

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 4 mechanisms: Additive HMG-CoA reductase inhibition, OATP transporter inhibition (reduced absorption), Additive lipid lowering, and Statin-induced CoQ10 depletion. 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

Last reviewed 14 June 2026. Each interaction below lists the evidence its assessment drew on: some rest on studies of the exact pair, others on mechanism evidence, where a citation may support one part of the reasoning rather than the exact combination. The evidence line on each entry says which.

Additive HMG-CoA reductase inhibition

Amber Does Bergamot Extract (BPF / Bergavit40) interact with ?

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.

Evidence: Supported by human study data.

PMID 24239156 · PMID 20843083 · BNF: Rosuvastatin

OATP transporter inhibition (reduced absorption)

Amber Does Green Tea Extract interact with ?

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.

Evidence: Limited human data, based on case reports and a known mechanism.

PMID 35399656 · PMID 39748104 · BNF: Rosuvastatin

Reviewer-flagged: awaiting clinical-reviewer sign-off.

Additive lipid lowering

Green Does Beta-Glucan interact with ?

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.

Evidence: Supported by human study data.

PMID 25411276 · PMID 38441173 · BNF: Rosuvastatin

Statin-induced CoQ10 depletion

Green Does Coenzyme Q10 interact with ?

Statins do reduce plasma CoQ10 levels, but replacing it does not reliably ease muscle aches: four analyses of the trials split two against two, the two that measured muscle-damage enzymes found no change, and CoQ10 does not help people stay on their statin. We treat the pair as safe to combine, and it may be worth a trial if you already have statin muscle aches. If you have no symptoms, the evidence does not support taking it routinely.

Evidence: Well established across multiple human studies or interaction references.

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.

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For adults over 18. This tool gives evidence-graded information, not medical advice. Always discuss changes with your GP or pharmacist, especially if you take any medication, are pregnant, breastfeeding, or have a serious health condition.
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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.

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The free checker answers one interaction question at a time. A Distil report reviews the bigger picture: your goals, diet, medications, current supplements and any blood results you provide, then shows what appears worth keeping, changing, adding or leaving out.

  • what your diet already covers, so you are not adding a capsule for something food is already handling
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The interaction check is one section of the full report. You also get the reasoning behind each recommendation and the evidence references used.

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Distil's interactions database is reviewed and updated every quarter. We grade evidence transparently and publish our methodology, including every database change, at /about/methodology. This tool is information, not a substitute for clinical judgement. If you take medication and supplements together, your GP or pharmacist can review your full regimen against your medical history. If you want a full personalised stack reasoned against this same database, the Distil report is the next step up.