Statins are absorbed from the blood into the liver by a transporter called SLCO1B1. Genetic variation in the SLCO1B1 gene can result in SLCO1B1 poor or decreased transporter function. Poor or decreased transporter function can result in increased blood levels of statins and increase the risk of statin-associated musculoskeletal side effects.

Rosuvastatin is transported out of the cell by a transporter called ABCG2.  Genetic variation in the ABCG2 gene can result in ABCG2 poor transporter function.  Poor transporter function can result in increased plasma levels of rosuvastatin and increase the risk of musculoskeletal side effects.

The Clinical Pharmacogenetics Implementation Consortium (CPIC) is a group that evaluates the evidence for the use of pharmacogenetics and then develops clinical practice guidelines. For rosuvastatin, extensive guideline information can be found at: https://cpicpgx.org/guidelines/cpic-guideline-for-statins/,  a reference maintained by CPIC.  

Here is a video that reviews the CPIC guideline for rosuvastatin: https://www.youtube.com/watch?v=RXEh1778_As  

At UCHealth the use of pharmacogenetics when prescribing rosuvastatin will occur in patients who meet the following conditions:

1) Provided a blood or saliva sample to the Colorado Center for Personalized Medicine (CCPM) Biobank laboratory and this sample has undergone genotyping. 
2) Have consented for return of their results.
3) Are prescribed rosuvastatin.

This process takes a minimum of 4-6 weeks but may take several years. Therefore, results will not be available at initial presentation if a patient has not previously enrolled in the Biobank.  

If you are a provider AND your patient has SLCO1B1 decreased or poor function and/or ABCG2 poor function genetic variants, an inline medication warning will appear if you attempt to prescribe rosuvastatin.  If the inline medication warning is visible, links to resources will be listed for your reference.   

Visit our Provider FAQs page here.  For immediate questions, secure chat Groups: Pharmacogenomics Service in UCHealth's EHR.