Is Ezetimibe and Rosuvastatin (Roszet) affected by genetics?
Partially. 1 of 2 ingredients has pharmacogenetic evidence.
Ezetimibe and rosuvastatin contains 2 active ingredients, and 1 of them has published pharmacogenetic guidelines. The relevant genes are ABCG2, SLCO1B1. Your genotype can change how that ingredient behaves in your body, while the other ingredients aren't affected by genetics in any clinically established way. The strongest evidence level on this page is Strong, from the published guidelines shown below.
Also sold as Roszet.
Pharmacogenetic guidelines are written for one ingredient at a time, so the guidance below is for each ingredient on its own. What your genes mean for a combination product is less clear, because the dose and the other ingredients can change things. If you take Ezetimibe and rosuvastatin, it's worth talking over with your prescriber or pharmacist. How we handle combination products.
What's in Ezetimibe and rosuvastatin
Ezetimibe No known pharmacogenetics
No strong published pharmacogenetic guideline currently applies to ezetimibe.
Rosuvastatin Affected by ABCG2, SLCO1B1
Affected by ABCG2, SLCO1B1. Guidance from CPIC, strong evidence.
Read the full rosuvastatin genetics guideRosuvastatin phenotype recommendations
Published guidance from CPIC on how rosuvastatin should be dosed or substituted based on your SLCO1B1, ABCG2 phenotype.
| Phenotype | What it means | Recommendation | Evidence |
|---|---|---|---|
| Increased FunctionSLCO1B1 | Your genetics suggest normal handling of rosuvastatin, so standard dosing can be used. | CPIC Prescribe desired starting dose and adjust doses of rosuvastatin based on disease-specific and population-specific guidelines. |
Strong |
| Normal FunctionSLCO1B1 | Your genetics suggest normal handling of rosuvastatin, so standard dosing can be used. | CPIC Prescribe desired starting dose and adjust doses of rosuvastatin based on disease-specific and population-specific guidelines. |
Strong |
| Decreased FunctionSLCO1B1 | More of this statin stays in your blood, but the usual dose is fine. Very high doses may raise the risk of muscle side effects. | CPIC Prescribe desired starting dose and adjust doses of rosuvastatin based on disease-specific and population-specific guidelines. Prescriber should be aware of possible increased risk for myopathy especially for doses >20 mg. |
Strong |
| Possible Decreased FunctionSLCO1B1 | More of this statin stays in your blood, but the usual dose is fine. Very high doses may raise the risk of muscle side effects. | CPIC Prescribe desired starting dose and adjust doses of rosuvastatin based on disease-specific and population-specific guidelines. Prescriber should be aware of possible increased risk for myopathy especially for doses >20 mg. |
Strong |
| Poor FunctionSLCO1B1 | Much more of this statin stays in your blood, so your doctor may limit the dose. If that isn't enough, a second cholesterol drug can be added. | CPIC Prescribe ≤20 mg as a starting dose and adjust doses of rosuvastatin based on disease-specific and population-specific guidelines. If dose >20 mg is needed for desired efficacy, consider combination therapy (i.e., rosuvastatin plus nonstatin guideline-directed medical therapy). |
Moderate |
| Possible Poor FunctionSLCO1B1 | Much more of this statin stays in your blood, so your doctor may limit the dose. If that isn't enough, a second cholesterol drug can be added. | CPIC Prescribe ≤20 mg as a starting dose and adjust doses of rosuvastatin based on disease-specific and population-specific guidelines. If dose >20 mg is needed for desired efficacy, consider combination therapy (i.e., rosuvastatin plus nonstatin guideline-directed medical therapy). |
Moderate |
| IndeterminateSLCO1B1 | The impact of your genotype on response to this drug is unknown. | CPIC Initiate therapy with recommended starting dose. |
Not rated |
| Not availableSLCO1B1 | The impact of your genotype on response to this drug is unknown. | CPIC Initiate therapy with recommended starting dose. |
Not rated |
| Normal FunctionABCG2 | Your body handles this statin as expected, so the usual dose can be used. | CPIC Prescribe desired starting dose and adjust doses of rosuvastatin based on disease-specific and population-specific guidelines. |
Strong |
| Decreased FunctionABCG2 | A bit more of this statin may stay in your blood, but the usual dose is fine. | CPIC Prescribe desired starting dose and adjust doses of rosuvastatin based on disease-specific and population-specific guidelines. |
Moderate |
| Poor FunctionABCG2 | More of this statin stays in your blood, so it may lower cholesterol more. Your doctor may limit the dose and change drugs if more effect is needed. | CPIC Prescribe ≤20 mg as a starting dose and adjust doses of rosuvastatin based on disease-specific and population-specific guidelines. If dose >20 mg is needed for desired efficacy, consider an alternative statin or combination therapy (i.e., rosuvastatin plus nonstatin guideline-directed medical therapy). |
Optional |
| IndeterminateABCG2 | The impact of your genotype on response to this drug is unknown. | CPIC Initiate therapy with recommended starting dose. |
Not rated |
| Not availableABCG2 | The impact of your genotype on response to this drug is unknown. | CPIC Initiate therapy with recommended starting dose. |
Not rated |
Source: CPIC
The genes behind the guidance
ABCG2 ATP-Binding Cassette Subfamily G Member 2 (BCRP)
ABCG2 is a transporter that moves urate and several drugs out of cells. The Q141K variant (rs2231142) is common, particularly in East Asian populations, and reduces transporter function. Carriers tend to have higher serum urate and respond less to allopurinol, and the Dutch Pharmacogenetics Working Group advises a higher allopurinol dose for them. ABCG2 also affects how quickly the body clears rosuvastatin.
The DPWG advises 1.25 times the standard allopurinol dose for one copy of Q141K and 1.4 times for two.
See all drugs affected by ABCG2SLCO1B1 Solute Carrier Organic Anion Transporter 1B1
SLCO1B1 is the transporter that moves statins into liver cells where they work. A common variant (called *5) reduces transporter function and leaves more statin circulating in the bloodstream and muscle tissue. That's directly linked to statin-associated muscle pain and, rarely, more serious muscle damage.
People with reduced SLCO1B1 function are at higher risk of statin myopathy, especially on simvastatin and high-dose atorvastatin. Dose reduction or switching statin usually resolves it.
See all drugs affected by SLCO1B1Browse the full drug class: Statins.
Related medications
Find out how your genetics affect Ezetimibe and rosuvastatin
Informational only, not medical advice. Pharmacogenetic guidance describes population-level patterns; your individual response depends on many factors. Never start, stop, or change a medication without talking to your prescribing clinician.