Fluvastatin
Hypolipidaemic/Anti-atheroma · HMG-CoA reductase inhibitor
Indications
Adjunct to diet to reduce total cholesterol, LDL-cholesterol, apolipoprotein B and triglyceride levels in primary hypercholesterolaemia and mixed dyslipidaemia. To slow the progression of coronary atherosclerosis in patients with primary hypercholesterolaemia and concomitant coronary heart disease unresponsive to diet. Secondary prevention of coronary events after percutaneous coronary intervention.
Dosage
Adults: Hyperlipidaemia: 40 mg daily at night; may be increased if necessary to 80 mg daily, usual dose 20-40 mg once daily. Following percutaneous coronary intervention: 80 mg daily. Children: Under 9 yr, not recommended. Heterozygous familial hypercholesterolaemia: 9-18 yr, initially 20 mg daily in the evening, adjusted in steps of 20 mg daily at intervals of at least 6 wk, max 80 mg/day (40 mg twice daily).
Adverse Effects
GI disturbances, sinusitis, hypoesthesia, UTIs, insomnia, tooth disorders. Rarely abnormal liver function tests, myopathy, myalgia, angioedema, thrombocytopenia, muscle toxicity, headache, fatigue, dizziness, arthralgia, insomnia. Raised creatine kinase. Reports of depression, memory loss, sexual dysfunction and immune-mediated necrotising myopathy.
Risk Factor (Pregnancy/Lactation)
Pregnancy: Contraindicated in pregnancy. Lactation: Contraindicated or not recommended. Contraindications: Severe renal impairment. Active liver disease, hepatic impairment, undiagnosed persistent elevations in serum transaminases. Women of child bearing potential unless they are taking adequate contraceptive precautions. Precautions: History of liver disease or alcoholism. Perform liver function tests before and during therapy. Discontinue therapy if marked increase in aspartate or alanine transaminases or creatine phosphokinase. Renal impairment, hypothyroidism, history of muscle toxicity or muscle disorders, sepsis, hypotension, major surgery, severe metabolic, endocrine or electrolyte dysfunction, elderly. Risk of interstitial lung disease; advise patients to report symptoms incl dyspnoea, non-productive cough, fatigue, wt loss and fever. Risk of new onset diabetes; risk factors…
Interactions
Immunosuppressive drugs, nicotinic acid, erythromycin, rifampicin, cimetidine, ranitidine, gemfibrozil and other fibrates, cyclosporin, substrates or inhibitors of CYP2C9, glibenclamide, coumarin anticoagulants, phenytoin, colchicine, fluconazole, with or within 7 days of systemic fusidic acid.
Advice to Patient
Take with or without meals. Do not chew or crush extended release forms, swallow whole. Contact prescriber if there is muscle pain, cramps, weakness, memory loss, personality changes, depression, numbness, tingling or pain in extremities. Take low-fat diet. Follow monthly laboratory tests early in treatment.
Pharmacokinetics
Absorption: Rapidly and completely absorbed from the GI tract. Metabolism: Undergoes extensive first-pass metabolism in the liver. Bioavailability: Absolute: 24%. Half-life elimination: 1-3 hrs. ER: 9 hrs. Time to peak, plasma: Oral: <1 hr. ER tab taken with high-fat meal: 6 hrs. Excretion: Faeces (98%; mainly as metabolites). Urine (6%).
Brands with this active ingredient
Compiled by Healify Pharmacy from published drug references. How we compile it →
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