Fluvastatin

Indications

Fluvastatin is used for: Hyperlipidaemias, Hypercholesterolemia

Adult Dose

Oral Hypercholesterolemia & Mixed Dyslipidemia Adult: Initially, 20-40 mg once daily in the evening, may increase at intervals of 4 wk to max 80 mg/day in 12hrly divided dose. Hepatic Impairment Contraindicated in active liver disease or unexplained transaminase elevations

Child Dose

Oral Hyperlipidaemias Child: Heterozygous familial hypercholesterolaemia: 10-16 yr 20 mg once daily. If necessary, may increase dose at 6-wkly intervals to 40 mg bid or 80 mg once daily as modified-release.

Renal Dose

Renal Impairment CrCl <30 mL/min: Adjust dose amount; not to exceed 40 mg/day

Administration

May be taken with or without food.

Contra Indications

Acute liver disease; unexplained persistently raised serum aminotransferase concentrations; porphyria; pregnancy; lactation.

Precautions

History of liver disease; high alcohol intake. Manage hypothyroidism adequately before starting treatment. Report unexplained muscle pain. Monitor LFTs. Discontinue in case of marked or persistent increase in serum aminotransferase or creatine phosphokinase. Severe renal impairment. Lactation: enters breast milk; contraindicated

Pregnancy-Lactation

Pregnancy Category: X Lactation: enters breast milk; contraindicated

Interactions

Bleeding and increased prothrombin time w/ coumarin anticoagulants. May increase the risk of myopathy and rhabdomyolysis w/ HIV protease inhibitors, colchicine, bezafibrate, ciprofibrate or niacin (nicotinic acid), ciclosporin and fluconazole. Reduced bioavailability w/ concomitant rifampicin.

Adverse Effects

Side effects of Fluvastatin : 1-10% Headache (9%), Dyspepsia (8%), Abdominal pain (5%), Diarrhea (5%), Myalgia (5%), Fatigue (3%), Insomnia (3%), Nausea (3%), Sinusitis (3%), Bronchitis (2%), UTI (2%), Transaminases increased (1.1%) <1% Rash, Back pain, Arthralgia, Myopathy, Rhabdomyolysis, Rupture of tendon, CPK increased, Pharyngitis, Rhinitis, Cough, Constipation, Pancreatitis, Dizziness

Mechanism of Action

Fluvastatin acts by competitively inhibiting HMG-CoA reductase, the enzyme for cholesterol synthesis. It reduces total cholesterol, triglycerides, LDL and VLDL concentrations in plasma. It also increases HDL concentrations.