หน้าหลัก | สุขภาพดี | สุภาพสตรี | การแปลผลเลือด | โรคต่างๆ | วัคซีน | อาหารเพื่อสุขภาพ
Dosage Forms & Strengths
Hypercholesterolemia & Mixed Dyslipidemia
Start 20-40 mg PO qHS
Dose range 20-80 mg PO qDay
If 80 mg/day needed, divide into 40 mg PO q12hr
Sustained-release (Lescol XL): 80 mg PO qDay
Patients Requiring <25% Decrease in LDL-C
20 mg PO qDay; may adjust dose based on response and tolerability not to exceed 40 mg PO q12hr (immediate release capsule) or 80 mg PO q24hr extended release tablet
Renal Impairment
CrCl <30 mL/min: Adjust dose amount; not to exceed 40 mg/day
Hepatic Impairment
Contraindicated in active liver disease or unexplained transaminase elevations
Overdose Management
Adverse drug reactions from overdose may include peripheral neuropathy, diarrhea, increased K+, myopathy, rhabdomyolysis, acute renal failure, elevated LFT's, eye lens opacities
Treatment is supportive
Contraindicated (2)
- gemfibrozil
- red yeast rice
Serious - Use Alternative (11)
- clarithromycin
- colchicine
- cyclosporine
- eltrombopag
- fenofibrate
- fenofibrate micronized
- fenofibric acid
- gemfibrozil
- glyburide
- mifepristone
- niacin
Significant - Monitor Closely (58)
- axitinib
- carbamazepine
- caspofungin
- cholestyramine
- cimetidine
- clotrimazole
- daclatasvir
- daclizumab
- daptomycin
- digoxin
- efavirenz
- elbasvir/grazoprevir
- eltrombopag
- elvitegravir/cobicistat/emtricitabine/tenofovir df
- erythromycin base
- erythromycin ethylsuccinate
- erythromycin lactobionate
- erythromycin stearate
- flibanserin
- fluoxetine
- fluvoxamine
- fosphenytoin
- glyburide
- imatinib
- indinavir
- ivacaftor
- ketoconazole
- lanthanum carbonate
- lomitapide
- lumacaftor/ivacaftor
- mesterolone
- mipomersen
- nelfinavir
- nitisinone
- ombitasvir/paritaprevir/ritonavir
- ombitasvir/paritaprevir/ritonavir & dasabuvir
- paclitaxel
- pazopanib
- peginterferon alfa 2b
- phenytoin
- pioglitazone
- ponatinib
- ranolazine
- regorafenib
- repaglinide
- rifampin
- ritonavir
- rosiglitazone
- sacubitril/valsartan
- saquinavir
- sildenafil
- sofosbuvir/velpatasvir
- tacrolimus
- telithromycin
- telmisartan
- teriflunomide
- valsartan
- warfarin
Minor (34)
- amiodarone
- bosentan
- carbamazepine
- cimetidine
- clopidogrel
- coenzyme q10
- colestipol
- disulfiram
- divalproex sodium
- esomeprazole
- etravirine
- fluconazole
- hexobarbital
- isradipine
- ketoconazole
- leflunomide
- mephobarbital
- metronidazole
- miconazole vaginal
- nateglinide
- nilotinib
- omeprazole
- orlistat
- phenobarbital
- primidone
- rifampin
- rifapentine
- ruxolitinib
- secobarbital
- sitaxentan
- sulfamethoxazole
- valproic acid
- voriconazole
- zafirlukast
Adverse Effects
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
Postmarketing Reports
Musculoskeletal: Muscle cramps, myalgia, myopathy, rhabdomyolysis, arthralgias, muscle spasms, muscle weakness, myositis
Neurological: Dysfunction of certain cranial nerves (including alteration of taste, impairment of extra-ocular movement, facial paresis), tremor, dizziness, vertigo, paresthesia, hypoesthesia, dysesthesia, peripheral neuropathy, peripheral nerve palsy; also rare reports of cognitive impairment (eg, memory loss, forgetfulness, amnesia, memory impairment, confusion) associated with statin use
Psychiatric: Anxiety, insomnia, depression, psychic disturbances
Hypersensitivity reactions: Hypersensitivity syndrome including anaphylaxis, angioedema, lupus erythematosus-like syndrome, polymyalgia rheumatica, vasculitis, purpura, thrombocytopenia, leukopenia, hemolytic anemia, positive ANA, increased ESR, eosinophilia, arthritis, arthralgia, urticaria, asthenia, photosensitivity reaction, fever, chills, flushing, malaise, dyspnea, toxic epidermal necrolysis, and erythema multiforme including Stevens-Johnson syndrome
Gastrointestinal: Pancreatitis, hepatitis, including chronic active hepatitis, cholestatic jaundice, fatty change in liver, cirrhosis, fulminant hepatic necrosis, hepatoma, anorexia, vomiting, fatal and nonfatal hepatic failure
Skin: Rash, dermatitis, including bullous dermatitis, eczema, alopecia, pruritus, a variety of skin changes (eg, nodules, discoloration, dryness of skin/mucous membranes, changes to hair/nails)
Reproductive: Gynecomastia, loss of libido, erectile dysfunction
Eye: Progression of cataracts (lens opacities), ophthalmoplegia
Laboratory abnormalities: Elevated transaminases, alkaline phosphatase, gamma-glutamyl transpeptidase and bilirubin; thyroid function abnormalities
Warnings
Contraindications
Hypersensitivity to fluvastatin
Active liver disease, or unexplained elevated transminases
Pregnancy, lactation
Cautions
Non-serious and reversible cognitive side effects may occur
Increased blood sugar and glycosylated hemoglobin (HbA1c) levels reported with statin intake
Heavy alcohol use, history of liver disease, renal failure
Myopathy, risk of myopathy - incr by co-administration w/ fibrates, niacin, cyclosporine, macrolides, azole antifungals.
Withhold or discontinue treatment if myopathy develops, renal failure, or transaminase levels >3 times the upper limit of normal
Rare reports of immune-mediated necrotizing myopathy (IMNM), characterized by increased serum creatine kinase that persist despite discontinuing statin
Lipid-lowering effects additive with bile-acid binding resin or niacin
Take 2 hr after bile acid sequestrant
Pregnancy & Lactation
Pregnancy Category: X
Lactation: enters breast milk; contraindicated