Fluvastatin

What is fluvastatin used for?

Fluvastatin belongs to a group of lipid-regulating medicines called statins. It is used in combination with a healthy diet and lifestyle to reduce the level of  “bad” cholesterol (LDL) in the blood and to raise the level of “good cholesterol” (HDL). It is prescribed to patients at high risk of developing heart disease, heart attack or stroke.

How does fluvastatin work?

Cholesterol is produced by the liver and plays a vital role in the functioning of all cells in the body. A high level of high-density lipoprotein (HDL), known as “good cholesterol”, is good for you, but a high level of low-density lipoprotein (LDL), or “bad” cholesterol, can contribute to blocked arteries, which can lead to a heart attack or stroke. The best way to prevent heart disease & stroke is to eat a healthy diet that is low in saturated fats and to exercise regularly. Alongside these measures, fluvastatin is prescribed to people at high risk of heart disease and works by reducing the amount of LDL produced in the liver.

How long does it take for fluvastatin to work?

If fluvastatin is taken correctly cholesterol levels should begin to drop within four weeks. Statins are most effective when taken over a long period of time and when accompanied by the appropriate lifestyle changes.

How do I know if fluvastatin is working?

You will not be able to feel fluvastatin working, but your doctor may wish to conduct regular blood tests to monitor your cholesterol level during treatment. The effectiveness of fluvastatin is somewhat dependent on the lifestyle of the patient, and it is therefore imperative to maintain a low-fat diet when taking this medication.

How effective is fluvastatin?

When accompanied by a healthy, low-fat diet, regular exercise and weight loss where necessary, fluvastatin is considered to be a safe and effective means of treating high cholesterol.

Active ingredients

The active ingredient in fluvastatin is fluvastatin sodium.

Inactive ingredients

The inactive ingredients in fluvastatin are calcium carbonate, cellulose microcrystalline, pregelatinised starch, talc, sodium hydrogen carbonate, magnesium stearate, gelatin, titanium dioxide (E 171), iron oxide red (E 172) and sodium lauryl sulphate.

Please note: different brands of generic fluvastatin may contain different inactive ingredients than those listed here.

How to take fluvastatin?

Always take fluvastatin as instructed by a doctor. Before starting this medication, your doctor will counsel you on a low-cholesterol diet, which you should follow for the duration of treatment. Fluvastatin can be taken with or without food at the same time each day. To help you remember, try and make this a part of your daily routine.

If you forget to take a dose, just take it when you remember. However, do not take it if there is less than 4 hours before your next dose. In this case, take your next dose at the usual time.

Do not take a double dose to make up for a missed dose.

Fluvastatin dosage

Fluvastatin is available in 20 mg, 40 mg and 80 mg tablets. 20mg and 40mg tablets are available from Dr Felix. A doctor will prescribe the correct dose for you, which may be increased at intervals of fore weeks or more if necessary.

Fluvastatin side effects

If you experience either of the following, stop taking this medication and consult a doctor immediately:

• Signs of an allergic reaction, including swelling of the face, lips, tongue or throat, difficulty breathing, sudden wheezing, severe rash or itching, high fever
• Joint pain or inflammation
• Skin eruptions or inflammation, hives or sudden sensitivity to sunlight
• Sudden muscle pain or weakness
• Unexpected bruising or bleeding
• Yellow discolouration of the skin or eyes, itching, dark-coloured urine or pale-coloured stool
• Abdominal pain

Common or very common side effects (occurring in less than 1 in 10 people)

• Weakness or aching muscles
• Changed to bowel habit
• Dizziness
• Flatulence
• Abdominal discomfort
• Headache
• Nausea
• Difficulty sleeping
• Thrombocytopenia (low platelets, manifested by easily bruising)

Uncommon side effects:

• Hair loss (alopecia)
• Liver disorders
• Memory loss
• Pancreatitis (inflammation of the pancreas, manifested by upper abdominal pain)
• Numbness (paraesthesia)
• Sexual dysfunction
• Skin reactions
• Vomiting

Rare or very rare side effects:

• Muscle pain (myopathy)
• Tingling or pins and needles sensations
• Tendon pain
• Facial oedema

Frequency not known:

• Depression
• Diabetes (in those at risk of diabetes)
• Interstitial lung disease

Contraindications

Do NOT take fluvastatin if you are:

• Allergic to any of the ingredients
• Pregnant or may become pregnant whilst taking fluvastatin
• Breastfeeding
• Taking any medications that interact with fluvastatin (your doctor should be able to advise you on this)

Before taking fluvastatin, tell your doctor and take special care if you:

• Have a history of liver problems
• Have any kidney problems
• Have any thyroid problems
• Have a personal or family history of any disorder of the muscles
• Drink a lot of alcohol

Drug interactions

Before taking fluvastatin, tell your doctor if you are taking any other medicines, including those purchased over the counter without a prescription. In particular, tell your doctor if you are taking

• Fibrates e.g. bezafibrate, gemfibrozil, ciprofibrate
• Niacin
• Fusidic acid
• Colchicines
• Ciclosporin
• Fluconazole
• Rifampicin
• Phenytoin
• Blood thinners such as warfarin
• Glibenclamide

Fluvastatin and alcohol

You should limit the amount of alcohol you drink while taking this medication, as the combination of alcohol and fluvastatin can increase your risk of liver problems.

Fluvastatin and foods to avoid

Fluvastatin is not known to interact with any particular foods, however, you should aim to follow a low-cholesterol diet for maximum benefit.

Alternatives to fluvastatin

Statins are an effective means of lowering cholesterol and different people require different formulations. A consultation with a doctor will help determine which option is best for you. However, if your doctor does not think that statins are right for you they may recommend a different type of treatment.

Aspirin is sometimes prescribed at a low daily dose to help prevent blood clots from forming in patients at a high risk of cardiovascular disease (CVD). 

Alternatively, ezetimibe is a medication that blocks the absorption of cholesterol from food and bile juices into your blood. It can be taken alone or in combination with a statin, and although it is not as effective as statins, it is less likely to cause side effects.

You may be prescribed a bile acid sequestrant or a fibrate, which bind to bile acids in the intestine and stop them from being reabsorbed. Your body then uses up cholesterol to make bile acid, reducing the overall level in the blood.

Fluvastatin vs other statins

The 5 types of statin available on prescription in the UK are fluvastatin (Lescol), atorvastatin (Lipitor), pravastatin (Lipostat), rosuvastatin (Crestor) and simvastatin (Zocor). Different statins work differently for different people; if you are experiencing troublesome side effects, your doctor may recommend switching to a different type of statin. The main difference between statins is their lowering effect on cholesterol levels. Fluvastatin, pravastatin and simvastatin are low-intensity statins and are sufficient for lowering cholesterol in most patients. If your doctor feels that a higher dose is needed, they may suggest a high-intensity statin, such as atorvastatin or rosuvastatin.

Does fluvastatin have less side effects than other statins?

Fluvastatin may have fewer side effects than some other statins, although different people react differently to different statins. Your doctor will assess your medical history and decide which type of statin is best suited to you. If you experience troublesome side effects, speak to your doctor about the possibility of switching to a different type of statin.

Switching statins

Different types of statins are prescribed according to the patient’s cholesterol level. To begin with, a doctor will usually prescribe a low-intensity statin at a low dose which can be increased over time. If your doctor feels that you need a stronger dose, or if you are experiencing side effects with the treatment, they may suggest switching to another statin of a different intensity level. You should never stop taking statins or switch to a different variant without the instruction of a doctor.

Lifestyle changes to make when taking fluvastatin

Making a few lifestyle changes is the best way to reduce LDL in your blood and will also greatly increase the effectiveness of statins. Your doctor will recommend that you follow a low-cholesterol diet while using this medication. Try to cut down on foods that are high in saturated fats, including fatty cuts of meat and processed meats, butter, lard, cream, ice cream, cheese, cakes, biscuits and chocolate. If you are overweight, the best way to lower your cholesterol is to lose weight healthily and according to an approved diet plan. Exercising regularly is also extremely beneficial and will improve your general wellbeing. You should also try to cut down on alcohol and caffeine and, if you haven’t done so already, quit smoking.

Will I have to take fluvastatin forever?

Fluvastatin is intended for long-term use and indeed works better when taken over a period of several years. Many people do continue taking statins for the rest of their life, as cholesterol levels tend to rise again once they are stopped. For patients at high risk of developing heart disease, such as those with a history of heart attack or stroke, coming off of statins can be extremely dangerous. For this reason, statins are usually prescribed to patients at a continuously high risk of heart disease.