Fluvastatin

About Fluvastatin

Fluvastatin blocks HMG-CoA reductase, the liver enzyme that makes cholesterol. The labels approve it, with diet, to lower LDL cholesterol in adults and in children with heterozygous familial hypercholesterolemia (ages 10 to 16 on the capsule label, girls at least one year after their first period; 10 and older on the tablet labels), and, in adults with coronary heart disease, to lower the chance of needing an artery reopened and to slow atherosclerosis. Adults usually start on one 40 mg capsule in the evening, one 40 mg capsule twice a day, or one 80 mg extended-release tablet once a day; children start on one 20 mg capsule, adjusted every six weeks. Lipids are checked after about four weeks.

There is no boxed warning. Statins can cause muscle injury and, rarely, rhabdomyolysis, a muscle breakdown that can harm the kidneys; the risk is higher at 65 and older, with untreated low thyroid function or kidney disease, and with some other medicines. A rare autoimmune muscle disease has been reported. Liver enzyme tests are considered before starting, and statins can raise blood sugar. The tablet must not be used in acute liver failure or decompensated cirrhosis, and the capsule must not be used with active liver disease or unexplained, lasting liver enzyme rises. Common side effects include headache, indigestion, nausea, abdominal pain, diarrhea, muscle aches, flu-like symptoms and trouble sleeping.

What is distinctive is the two forms. The tablet comes only as 80 mg, is swallowed whole, never broken or crushed, and is not used to start treatment in children; capsules are not opened, and two 40 mg capsules are never taken at once. With cyclosporine or fluconazole the capsule label caps the dose at 20 mg twice a day, and the Lescol XL label says to avoid them. The extended-release tablet labels dropped pregnancy and breastfeeding as contraindications in November 2023 but still say to stop it once pregnancy is recognized and not to breastfeed; the generic capsule label still lists both. It is not a controlled substance.

Taking Fluvastatin

How to take it

Take capsules in the evening or twice a day, and the tablet once a day, with or without food at the same time each day. Swallow tablets whole and do not open capsules.

If you miss a dose

Take the missed dose as soon as you remember, but if more than 12 hours have passed since your last dose, skip it and go back to your usual schedule. Do not take a double dose.

Storage

Keep it tightly closed in the original container at room temperature, 20 to 25 degrees C (68 to 77 degrees F), away from light and moisture and out of reach of children.

Interactions to know about

Gemfibrozil is avoided, and cyclosporine and fluconazole limit or rule out use. Niacin, other fibrates and colchicine add muscle risk; warfarin, glyburide and phenytoin need monitoring. Tell the pharmacist about every medicine.

This summarizes the official prescribing information. Your prescriber’s and pharmacist’s instructions, and the leaflet that comes with your medicine, take priority.

Why the cash price for Fluvastatin differs from pharmacy to pharmacy

Few makers supply fluvastatin, so a quote depends on whether the pharmacy stocks it or orders it in, which maker it buys from and its own cash pricing. Capsules and extended-release tablets are separate products: a quote for 40 mg capsules twice a day is not a quote for one 80 mg tablet, and a pharmacist cannot switch between them without a new prescription. Lescol XL with substitution blocked is priced as a brand and costs far more than a generic tablet.

Bottle sizes differ by maker, and on a single month’s fill the dispensing fee is a noticeable share of the quote.

Ways to pay less for Fluvastatin without insurance

• If the prescription is for Lescol XL, ask the prescriber to allow substitution, since AB rated generic 80 mg extended-release tablets can be dispensed in its place.
• Once the dose is settled, ask the prescriber whether a ninety-day supply is appropriate.
• Compare quotes from more than one pharmacy, since some may need to order fluvastatin in.
• Ask the prescriber whether another generic statin, such as pravastatin or rosuvastatin, would suit you if fluvastatin is hard to find.
• Upload the prescription to Script Unlock so licensed pharmacies can quote their cash price. You pay the pharmacy directly.

Questions to ask your pharmacist about Fluvastatin

1. 1.Is my fluvastatin a capsule or an extended-release tablet, and how many times a day do I take it?
2. 2.Do any of my medicines, such as cyclosporine, fluconazole, gemfibrozil, niacin or colchicine, change my statin dose or risk?
3. 3.Which muscle or liver symptoms mean I should call my doctor right away?
4. 4.I take warfarin or a diabetes medicine; do I need extra blood tests when I start fluvastatin?

Related medications