HEALTHY LIFESTYLE




Fluvastatin
Fluvastatin.JPG

Fluvastatin

CLINICAL USE

HMG CoA reductase inhibitor:Primary hypercholesterolaemia Slowing progression of atherosclerosis Secondary prevention of coronary events after percutaneous coronary intervention

DOSE IN NORMAL RENAL FUNCTION

20–80 mg daily in the eveningXL: 80 mg daily

PHARMACOKINETICS

  • Molecular weight                           :433.4 (as sodium salt)
  • %Protein binding                           :>98
  • %Excreted unchanged in urine     : 6
  • Volume of distribution (L/kg)       :0.35
  • half-life – normal/ESRD (hrs)      :1.4–3.2/–

    DOSE IN RENAL IMPAIRMENT

    GFR (mL/MIN)

  • 20 to 50     : Dose as in normal renal function
  • 10 to 20     : Dose as in normal renal function
  • <10           : Dose as in normal renal function

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

  • CAPD                :Removal unlikely. Dose as in normal renal function
  • HD                     :Removal unlikely. Dose as in normal renal function
  • HDF/high flux   :Removal unlikely. Dose as in normal renal function
  • CAV/VVHD      :Removal unlikely. Dose as in normal renal function

    IMPORTANT DRUG INTERACTIONS

    Potentially hazardous interactions with other drugs
  • Antibacterials: rifampicin increases metabolism; increased risk of myopathy with daptomycin
  • Anticoagulants: anticoagulant effect enhanced
  • Ciclosporin: concomitant treatment with ciclosporin may lead to risk of muscle toxicityColchicine: isolated cases of myopathy have been reportedLipid-lowering drugs: increased risk of myopathy with gemfibrozil, fibrates and nicotinic acid – avoid concomitant use with gemfibrozil

    ADMINISTRATION

    Reconstition

    Route

    Oral

    Rate of Administration

    Comments

    OTHER INFORMATION

    The Committee on Safety of Medicines has advised that rhabdomyolysis associated with lipid-lowering drugs, such as the fibrates and statins, appears to be rare (approx. 1 case in every 100 000 treatment years), but may be increased in those with renal impairment and possibly in those with hypothyroidismManufacturer’s literature indicates fluvastatin is contraindicated in patients with severe renal impairment (creatinine greater than or equal to 160 µmol/L).
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