Meta Information
ID:fluvastatin
Name:
Schema Version:AIM-2.0
Interactions
Target id:
/class/fibrates
Target name:
Fibrates
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
Combining fluvastatin with fibrates, particularly gemfibrozil, significantly increases the risk of severe muscle damage (myopathy) and a potentially fatal condition called rhabdomyolysis.
Actionable advice:
Avoid using fibrates with fluvastatin; if combination is essential, use fenofibrate only with extreme caution and close medical supervision.
Target id:
/class/cyp2c9-inhibitors
Target name:
Strong CYP2C9 Inhibitors (e.g., Fluconazole)
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
These drugs block the CYP2C9 enzyme, which is the primary pathway for breaking down fluvastatin. This leads to dangerously high levels of fluvastatin in the blood, increasing the risk of severe muscle toxicity.
Actionable advice:
Avoid using these drugs together. If a strong CYP2C9 inhibitor is medically necessary, fluvastatin therapy should be temporarily paused.
Target id:
/class/immunosuppressants
Target name:
Cyclosporine
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
Cyclosporine significantly inhibits the metabolism and transport of fluvastatin, leading to a large increase in its concentration and a very high risk of severe muscle damage.
Actionable advice:
Avoid this combination. If unavoidable, the dose of fluvastatin must be significantly reduced under strict medical supervision.
Target id:
/condition/pregnancy
Target name:
Pregnancy
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
Statins are contraindicated in pregnancy as they may cause fetal harm by interfering with cholesterol synthesis, which is critical for normal fetal development.
Actionable advice:
Do not take fluvastatin if you are pregnant, trying to conceive, or could become pregnant.
Target id:
/condition/lactation
Target name:
Breastfeeding (Lactation)
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
Due to the potential for interfering with infant development and causing serious adverse reactions, fluvastatin is contraindicated during breastfeeding.
Actionable advice:
Do not take fluvastatin while breastfeeding.
Target id:
/condition/hepatic-impairment
Target name:
Active Liver Disease
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
Fluvastatin is metabolized by the liver and can itself cause liver enzyme elevations; it is contraindicated in patients with active liver disease or unexplained high liver enzymes.
Actionable advice:
Do not use fluvastatin if you have active liver disease.
Target id:
/intervention/red-yeast-rice
Target name:
Red Yeast Rice
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
Red yeast rice contains monacolin K, a naturally occurring statin chemically identical to lovastatin. Taking it with fluvastatin constitutes duplicative therapy and greatly increases the risk of muscle and liver toxicity.
Actionable advice:
Never take red yeast rice supplements while on any prescribed statin medication.
Target id:
/circadian/sleep
Target name:
Going to Sleep
Severity:
moderate
Interaction type:
synergistic
Nature:
temporal
Temporal spacing:
Hours before target:
2
Hours after target:
null
Description:
The body's natural cholesterol production peaks overnight. Taking short-acting statins like fluvastatin in the evening aligns the drug's peak effect with this period, maximizing its cholesterol-lowering efficacy.
Actionable advice:
Take your daily dose of fluvastatin in the evening, ideally within a couple of hours of bedtime.
Target id:
/intervention/warfarin
Target name:
Warfarin
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
Fluvastatin can slightly inhibit the metabolism of warfarin (via CYP2C9), which may increase warfarin's blood-thinning effect and raise the risk of bleeding.
Actionable advice:
Your INR (blood clotting time) must be monitored closely when starting, stopping, or changing the dose of fluvastatin.
Target id:
/class/cyp2c9-inducers
Target name:
CYP2C9 Inducers (e.g., Rifampin, Carbamazepine)
Severity:
moderate
Interaction type:
diminishing
Nature:
absolute
Temporal spacing:
null
Description:
These drugs accelerate the CYP2C9 enzyme, causing the body to break down fluvastatin much faster. This can significantly reduce fluvastatin's effectiveness at lowering cholesterol.
Actionable advice:
Avoid this combination or anticipate the need for a higher fluvastatin dose with regular lipid monitoring.
Target id:
/intervention/colchicine
Target name:
Colchicine
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
Using colchicine (for gout) with fluvastatin increases the risk of developing muscle pain and damage (myopathy), particularly in older adults or those with kidney problems.
Actionable advice:
Use this combination with caution and immediately report any unexplained muscle pain, tenderness, or weakness.
Target id:
/intervention/niacin
Target name:
Niacin (Vitamin B3)
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
Combining fluvastatin with high doses of niacin (typically over 1 gram per day) can increase the risk of developing severe muscle problems (myopathy and rhabdomyolysis).
Actionable advice:
Use with caution, especially at niacin doses above 1g/day, and monitor for any muscle-related symptoms.
Target id:
/dietary/alcohol-acute
Target name:
Alcohol
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
Substantial, regular alcohol consumption can add to the potential for liver stress and damage when combined with statin therapy.
Actionable advice:
Limit alcohol intake and avoid heavy or daily drinking while taking fluvastatin.
Target id:
/condition/renal-impairment
Target name:
Severe Renal Impairment
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
In severe kidney disease, the body's ability to clear fluvastatin may be reduced, increasing drug levels and the risk of muscle-related side effects.
Actionable advice:
Use with caution in severe renal impairment; a lower starting dose and careful monitoring are required.
Target id:
/intervention/saint-johns-wort
Target name:
Saint John's Wort
Severity:
moderate
Interaction type:
diminishing
Nature:
absolute
Temporal spacing:
null
Description:
St. John's Wort induces metabolic enzymes, including CYP2C9, which can accelerate the breakdown of fluvastatin and significantly reduce its cholesterol-lowering effect.
Actionable advice:
Avoid taking St. John's Wort supplements while on fluvastatin therapy.
Target id:
/intervention/coenzyme-q10
Target name:
Coenzyme Q10 (CoQ10)
Severity:
minor
Interaction type:
synergistic
Nature:
absolute
Temporal spacing:
null
Description:
Fluvastatin inhibits the HMG-CoA reductase pathway, which is responsible for producing both cholesterol and CoQ10. This can lower the body's CoQ10 levels, and supplementation may help replenish them.
Actionable advice:
Consider supplementing with CoQ10 to potentially mitigate statin-related side effects like muscle fatigue.
Target id:
/intervention/glyburide
Target name:
Glyburide (Glibenclamide)
Severity:
minor
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
Fluvastatin may increase the concentration of the diabetes medication glyburide, which could raise the risk of experiencing low blood sugar (hypoglycemia).
Actionable advice:
Monitor blood glucose levels closely if you are taking these two medications together.
Target id:
/intervention/phenytoin
Target name:
Phenytoin
Severity:
minor
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
Fluvastatin may slightly inhibit the metabolism of the anti-seizure medication phenytoin, potentially leading to increased phenytoin levels and side effects.
Actionable advice:
Your doctor may need to monitor phenytoin levels if fluvastatin is started, stopped, or the dose is changed.
Target id:
/class/acid-suppressors
Target name:
Gastric Acid Suppressors (PPIs, H2 Blockers)
Severity:
minor
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
Drugs like cimetidine, ranitidine, and omeprazole can increase the absorption and peak concentration of fluvastatin, though the clinical impact on safety or efficacy is generally minimal.
Actionable advice:
Be aware of this potential interaction, but no specific scheduling or avoidance is typically required.
Target id:
/dietary/grapefruit-pomelo
Target name:
Grapefruit and Grapefruit Juice
Severity:
minor
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
Unlike many other statins (e.g., atorvastatin, simvastatin), fluvastatin is primarily metabolized by CYP2C9, not CYP3A4. Therefore, the interaction with grapefruit is not considered clinically significant.
Actionable advice:
No special precautions are needed regarding grapefruit consumption while taking fluvastatin.
Target id:
/dietary/meal
Target name:
Food
Severity:
minor
Interaction type:
diminishing
Nature:
absolute
Temporal spacing:
null
Description:
Taking immediate-release fluvastatin with food can delay its absorption and reduce its peak concentration in the blood, but the overall long-term lipid-lowering effect is not significantly changed.
Actionable advice:
Fluvastatin can be taken with or without food, but try to be consistent from day to day.