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What is
Fluvastatin sodium?
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Fluvastatin
(Fluvastatin sodium, Canef) is in a class of
medications called HMG-CoA reductase inhibitors (statins);
used to treat hypercholesterolemia and to prevent
cardiovascular disease. It has also been shown to
exhibit antiviral activity against Hepatitis C.
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How does Fluvastatin
sodium work? |
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Pending revision, the material in
this section should be considered in light of more
recently available information in the MedWatch
notification at the beginning of this monograph.
Fluvastatin is used together with lifestyle changes
(diet, weight-loss, exercise) to reduce the amount
of cholesterol (a fat-like substance) and certain
other fatty substances in the blood.
Fluvastatin Sodium
is indicated as an adjunct to diet for the reduction
of elevated total-C, LDL-C, apo B and TG levels in
patients with primary hypercholesterolaemia and
mixed dyslipidaemia (Fredrickson types IIa and IIb).
Fluvastatin sodium
reduces the amount of cholesterol produced in the
body. In people with high cholesterol it can help to
prevent certain heart and circulation events such as
a heart attack or stroke.
It may also be
useful in reducing the chances of having certain
heart and circulation events, such as a heart attack
or stroke, in people who have already had them.
Fluvastatin Sodium
is also indicated to slow the progression of
coronary atherosclerosis in patients with primary
hypercholesterolaemia and concomitant coronary heart
disease who do not adequately respond to dietary
control.
Fluvastatin Sodium
is also indicated in patients with coronary heart
disease for the secondary prevention of coronary
events after percutaneous coronary intervention
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Who should not use Fluvastatin sodium? |
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Your prescriber may
only prescribe this medicine with special care or
may not prescribe it at all if you:
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are allergic or sensitive to or have had a
reaction to any of the ingredients in the
medicine |
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drink alcohol heavily |
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have had muscular toxicity caused by a statin or
a fibrate |
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have or have had liver problems |
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have risk factors for developing muscle problems
such as if you are over 70 years of age, have
kidney problems, have hypothyroidism, have
muscle disorders or have a family history of
muscle disorders |
Furthermore, the prescriber may not prescribe this medicine for someone
who is under 18 years of age.
As part of the
process of assessing suitability to take this
medicine a prescriber may also arrange tests:
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to determine whether or not the medicine is
suitable and whether it must be prescribed with
extra caution |
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to check that this medicine is having the
desired effect |
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to check that this medicine is not having any
undesired effects |
Over time it is
possible that Fluvastatin sodium can become
unsuitable for some people, or they may become
unsuitable for it. If at any time it appears that
Fluvastatin sodium has become unsuitable, it is
important that the prescriber is contacted
immediately. |
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How should I use Fluvastatin sodium? |
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Prior to initiating
Fluvastatin Sodium, secondary causes of
hypercholesterolaemia should be excluded, and the
patient placed on a standard cholesterol-lowering
diet. Dietary therapy should be continued during
treatment.
•Dose
recommendations for lipid lowering effect
The recommended
starting dose is 40 mg (1 capsule Fluvastatin Sodium
40 mg) once daily in the evening, although a dose of
20 mg fluvastatin (1 capsule Fluvastatin Sodium 20
mg) once daily may be adequate in mild cases. Most
patients will require a dose of 20 mg to 40 mg once
daily but the dose may be increased to 80 mg daily
(1 tablet Fluvastatin Sodium XL 80 mg or 1 capsule
Fluvastatin Sodium 40 mg twice daily),
individualized according to baseline LDL-C levels
and the recommended goal of therapy to be
accomplished. The maximum recommended daily dose is
80 mg.
The maximum
lipid-lowering effect with a given dose of the drug
is achieved within 4 weeks. Doses should be adjusted
according to the patient's response and dose
adjustment made at intervals of 4 weeks or more. The
therapeutic effect of Fluvastatin Sodium is
maintained with prolonged administration.
For patients
requiring a dose of 40 mg twice daily, a calendar
pack of 56 Fluvastatin Sodium Capsules 40 mg is
available containing morning and evening doses in
marked blister strips
Fluvastatin Sodium
is efficacious in monotherapy or in combination with
bile acid sequestrants. When Fluvastatin Sodium is
used in combination with cholestyramine or other
resins, it should be administered at least 4 hours
after the resin to avoid a significant interaction
due to binding of the drug to the resin. Minimal
data exist to support the efficacy and safety of
Fluvastatin Sodium in combination with nicotinic
acid or fibrates.
•Dose
recommendations for slowing the progression of
coronary atherosclerosis
In a study in
patients with primary hypercholesterolaemia and
concomitant coronary heart disease 40 mg daily
slowed the progression of coronary atherosclerosis.
•Dose
recommendations for the secondary prevention of
coronary events after percutaneous coronary
intervention
In patients with
coronary heart disease after percutaneous coronary
intervention, the dose is 80 mg daily.
Patients with
impaired kidney function
Fluvastatin is
cleared by the liver, with less than 6% of the
administered dose excreted into the urine. The
pharmacokinetics of fluvastatin remain unchanged in
patients with mild to severe renal insufficiency
(creatinine > 260 µmol/L). No dose adjustments are
therefore necessary in these patients.
Patients with
impaired liver function
Fluvastatin Sodium
is contraindicated in patients with active liver
disease, or unexplained, persistent elevations in
serum transaminases.
USE IN THE
ELDERLY
There is no
evidence of reduced tolerability or altered dosage
requirements in elderly patients.
USE IN CHILDREN
As there is no
experience with the use of Fluvastatin Sodium in
individuals less than 18 years of age, its use is
contraindicated in this group. |
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What happens if I miss a Fluvastatin sodium dose?
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Take the missed
Fluvastatin sodium dose as soon as you remember it.
However, if it is almost time for the next dose,
skip the missed dose and continue your regular
dosing schedule. Do not take a double dose to make
up for a missed one. |
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What happens if I overdose?
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The experience with
overdoses of Fluvastatin Sodium is very limited.
Should an accidental overdosage occur,
administration of activated charcoal is recommended.
In the case of a very recent oral intake gastric
lavage may be considered. Treatment should be
symptomatic. |
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What should I avoid while using Fluvastatin sodium? |
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Before
taking fluvastatin,
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tell your doctor and pharmacist
if you are allergic to fluvastatin or any other
medications. |
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tell your doctor and pharmacist
what prescription and nonprescription
medications, vitamins, nutritional supplements,
and herbal products you are taking or plan to
take. Be sure to mention any of the following:
anticoagulants ('blood thinners') such as
warfarin; cimetidine (Tagamet); cyclosporine
(Neoral, Sandimmune); diclofenac (Cataflam,
Voltaren); digoxin (Lanoxin); erythromycin (E.E.S.,
E-Mycin, Erythrocin); glyburide (DiaBeta,
Glynase, Micronase); ketoconazole (Nizoral);
omeprazole (Prilosec); other
cholesterol-lowering medications such as
fenofibrate (Tricor) and gemfibrozil (Lopid);
phenytoin (Dilantin); ranitidine (Zantac);
rifampin (Rifadin, Rimactane); and
spironolactone (Aldactone). Your doctor may need
to change the doses of your medications or
monitor you carefully for side effects.
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if you are taking cholestyramine
(Questran), take it at least 4 hours before
fluvastatin. |
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tell your doctor if you have
liver disease. Your doctor will probably tell
you not to take fluvastatin. |
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tell your doctor if you drink
large amounts of alcohol and if you have ever
had liver or have or ever had diabetes or
thyroid or kidney disease. |
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tell your doctor if you are
pregnant, or plan to become pregnant. If you
become pregnant while taking fluvastatin, stop
taking fluvastatin and call your doctor
immediately. Fluvastatin may harm the fetus.
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do not breastfeed while you are
taking this medication. |
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if you are having surgery,
including dental surgery, tell the doctor or
dentist that you are taking fluvastatin.
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ask your doctor about the safe
use of alcoholic beverages while you are taking
fluvastatin. Alcohol can increase the risk of
serious side effects. |
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What are the possible side effects of Fluvastatin sodium? |
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Fluvastatin may cause side effects.
Tell your doctor if any of these symptoms are severe
or do not go away:
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headache |
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heartburn |
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difficulty falling asleep or
staying asleep |
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sinus pain |
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cough |
Some side effects can be serious.
The following symptoms are uncommon, but if you
experience any of them, call your doctor
immediately:
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muscle pain, tenderness, or
weakness |
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lack of energy
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fever |
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yellowing of the skin or eyes
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pain in the upper right part of
the stomach |
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nausea |
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extreme tiredness
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unusual bleeding or bruising
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loss of appetite
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flu-like symptoms
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rash |
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hives |
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itching |
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difficulty breathing or
swallowing |
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swelling of the face, throat,
tongue, lips, eyes, hands, feet, ankles, or
lower legs |
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hoarseness |
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pain during urination
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frequent urge to urinate
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Fluvastatin may cause other side
effects. Call your doctor if you have any unusual
problems while taking this medication.
If you experience a serious side
effect, you or your doctor may send a report to the
Food and Drug Administration's (FDA) MedWatch
Adverse Event Reporting program online [at http://www.fda.gov/MedWatch/index.html]
or by phone [1-800-332-1088]. |
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What other drugs will affect Fluvastatin sodium? |
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The following
medicines may interact with Fluvastatin sodium:
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amlodipine |
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bezafibrate |
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ciclosporin |
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cimetidine |
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ciprofibrate |
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colchicine |
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colestyramine |
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erythromycin |
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fluconazole |
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gemfibrozil |
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glibenclamide |
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itraconazole |
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nicotinic acid |
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omeprazole |
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phenytoin |
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ranitidine |
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rifampicin |
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warfarin |
The following types
of medicine may interact with Fluvastatin sodium:
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bile acid sequestrants |
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coumarin anticoagulants |
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fibrates |
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immunosuppressant medicines |
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liver enzyme inhibitors |
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nicotinic acid derivatives |
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What special dietary instructions
should I follow?
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Eat a low-cholesterol, low-fat diet,
which includes cottage cheese, fat-free milk, fish,
vegetables, poultry, and egg whites. Use
monounsaturated oils such as olive, peanut, and
canola oils or polyunsaturated oils such as corn,
safflower, soy, sunflower, cottonseed, and soybean
oils. Avoid foods with excess fat in them such as
meat (especially liver and fatty meat), egg yolks,
whole milk, cream, butter, shortening, pastries,
cakes, cookies, gravy, peanut butter, chocolate,
olives, potato chips, coconut, cheese (other than
cottage cheese), coconut oil, palm oil, and fried
foods. |
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Where can I get more information? |
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If you
have questions about the medicine you are taking or
would like more information, check with your doctor,
pharmacist, or other health care provider |
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Fluvastatin
sodium Storage |
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Do not store above
25°C. |
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Nursing Mothers use of Fluvastatin sodium |
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In the case of
Fluvastatin sodium, women who
are breast-feeding must not take this medicine
Before you have your
baby you should discuss breast-feeding with your
doctor or midwife. If you wish to breast-feed you
should discuss with your prescriber whether there
are any other medicines you could take which would
also allow you to breast-feed. You should not stop
this medicine without taking advice from your
doctor. |
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Pregnancy
and use of Fluvastatin sodium |
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In the case of
Fluvastatin sodium you must
not take Fluvastatin sodium during pregnancy. If you
could become pregnant, you must use effective
contraception or abstain from penetrative sex. You
must contact your prescriber if you become pregnant,
or think you have become pregnant, while taking
Fluvastatin sodium
This medicine is not
suitable during pregnancy. It is essential that you
seek urgent medical advice if you become pregnant or
think you have become pregnant while taking this
medicine.
If you are planning
to become pregnant, you should discuss your personal
circumstances with your doctor so that together you
can make a decision about what treatment you may
need during your pregnancy. |
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Disclaimer:
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Information on this
page is provided for general information purposes.
You should not make a clinical treatment decision
based on information contained in this page without
consulting other references including the package
insert of the drug, textbooks and where relevant,
expert opinion. We cannot be held responsible for
any errors you make in administering drugs mentioned
on this page, nor for use of any erroneous
information contained on this page. |
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