Lescol, Lescol XL
Classifications: hmg-coa reductase inhibitor (statin); antilipemic agent; Therapeutic: cholesterol-lowering agent (statin)
Pregnancy Category: X
20 mg, 40 mg capsules; 80 mg extended release tablet
Inhibits reductase 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) that is essential to hepatic production of cholesterol.
Cholesterol-lowering effect triggers induction of LDL receptors, which promotes removal of LDL and VLDL remnants (precursors
of LDL) from plasma.
Results in an increase in plasma HDL concentration. HDLs collect excess cholesterol from body cells and transport it to the
liver for excretion.
Adjunct to diet for the reduction of elevated total LDL cholesterol in patients with primary hypercholesterolemia (Types IIa
Other types of hyperlipidemias.
Hypersensitivity to fluvastatin, lovastatin, pravastatin, or simvastatin; active liver disease or unexplained persistent elevated
liver function tests; pregnancy (category X), lactation; children ≤10 y.
Patients who consume substantial quantities of alcohol; history of liver disease; renal impairment.
Route & Dosage
Adult: PO 20 mg h.s., may increase up to 80 mg/d in 12 doses
- Give at bedtime.
- Ensure the extended release tablet is not chewed or crushed. It must be swallowed whole.
- Separate doses of this drug and bile-acid resin (e.g., cholestyramine) by at least 2 h when given concomitantly.
- Note: Dosage adjustments may be required in patients with significant renal or hepatic impairment.
- Store at room temperature, 15°30° C (59°86° F).
Adverse Effects (≥1%)CNS:
. Body as a Whole:
, abdominal pain. Skin:
May increase risk of bleeding with warfarin; cholestyramine
decreases fluvastatin absorption; rifampin
of fluvastatin; may increase risk of myopathy and rhabdomyolysis with gemfibrozil, fenofibrate, clofibrate.
Readily from GI tract; about 24% reaches systemic circulation after first-pass metabolism
36 wk. Peak: Serum
level 0.51 h. Distribution:
98% protein bound; distributed into breast milk. Metabolism:
In liver. Elimination:
95% in bile; 5% in urine. Half-Life:
Assessment & Drug Effects
- Lab tests: Monitor lipoprotein levels; maximal lipid-lowering effect occurs in 46 wk. Monitor serum transaminase and
CPK levels every 34 mo for the first year and periodically thereafter.
- Monitor PT & INR in patients on concurrent warfarin therapy; PT & INR may be prolonged.
Patient & Family Education
- Take fluvastatin at bedtime.
- Be alert & report signs of bleeding immediately when also taking warfarin.
- Notify physician immediately of the following: Fever; rash; muscle pain, weakness, tenderness, or cramping.
- Reduce or eliminate alcohol consumption while taking fluvastatin.