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[Pharmacology](https://durgical.com/en/pharmacology/) · [Statins](https://durgical.com/en/pharmacology/classes/statins/)

# Fluvastatin

A lower-potency statin metabolized mainly by CYP2C9 rather than CYP3A4. It lowers LDL moderately.

Updated 2026-11-01

- Class: [Statins](https://durgical.com/en/pharmacology/classes/statins/)
- Enzyme: HMG-CoA reductase
- ATC code: C10AA04
- WHO Model List of Essential Medicines

✂**HMG-CoA reductase**Fluvastatin

ⓘ The figure shows fluvastatin in the HMG-CoA pocket of the catalytic portion of human HMG-CoA reductase.

**Target in 3D:** HMG-CoA reductase. PDB structure 1HWI (RCSB PDB, public domain). [View the structure at RCSB PDB](https://www.rcsb.org/structure/1HWI) · Drag to rotate · pinch to zoom

## Mechanism of action

Fluvastatin competitively inhibits HMG-CoA reductase in the liver. Lower intracellular cholesterol activates SREBP-2, increases LDL receptors and lowers blood LDL.

- Occupies the HMG-CoA pocket of HMG-CoA reductase
- Liver cholesterol synthesis falls
- More LDL receptors clear LDL from the blood

## Pharmacokinetics

**Absorption**
Oral; capsules and an extended-release tablet exist.

**Metabolism**
Mainly by CYP2C9 (about 75%), with minor roles for CYP2C8 and CYP3A4; its metabolites are not significantly active.

**Elimination**
Mostly in feces as metabolites; very little in urine.

## Indications

- High LDL cholesterol and mixed dyslipidemia [Atherosclerosis and dyslipidaemia →](https://durgical.com/en/conditions/atherosclerosis-and-dyslipidaemia/)
- Heterozygous familial hypercholesterolemia, including in children and adolescents [Familial hypercholesterolemia →](https://durgical.com/en/conditions/familial-hypercholesterolemia/)
- Secondary prevention of coronary events after percutaneous coronary intervention

## Adverse effects

### Common

- Dyspepsia, abdominal pain
- Headache
- Muscle aches
- Raised liver transaminases

### Serious (rare, important)

- Myopathy and rhabdomyolysis (rare)
- Immune-mediated necrotizing myopathy (rare)

## Contraindications

- Active liver disease or unexplained persistent transaminase rises
- Pregnancy and breastfeeding
- Hypersensitivity to a component

## Key interactions

**Cyclosporine, fluconazole**
Raise fluvastatin exposure; the dose is limited.

**Gemfibrozil, other fibrates, niacin**
Add to the muscle risk.

**Warfarin**
Prothrombin time is checked when fluvastatin is started, stopped or changed.

**Glyburide, phenytoin**
Glucose or phenytoin levels are checked when the fluvastatin dose changes.

## What is monitored

- Lipid panel
- Liver enzymes
- Creatine kinase if there are muscle symptoms

## Administration and safety

- Oral; capsules and extended-release tablets are different products, and the prescribed form is checked.
- Separated from bile acid resins when both are used.
- Capsules (immediate release) are usually taken in the evening.

## Nursing care

- Before: lipid panel, liver enzymes, interacting drugs (fluconazole, cyclosporine, warfarin).
- Ask about muscle pain or weakness.
- Check the INR more often in patients on warfarin.
- Ask about pregnancy plans.

## Pregnancy and breastfeeding

Contraindicated in pregnancy and in women who may become pregnant, and not used while breastfeeding.

## Memory aid

«Flu-vastatin takes the 2C9 flight»: unlike the 3A4 statins, it travels through CYP2C9, so watch 2C9 partners such as fluconazole and phenytoin.

## Test yourself

Think of the answer, then tap the question to see it.

## Which CYP enzyme mainly metabolizes fluvastatin?

CYP2C9 (about 75%), unlike simvastatin, lovastatin and atorvastatin, which depend on CYP3A4.

## Which antifungal requires a fluvastatin dose limit?

Fluconazole, which raises fluvastatin exposure.

## In which coronary patients was fluvastatin shown to reduce recurrent cardiac events?

In patients with coronary heart disease after a percutaneous coronary intervention (PCI).

[Add to my cards (3)](https://durgical.app/estudiar/?add=/en/pharmacology/fluvastatin/)

## Related drugs

- [Rosuvastatin](https://durgical.com/en/pharmacology/rosuvastatin/)
- [Pravastatin](https://durgical.com/en/pharmacology/pravastatin/)
- [Lovastatin](https://durgical.com/en/pharmacology/lovastatin/)

## Related conditions

- [Atherosclerosis and dyslipidaemia](https://durgical.com/en/conditions/atherosclerosis-and-dyslipidaemia/)
- [Familial hypercholesterolemia](https://durgical.com/en/conditions/familial-hypercholesterolemia/)

[← Back to the class: Statins](https://durgical.com/en/pharmacology/classes/statins/)

Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.

Sources: [Fluvastatin: MedlinePlus Drug Information](https://medlineplus.gov/druginfo/meds/a694010.html) (MedlinePlus (U.S. National Library of Medicine), 2026); [DailyMed - FLUVASTATIN capsule](https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=ccd6bbe1-e293-4e1c-9ec4-e6c217612e77) (DailyMed (U.S. National Library of Medicine), 2026); [COMPLEX OF THE CATALYTIC PORTION OF HUMAN HMG-COA REDUCTASE WITH FLUVASTATIN](https://www.rcsb.org/structure/1HWI) (RCSB Protein Data Bank, 2001).

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Representative model, for educational purposes only.

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Source: https://durgical.com/en/pharmacology/fluvastatin/
License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/pharmacology/fluvastatin/