Lescol Xl (Fluvastatin Sodium)

Lescol XL is a statin that acts on the cholesterol synthesis pathway to treat dyslipidaemia and related cardiovascular conditions.

• Primary hypercholesterolemia: reduces LDL‑C and total cholesterol levels.
• Mixed dyslipidaemia: lowers triglycerides and raises HDL‑C while decreasing LDL‑C.
• Secondary prevention of cardiovascular disease: helps prevent myocardial infarction, stroke and revascularisation in patients with established atherosclerotic disease.
• Familial hypercholesterolaemia (heterozygous): provides additional LDL‑C reduction when diet and other therapies are insufficient.

• Fluvastatin Sodium competitively inhibits HMG‑CoA reductase, the key enzyme in hepatic cholesterol biosynthesis. This inhibition decreases intracellular cholesterol, leading to up‑regulation of LDL receptors on hepatocyte surfaces, which enhances clearance of circulating LDL particles and lowers overall plasma cholesterol concentrations.

Fluvastatin Sodium may cause a range of adverse reactions, from mild to serious.

Common Side Effects

• Headache: mild to moderate intensity.
• Myalgia: muscle aches without weakness.
• Gastrointestinal discomfort: nausea, abdominal pain or diarrhoea.
• Elevated liver enzymes: transient increases in ALT/AST.
• Dizziness: occasional light‑headedness.

Serious or Rare Side Effects

• Rhabdomyolysis: severe muscle breakdown with dark urine.
• Hepatotoxicity: marked elevation of liver transaminases.
• Acute renal failure: secondary to rhabdomyolysis.
• Severe allergic reactions: rash, angioedema or anaphylaxis.
• Thrombocytopenia: low platelet count.
• Cognitive impairment: rare reports of memory loss or confusion.

Before initiating therapy, consider patient‑specific factors and monitor appropriately.

• Liver function: assess baseline ALT/AST and repeat if clinically indicated.
• Renal impairment: adjust dose in moderate to severe renal dysfunction.
• Drug‑induced myopathy: avoid concomitant strong CYP3A4 inhibitors.
• Pregnancy and lactation: use only if potential benefit justifies potential risk.
• Elderly patients: start at lower dose and monitor for adverse effects.
• Store at ambient temperature: keep below 25 °C, in the original container, protected from moisture and direct sunlight.

Fluvastatin Sodium can interact with several medicines, affecting its efficacy or safety.

Major Interactions (Avoid)

• Strong CYP3A4 inhibitors (e.g., itraconazole, clarithromycin): may increase fluvastatin exposure and risk of myopathy.
• Gemfibrozil: synergistic increase in muscle toxicity.
• Cyclosporine: elevates plasma concentrations, heightening adverse effect risk.

Moderate Interactions (Monitor Closely)

• Antacids (aluminum or magnesium): may reduce absorption; separate dosing by at least 2 hours.
• Warfarin: may enhance anticoagulant effect; monitor INR.
• Digoxin: possible increase in serum levels; observe for toxicity.
• Niacin: combined therapy can increase risk of liver enzyme elevations.
• St. John’s Wort: may reduce fluvastatin levels via CYP3A4 induction.