FLUVASTATIN

Interactions with Dietary Supplements

Coenzyme Q10
In a randomized, double-blind trial, blood levels of coenzyme Q10 (CoQ10) were measured in 45 people with high cholesterol treated with lovastatin or pravastatin (drugs related to fluvastatin) for 18 weeks.¹ A significant decline in blood levels of CoQ10 occurred with either drug. One study found that supplementation with 100 mg of CoQ10 prevented declines in CoQ10 when taken with simvastatin (another HMG-CoA reductase inhibitor drug).² Many doctors recommend that people taking HMG-CoA reductase inhibitor drugs such as fluvastatin also supplement with approximately 100 mg CoQ10 per day, although lower amounts, such as 10–30 mg per day, might conceivably be effective in preventing the decline in CoQ10 levels.

Niacin
Niacin is the form of vitamin B3 used to lower cholesterol. Fluvastatin and niacin used together have been shown to be more effective than either drug alone.³ High-dose niacin taken with lovastatin (a drug closely related to fluvastatin) may cause muscle disorders (myopathy) that can become serious (rhabdomyolysis).^{4 5} Such problems appear to be uncommon.^{6 7} No interactions have yet been reported with fluvastatin and niacin. Nonetheless, until more is known, people taking both fluvastatin and niacin should be monitored for muscle disorders by the prescribing physician.

Vitamin A
A study of 37 people with high cholesterol treated with diet and HMG-CoA reductase inhibitors found blood vitamin A levels increased during two years of therapy.⁸ Until more is known, people taking HMG-CoA reductase inhibitors, including fluvastatin, should have blood levels of vitamin A monitored if they intend to supplement vitamin A.