Fluconazole with Fluvastatin Interaction Details
Brand Names Associated with Fluconazole
- Diflucan®
- Fluconazole
Brand Names Associated with Fluvastatin
- Fluvastatin
- Lescol®
- Lescol® XL
Medical Content Editor Dr. Brian Staiger, PharmD
Last updated
Nov 27, 2023
Interaction Effect
Increased fluvastatin exposure and an increased risk of myopathy and rhabdomyolysis
Interaction Summary
Do not exceed a fluvastatin dose of 20 mg twice daily in patients receiving fluconazole. Concomitant use of fluconazole (a moderate CYP2C9 and moderate CYP3A4 inhibitor) with CYP2C9 and CYP3A4 substrates, such as fluvastatin, may increase fluvastatin exposure and increase the risk for toxicity . If coadministration is required, monitor creatine kinase (CK) levels and symptoms of myopathy and rhabdomyolysis. Discontinue fluvastatin use if significant CK elevations occur or if myopathy or rhabdomyolysis is diagnosed or suspected. Dose reduction of fluvastatin may be needed. Fluconazole enzyme inhibitory effects may persist for 4 to 5 days after discontinuation due to its long half-life . AUC increases up to 84% have been reported as a result of the interaction between fluvastatin and fluconazole. An individual patient using fluvastatin 80 mg daily may be exposed to considerable fluvastatin concentrations if treated with high doses of fluconazole .
Severity
Major
Onset
Delayed
Evidence
Probable
How To Manage Interaction
Do not exceed a fluvastatin dose of 20 mg twice daily in patients receiving fluconazole. Concomitant use of fluvastatin and fluconazole may increase atorvastatin exposure and increase risk for myopathy and rhabdomyolysis. If concurrent therapy is required, monitor for signs and symptoms of myopathy and rhabdomyolysis (ie, muscle pain, tenderness, or weakness). Monitor creatine kinase (CK) levels and discontinue use if CK levels show a marked increase, or if myopathy or rhabdomyolysis is diagnosed or suspected. Dose reduction of fluvastatin may be needed .
Mechanism Of Interaction
Inhibition of CYP2C9-mediated metabolism of fluvastatin; inhibition of CYP3A4-mediated metabolism of fluvastatin by fluconazole
Literature Reports
A) Plasma fluvastatin concentrations were significantly increased by a 4-day pretreatment with fluconazole. In this randomized, double-blind, two-phase, crossover study, 12 healthy volunteers were observed to evaluate the effects of fluconazole on the plasma concentration of fluvastatin. The mean AUC of fluvastatin was increased by 84%, and the Cmax was increased by 44% with fluconazole. The mean half-life of fluvastatin was increased by 80% .
Fluconazole Overview
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Fluconazole is used to treat fungal infections, including yeast infections of the vagina, mouth, throat, esophagus (tube leading from the mouth to the stomach), abdomen (area between the chest and waist), lungs, blood, and other organs. Fluconazole is also used to treat meningitis (infection of the membranes covering the brain and spine) caused by fungus. Fluconazole is also used to prevent yeast infections in patients who are likely to become infected because they are being treated with chemotherapy or radiation therapy before a bone marrow transplant (replacement of unhealthy spongy tissue inside the bones with healthy tissue). Fluconazole is in a class of antifungals called triazoles. It works by slowing the growth of fungi that cause infection.
Fluvastatin Overview
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Fluvastatin is used together with diet, weight loss, and exercise to reduce the risk of heart attack and stroke and to decrease the chance that heart surgery will be needed in people who have heart disease or who are at risk of developing heart disease. Fluvastatin is also used to decrease the amount of fatty substances such as low-density lipoprotein (LDL) cholesterol ('bad cholesterol') and triglycerides in the blood and to increase the amount of high-density lipoprotein (HDL) cholesterol ('good cholesterol') in the blood. Fluvastatin may also be used to decrease the amount of cholesterol and other fatty substances in the blood in children and teenagers 10 to 17 years of age who have familial heterozygous hypercholesterolemia (an inherited condition in which cholesterol cannot be removed from the body normally). Fluvastatin is in a class of medications called HMG-CoA reductase inhibitors (statins). It works by slowing the production of cholesterol in the body to decrease the amount of cholesterol that may build up on the walls of the arteries and block blood flow to the heart, brain, and other parts of the body.
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Accumulation of cholesterol and fats along the walls of your arteries (a process known as atherosclerosis) decreases blood flow and, therefore, the oxygen supply to your heart, brain, and other parts of your body. Lowering your blood level of cholesterol and fats with fluvastatin has been shown to prevent heart disease, angina (chest pain), strokes, and heart attacks.
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Definitions
Severity Categories
Contraindicated
These drugs, generally, should not be used together simultaneously due to the high risk of severe adverse effects. Combining these medications can lead to dangerous health outcomes and should be strictly avoided unless otherwise instructed by your provider.
Major
This interaction could result in very serious and potentially life-threatening consequences. If you are taking this drug combination, it is very important to be under close medical supervision to minimize severe side effects and ensure your safety. It may be necessary to change a medication or dosage to prevent harm.
Moderate
This interaction has the potential to worsen your medical condition or alter the effectiveness of your treatment. It's important that you are monitored closely and you potentially may need to make adjustments in your treatment plan or drug dosage to maintain optimal health.
Minor
While this interaction is unlikely to cause significant problems, it could intensify side effects or reduce the effectiveness of one or both medications. Monitoring for changes in symptoms and your condition is recommended, and adjustments may be made if needed to manage any increased or more pronounced side effects.
Onset
Rapid: Onset of drug interaction typically occurs within 24 hours of co-administration.
Delayed: Onset of drug interaction typically occurs more than 24 hours after co-administration.
Evidence
Level of documentation of the interaction.
Established: The interaction is documented and substantiated in peer-reviewed medical literature.
Theoretical: This interaction is not fully supported by current medical evidence or well-documented sources, but it is based on known drug mechanisms, drug effects, and other relevant information.
How To Manage The Interaction
Provides a detailed discussion on how patients and clinicians can approach the identified drug interaction as well as offers guidance on what to expect and strategies to potentially mitigate the effects of the interaction. This may include recommendations on adjusting medication dosages, altering the timing of drug administration, or closely monitoring for specific symptoms.
It's important to note that all medical situations are unique, and management approaches should be tailored to individual circumstances. Patients should always consult their healthcare provider for personalized advice and guidance on managing drug interactions effectively.
Mechanism Of Interaction
The theorized or clinically determined reason (i.e., mechanism) why the drug-drug interaction occurs.
Disclaimer: The information provided on this page is for informational purposes only and should not be considered medical advice. Always consult with a qualified healthcare professional regarding your specific circumstances and medical conditions.
Where Does Our Information Come From?
Information for our drug interactions is compiled from several drug compendia, including:
The prescribing information for each drug, as published on DailyMED, is also used.
Individual drug-drug interaction detail pages contain references specific to that interaction. You can click on the reference number within brackets '[]' to see what reference was utilized.
The information posted is fact-checked by HelloPharmacist clinicians and reviewed quarterly.