Gemfibrozil and Fluvastatin: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Gemfibrozil
Fluvastatin
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
What happens
An increased risk of myopathy or rhabdomyolysis
Interaction Deep Dive
Concurrent use of fluvastatin with gemfibrozil should be avoided due to an increased risk of myopathy and rhabdomyolysis12. Several small studies have investigated the concomitant use of fluvastatin and gemfibrozil, and found no adverse effects on muscle tissue 6 nor any pharmacokinetic interactions, lending support to the clinical observations that the combination may be safe 4. However, the potential risks and benefits of combination therapy with fluvastatin and gemfibrozil should be carefully considered as rhabdomyolysis has been reported 5. In patients whose lipid response is inadequate with either drug alone, the increased risk of serious events associated with combination therapy appear to outweigh the potential benefits on lipid levels 3.
Why it happens (mechanism)
Unknown
Literature reports
3 reports — tap to read
a) In an open-label crossover pharmacokinetic study of 17 hyperlipidemic patients, researchers found no significant differences in the area under the concentration-time curve (AUC), maximum concentration (Cmax), or time to maximum concentration (Tmax) between fluvastatin 20 mg twice daily taken alone, gemfibrozil 600 mg twice daily taken alone, or the combination of the two drugs. There were no significant adverse effects noted. However, the authors point out that because of the small sample size, conclusions cannot be drawn about safety 4.
b) A 56-year-old female developed rhabdomyolysis one month after beginning therapy with fluvastatin 80 mg per day and gemfibrozil 1200 mg per day. The patient had a history of hyperlipidemia and was receiving no other drug therapy. She presented with fatigue, weakness in her legs, and red-colored urine. Her liver enzymes were elevated (alanine aminotransferase 2100 units/L, aspartate aminotransferase 2640 units/L) and her renal function tests revealed renal dysfunction (creatinine 1.84 mg/dL, BUN 58 mg/dL). Serum creatinine phosphokinase was 45,758 units/L (reference range 30-170), lactate dehydrogenase was 7169 units/L (230-460), and myoglobin was more than 3000 ng/mL (0-72). She was diagnosed with acute hepatocellular injury and acute renal failure secondary to rhabdomyolysis. All medications were withheld and her nutritional status and liver and kidney function test results returned to normal within two weeks. The author concludes that this patient's hepatocellular injury and rhabdomyolysis were associated with an interaction between fluvastatin and gemfibrozil. Potential risks and benefits should be considered and the patient should be advised of potential toxicities and side effects when fluvastatin and gemfibrozil are coadministered 5.
c) Fluvastatin and gemfibrozil, administered either as monotherapy or as combination therapy, did not induce muscle damage in 21 patients with combined hyperlipidemia in a 6-week, double-blind, placebo-controlled study. Subjects were randomized into three groups: fluvastatin 40 mg daily plus gemfibrozil placebo; gemfibrozil 600 mg twice daily plus fluvastatin placebo; or fluvastatin 40 mg daily plus gemfibrozil 600 mg twice daily. Muscle damage was assessed by means of a 45-minute exercise muscle-provocation test both before and after the six week treatment period, followed by a muscle needle biopsy from the quadriceps 48 hours after the exercise tests, as well as serum CPK and myoglobin samples. The authors found no significant difference between the pre- and post-treatment mean peak CPK rise with combination therapy or fluvastatin alone. The authors concluded that combination therapy has no adverse effects on muscle 6.
Common questions
Can I take Gemfibrozil and Fluvastatin together?
An increased risk of myopathy or rhabdomyolysis Always confirm with your pharmacist or prescriber before making any change.
How serious is the Gemfibrozil and Fluvastatin interaction?
It is rated major. Potentially serious — often needs a change or close monitoring.
How quickly could this interaction happen?
The documented onset is "delayed". Effects tend to build up gradually over days to weeks.
How strong is the evidence for this interaction?
The evidence is graded "probable". Good supporting evidence, though not definitively proven.
Questions for your pharmacist
- Does my dose of Gemfibrozil or Fluvastatin need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there a safer alternative to one of these medications for me?
References (6)
- Product Information: LESCOL(R) oral capsules, fluvastatin sodium oral capsules. Novartis Pharmaceuticals Corporation (Per FDA), East Hanover, NJ, 2012. DailyMed
- Product Information: Lescol(R) XL oral extended release tablets, fluvastatin sodium oral extended release tablets. Sandoz, Inc.(per FDA), Princeton, NJ, 2023. DailyMed
- Product Information: LOPID(R) oral tablets, gemfibrozil oral tablets. Parke-Davis, New York, NY, 2009. DailyMed
- Spence JD, Munoz CE, Hendricks L, et al: Pharmacokinetics of the combination of fluvastatin and gemfibrozil. Am J Cardiol 1995; 76:80A-83A. PubMed
- Akoglu H, Yilmaz R, Kirkpantur A, et al: Combined Organ Failure with Combination Antihyperlipidemic Treatment: A Case of Hepatic Injury and Acute Renal Failure. Ann Pharmacother 2007; 41(1):143-147. PubMed
- Smit JWA, Jansen GH, de Bruin TWA, et al: Treatment of combined hyperlipidemia with fluvastatin and gemfibrozil, alone or in combination, does not induce muscle damage. Am J Cardiol 1995; 76:126A-128A. PubMed
Keep reading about Gemfibrozil
Keep reading about Fluvastatin
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