Try these helpful products which may be beneficial if taken with this medicine
CoQ10
Supplementing with 30 to 100 mg of coenzyme Q10 per day may maintain adequate blood levels
of this heart-healthy nutrient
Cholesterol-lowering margarine
Using margarines containing sitostanol (Benecol), which is made from pine tree wood pulp
and naturally occurring unsaturated sterols obtained from soybean oil (Take Control), can help
lower LDL (“bad”) cholesterol
These recommendations are not comprehensive and are not intended to
replace the advice of your doctor or pharmacist. Continue reading the full article for more
information on interactions with vitamins, herbs, and foods.
Summary of
Interactions with Vitamins, Herbs, and Foods
In some cases, an herb or supplement may appear in more than one category, which may seem
contradictory. For clarification, read the full article for details about the summarized
interactions.
May Be Beneficial:Depletion or
interference—The medication may deplete or interfere with the absorption or
function of the nutrient. Taking these nutrients may help replenish them.
Coenzyme Q10
May Be Beneficial:Supportive
interaction—Taking these supplements may support or otherwise help your medication
work better.
Sitostanol
Avoid:Adverse interaction—Avoid these supplements when taking this
medication because taking them together may cause undesirable or dangerous results.
Red yeast rice
Vitamin A*
Check:Other—Before taking any of these supplements or eating any of
these foods with your medication, read this article in full for details.
Vitamin B3 (niacin)
Side effect reduction/prevention
None known
Reduced drug
absorption/bioavailability
None known
An asterisk (*) next to an item in the summary indicates that the
interaction is supported only by weak, fragmentary, and/or contradictory scientific
evidence.
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.
Vitamin B3
(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 substance alone.3
Ingestion of large amounts of niacin along with HMG-CoA reductase inhibitors such as
fluvastatin may cause muscle disorders (myopathy) that can become serious
(rhabdomyolysis).45 Such problems appear to be uncommon.67 Nonetheless, individuals taking fluvastatin should consult with their doctor
before taking niacin.
Sitostanol
A synthetic molecule related to
beta-sitosterol, sitostanol, is available in a special margarine and has been shown to lower cholesterol levels. In one study, supplementing
with 1.8 grams of sitostanol per day for six weeks enhanced the cholesterol-lowering effect of
various statin drugs.8
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.9 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.
Interactions with Herbs
Red yeast rice(Monascus purpureas)
A supplement containing red yeast rice (Cholestin) has been shown to effectively lower cholesterol and triglycerides in people with moderately elevated
levels of these blood lipids.10 This extract contains small amounts of naturally
occurring HMG-CoA reductase inhibitors such as lovastatin and should not be used if you are
currently taking a statin medication.
Interactions with Foods and Other Compounds
Food
Fluvastatin is equally effective taken with or without food in the evening.11
Alcohol
In a study of 31 people with primary
hypercholesterolemia treated with fluvastatin, six weeks of daily, moderate alcohol
consumption slowed the absorption and metabolism of fluvastatin but did not interfere with its
effectiveness.12
References (To view, roll mouse over the "References" heading; to hide, click on the heading)
1. Mortensen SA, Leth A, Agner E, Rohde M. Dose-related decrease of serum
coenzyme Q10 during treatment with HMG-CoA reductase inhibitors. Mol Aspects Med
1997;18(suppl):S137–44.
2. Bargossi AM, Grossi G, Fiorella PL, et al. Exogenous CoQ10
supplementation prevents plasma ubiquinone reduction induced by HMG-CoA reductase inhibitors.
Molec Aspects Med 1994;15(suppl):s187–93.
3. Jacobson TA, Chin MM, Fromell GJ, et al. Fluvastatin with and without
niacin for hypercholesterolemia. Am J Cardiol 1994;74:149–54.
4. Garnett WR. Interactions with hydroxymethylglutaryl-coenzyme A
reductase inhibitors. Am J Health Syst Pharm 1995;52:1639–45.
5. Yee HS, Fong NT. Atorvastatin in the treatment of primary
hypercholesterolemia and mixed dyslipidemias. Ann Pharmacother
1998;32:1030–43.
6. Jacobson TA, Amorosa LF. Combination therapy with fluvastatin and
niacin in hypercholesterolemia: a preliminary report on safety. Am J Cardiol
1994;73:25D–9D.
7. Jokubaitis LA. Fluvastatin in combination with other lipid-lowering
agents. Br J Pract Suppl 1996;77A:28–32.
8. Goldberg AC, Ostlund RE Jr, Bateman JH, et al. Effect of plant stanol
tablets on low-density lipoprotein cholesterol lowering in patients on statin drugs. Am J
Cardiol 2006;97:376–9.
9. Muggeo M, Zenti MG, Travia D, et al. Serum retinol levels throughout 2
years of cholesterol-lowering therapy. Metabolism 1995;44:398–403.
10. Heber D, Yip I, Ashley JM, et al. Cholesterol-lowering effects of a
proprietary Chinese red-yeast-rice dietary supplement. Am J Clin Nutr
1999;69:231–6.
11. Dujovne CA, Davidson MH. Fluvastatin administration at bedtime versus
with the evening meal: a multicenter comparison of bioavailability, safety, and efficacy.
Am J Med 1994;96:37S–40S.
12. Smit JW, Wijnne HJ, Schobben F, et al. Effects of alcohol and
fluvastatin on lipid metabolism and hepatic function. Ann Intern Med
1995;122:678–80.
The information presented in Healthnotes is for informational purposes
only. It is based on scientific studies (human, animal, or in vitro), clinical
experience, or traditional usage as cited in each article. The results reported may not
necessarily occur in all individuals. For many of the conditions discussed, treatment with
prescription or over the counter medication is also available. Consult your doctor,
practitioner, and/or pharmacist for any health problem and before using any supplements or
before making any changes in prescribed medications. Information expires June 2009.
