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Details

Stereochemistry RACEMIC
Molecular Formula C24H26FNO4
Molecular Weight 411.4668
Optical Activity ( + / - )
Defined Stereocenters 2 / 2
E/Z Centers 1
Charge 0

SHOW SMILES / InChI
Structure of FLUVASTATIN

SMILES

CC(C)n1c2ccccc2c(-c3ccc(cc3)F)c1/C(/[H])=C(\[H])/[C@@]([H])(C[C@@]([H])(CC(=O)O)O)O

InChI

InChIKey=FJLGEFLZQAZZCD-JUFISIKESA-N
InChI=1S/C24H26FNO4/c1-15(2)26-21-6-4-3-5-20(21)24(16-7-9-17(25)10-8-16)22(26)12-11-18(27)13-19(28)14-23(29)30/h3-12,15,18-19,27-28H,13-14H2,1-2H3,(H,29,30)/b12-11+/t18-,19-/m0/s1

HIDE SMILES / InChI
Fluvastatin is an antilipemic agent that competitively inhibits hydroxymethylglutaryl-coenzyme A (HMG-CoA) reductase. Fluvastatin is marketed under the trade names Lescol, Canef, Vastin. LESCOL/LESCOL XL is an HMG-CoA reductase inhibitor (statin) indicated as an adjunctive therapy to diet to: Reduce elevated TC, LDL-C, Apo B, and TG, and to increase HDL-C in adult patients with primary hypercholesterolemia and mixed dyslipidemia Reduce elevated TC, LDL-C, and Apo B levels in boys and post-menarchal girls, 10 to 16 years of age, with heterozygous familial hypercholesterolemia after failing an adequate trial of diet therapy Reduce the risk of undergoing revascularization procedures in patients with clinically evident CHD Slow the progression of atherosclerosis in patients with CHD. Fluvastatin selectively and competitively inhibits the hepatic enzyme hydroxymethylglutaryl-coenzyme A (HMG-CoA) reductase. HMG-CoA reductase is responsible for converting HMG-CoA to mevalonate, the rate-limiting step in cholesterol biosynthesis. Inhibition results in a decrease in hepatic cholesterol levels which stimulates the synthesis of LDL receptors and increases hepatic uptake of LDL cholesterol. The end result is decreased levels of plasma total and LDL cholesterol.

Originator

Curator's Comment:: # Novartis

Approval Year

TargetsConditions

Conditions

ConditionModalityTargetsHighest PhaseProduct
Primary
LESCOL

Approved Use

LESCOL/LESCOL XL is an HMG-CoA reductase inhibitor (statin) indicated as an adjunctive therapy to diet to: Reduce elevated TC, LDL-C, Apo B, and TG, and to increase HDL-C in adult patients with primary hypercholesterolemia and mixed dyslipidemia (1.1) Reduce elevated TC, LDL-C, and Apo B levels in boys and post-menarchal girls, 10 to 16 years of age, with heterozygous familial hypercholesterolemia after failing an adequate trial of diet therapy (1.1) Reduce the risk of undergoing revascularization procedures in patients with clinically evident CHD (1.2) Slow the progression of atherosclerosis in patients with CHD (1.2)

Launch Date

7.5729601E11
Primary
LESCOL

Approved Use

LESCOL/LESCOL XL is an HMG-CoA reductase inhibitor (statin) indicated as an adjunctive therapy to diet to: Reduce elevated TC, LDL-C, Apo B, and TG, and to increase HDL-C in adult patients with primary hypercholesterolemia and mixed dyslipidemia (1.1) Reduce elevated TC, LDL-C, and Apo B levels in boys and post-menarchal girls, 10 to 16 years of age, with heterozygous familial hypercholesterolemia after failing an adequate trial of diet therapy (1.1) Reduce the risk of undergoing revascularization procedures in patients with clinically evident CHD (1.2) Slow the progression of atherosclerosis in patients with CHD (1.2)

Launch Date

7.5729601E11
Primary
LESCOL

Approved Use

LESCOL/LESCOL XL is an HMG-CoA reductase inhibitor (statin) indicated as an adjunctive therapy to diet to: Reduce elevated TC, LDL-C, Apo B, and TG, and to increase HDL-C in adult patients with primary hypercholesterolemia and mixed dyslipidemia (1.1) Reduce elevated TC, LDL-C, and Apo B levels in boys and post-menarchal girls, 10 to 16 years of age, with heterozygous familial hypercholesterolemia after failing an adequate trial of diet therapy (1.1) Reduce the risk of undergoing revascularization procedures in patients with clinically evident CHD (1.2) Slow the progression of atherosclerosis in patients with CHD (1.2)

Launch Date

7.5729601E11
Cmax

Cmax

ValueDoseCo-administeredAnalytePopulation
205 μg/mL
20 mg single, oral
dose: 20 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
FLUVASTATIN plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: FEMALE / MALE
food status: FASTED
AUC

AUC

ValueDoseCo-administeredAnalytePopulation
206.2 μg × h/mL
20 mg single, oral
dose: 20 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
FLUVASTATIN plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: FEMALE / MALE
food status: FASTED
T1/2

T1/2

ValueDoseCo-administeredAnalytePopulation
0.54 h
20 mg single, oral
dose: 20 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
FLUVASTATIN plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: FEMALE / MALE
food status: FASTED
Doses

Doses

DosePopulationAdverse events​
640 mg 1 times / day multiple, oral
Highest studied dose
Dose: 640 mg, 1 times / day
Route: oral
Route: multiple
Dose: 640 mg, 1 times / day
Sources: Page: p.505
unhealthy, ADULT
n = 7
Health Status: unhealthy
Condition: lipid metabolism disorder
Age Group: ADULT
Sex: M+F
Food Status: FED
Population Size: 7
Sources: Page: p.505
OverviewDrug as perpetrator​Drug as victim

Drug as victim

TargetModalityActivityMetaboliteClinical evidence
major
yes (co-administration study)
Comment: Coadministration with rifampicin (CYP2C9 inducer) increased the CL/F of fluvastatin by 95% and to reduce AUC by 50%.
minor
minor
minor
minor
unknown (co-administration study)
Comment: Coadministration with cyclocporine resulted in 3.1-fold increase in AUC; however, cannot be explained through these mechanisms, since neither pravastatin nor fluvastatin has been shown to be a substrate for either P-gp or CYP3A4; coadministration with itraconazole had no significant impact on Cmax and AUC of fluvastatin
no
no
no
no
no
no
no
unknown (co-administration study)
Comment: Coadministration with cyclocporine resulted in 3.1-fold increase in AUC; however, cannot be explained through these mechanisms, since neither pravastatin nor fluvastatin has been shown to be a substrate for either P-gp or CYP3A4
Page: 14.0
yes
yes
yes
unlikely (co-administration study)
Comment: coadministered with rifampin. See https://pubmed.ncbi.nlm.nih.gov/29768081/. Pharmacogenomic study also performed. Not significant: see https://www.lipidjournal.com/article/S1933-2874(14)00072-5/pdf
yes
yes (pharmacogenomic study)
Comment: AUC of drug increased by 72%
PubMed

PubMed

TitleDatePubMed
Troglitazone upregulates LDL receptor activity in HepG2 cells.
1998 Aug
Postural hypotension induced by paroxetine.
1998 Feb 21
[Cardiology in 1997].
1998 Oct 5
Statin + fibrate combination therapy fluvastatin with bezafibrate or ciprofibrate in high risk patients with vascular disease.
1999 Jun 1
Enhancement of low density lipoprotein catabolism by non-steroidal anti-inflammatory drugs in cultured HepG2 cells.
1999 May 21
A HMG-CoA reductase inhibitor possesses a potent anti-atherosclerotic effect other than serum lipid lowering effects--the relevance of endothelial nitric oxide synthase and superoxide anion scavenging action.
2001 Apr
Effect of fluvastatin, an inhibitor of 3-hydroxy-3-methylglutaryl coenzyme A reductase, on nitric oxide-induced hydroxyl radical generation in the rat heart.
2001 Apr 30
Preclinical and clinical pharmacology of Rosuvastatin, a new 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitor.
2001 Mar 8
Structural mechanism for statin inhibition of HMG-CoA reductase.
2001 May 11
Fibrate and statin synergistically increase the transcriptional activities of PPARalpha/RXRalpha and decrease the transactivation of NFkappaB.
2002 Jan 11
Molecular mechanism for inhibition of 3-hydroxy-3-methylglutaryl CoA (HMG-CoA) reductase by rosuvastatin.
2003 Jun
Expression of serum and glucocorticoid-inducible kinase1 in diabetic rats and its modulation by fluvastatin.
2005
In vitro and pharmacophore-based discovery of novel hPEPT1 inhibitors.
2005 Apr
Human hepatobiliary transport of organic anions analyzed by quadruple-transfected cells.
2005 Oct
Effects of chronic treatment with statins and fenofibrate on rat skeletal muscle: a biochemical, histological and electrophysiological study.
2006 Dec
Inhibitors of the mevalonate pathway as potential therapeutic agents in multiple myeloma.
2007 Mar
Pretreatment with statin attenuates the cardiotoxicity of Doxorubicin in mice.
2009 Jan 15
Roles of different CYP enzymes in the formation of specific fluvastatin metabolites by human liver microsomes.
2009 Nov
In vitro interactions between primycin and different statins in their effects against some clinically important fungi.
2010 Feb
Effects of add-on fluvastatin therapy in patients with chronic proteinuric nephropathy on dual renin-angiotensin system blockade: the ESPLANADE trial.
2010 Nov
Statins alter the hepatobiliary transport of unconjugated and conjugated bilirubin in sandwich-cultured rat hepatocytes.
2014 Sep
Systems pharmacological analysis of drugs inducing stevens-johnson syndrome and toxic epidermal necrolysis.
2015 May 18
Patents

Sample Use Guides

Usual Adult Dose for Hyperlipidemia Immediate Release Capsules: -Low-density lipoprotein cholesterol (LDL-C) reduction to a goal of 25% or greater: Initial dose of 40 mg orally once a day in the evening or 40 mg orally twice a day -LDL-C reduction to a goal of less than 25%: Initial dose of 20 mg orally once a day -Maintenance dose: 20 mg to 80 mg per day Usual Adult Dose for Hyperlipoproteinemia Type IIa (Elevated LDL) Immediate Release Capsules: -Low-density lipoprotein cholesterol (LDL-C) reduction to a goal of 25% or greater: Initial dose of 40 mg orally once a day in the evening or 40 mg orally twice a day -LDL-C reduction to a goal of less than 25%: Initial dose of 20 mg orally once a day -Maintenance dose: 20 mg to 80 mg per day
Route of Administration: Oral
Fluvastatin markedly inhibits the formation of thiobarbituric acid reactive substances in iron (II)-supported peroxidation of liposomes with IC50 of 12 uM. Fluvastatin ranging from 1 uM to 100 uM inhibits peroxyl radical-mediated peroxidation of liposomes induced by water-soluble and lipid-soluble radical generators, 2,2'-azobis (2-amidinopropane) dihydro-chloride and 2,2'-azobis (2,4-dimethylvaleronitrile), respectively.
Name Type Language
FLUVASTATIN
INN   MI   VANDF   WHO-DD  
INN  
Official Name English
FLUVASTATIN [WHO-DD]
Common Name English
FLUVASTATIN [VANDF]
Common Name English
FLUVASTATIN [MI]
Common Name English
NSC-758896
Code English
FLUVAS
Brand Name English
FLUVASTATIN [INN]
Common Name English
6-HEPTENOIC ACID, 7-(3-(4-FLUOROPHENYL)-1-(1-METHYLETHYL)-1H-INDOL-2-YL)-3,5-DIHYDROXY-, (3R,5S,6E)-REL-
Systematic Name English
Classification Tree Code System Code
WHO-VATC QC10AA04
Created by admin on Fri Jun 25 22:02:40 UTC 2021 , Edited by admin on Fri Jun 25 22:02:40 UTC 2021
NDF-RT N0000175589
Created by admin on Fri Jun 25 22:02:40 UTC 2021 , Edited by admin on Fri Jun 25 22:02:40 UTC 2021
LIVERTOX 430
Created by admin on Fri Jun 25 22:02:40 UTC 2021 , Edited by admin on Fri Jun 25 22:02:40 UTC 2021
NDF-RT N0000000121
Created by admin on Fri Jun 25 22:02:40 UTC 2021 , Edited by admin on Fri Jun 25 22:02:40 UTC 2021
NCI_THESAURUS C1655
Created by admin on Fri Jun 25 22:02:40 UTC 2021 , Edited by admin on Fri Jun 25 22:02:40 UTC 2021
WHO-ATC C10AA04
Created by admin on Fri Jun 25 22:02:40 UTC 2021 , Edited by admin on Fri Jun 25 22:02:40 UTC 2021
Code System Code Type Description
PUBCHEM
1548972
Created by admin on Fri Jun 25 22:02:40 UTC 2021 , Edited by admin on Fri Jun 25 22:02:40 UTC 2021
PRIMARY
NCI_THESAURUS
C61768
Created by admin on Fri Jun 25 22:02:40 UTC 2021 , Edited by admin on Fri Jun 25 22:02:40 UTC 2021
PRIMARY
RXCUI
41127
Created by admin on Fri Jun 25 22:02:40 UTC 2021 , Edited by admin on Fri Jun 25 22:02:40 UTC 2021
PRIMARY RxNorm
ChEMBL
CHEMBL2220442
Created by admin on Fri Jun 25 22:02:40 UTC 2021 , Edited by admin on Fri Jun 25 22:02:40 UTC 2021
PRIMARY
FDA UNII
4L066368AS
Created by admin on Fri Jun 25 22:02:40 UTC 2021 , Edited by admin on Fri Jun 25 22:02:40 UTC 2021
PRIMARY
IUPHAR
2951
Created by admin on Fri Jun 25 22:02:40 UTC 2021 , Edited by admin on Fri Jun 25 22:02:40 UTC 2021
PRIMARY
MESH
C065180
Created by admin on Fri Jun 25 22:02:40 UTC 2021 , Edited by admin on Fri Jun 25 22:02:40 UTC 2021
PRIMARY
INN
6547
Created by admin on Fri Jun 25 22:02:40 UTC 2021 , Edited by admin on Fri Jun 25 22:02:40 UTC 2021
PRIMARY
HSDB
8366
Created by admin on Fri Jun 25 22:02:40 UTC 2021 , Edited by admin on Fri Jun 25 22:02:40 UTC 2021
PRIMARY
EVMPD
SUB07768MIG
Created by admin on Fri Jun 25 22:02:40 UTC 2021 , Edited by admin on Fri Jun 25 22:02:40 UTC 2021
PRIMARY
DRUG BANK
DB01095
Created by admin on Fri Jun 25 22:02:40 UTC 2021 , Edited by admin on Fri Jun 25 22:02:40 UTC 2021
PRIMARY
EPA CompTox
93957-54-1
Created by admin on Fri Jun 25 22:02:40 UTC 2021 , Edited by admin on Fri Jun 25 22:02:40 UTC 2021
PRIMARY
CAS
93957-54-1
Created by admin on Fri Jun 25 22:02:40 UTC 2021 , Edited by admin on Fri Jun 25 22:02:40 UTC 2021
PRIMARY
LACTMED
Fluvastatin
Created by admin on Fri Jun 25 22:02:40 UTC 2021 , Edited by admin on Fri Jun 25 22:02:40 UTC 2021
PRIMARY
MERCK INDEX
M5515
Created by admin on Fri Jun 25 22:02:40 UTC 2021 , Edited by admin on Fri Jun 25 22:02:40 UTC 2021
PRIMARY Merck Index
WIKIPEDIA
FLUVASTATIN
Created by admin on Fri Jun 25 22:02:40 UTC 2021 , Edited by admin on Fri Jun 25 22:02:40 UTC 2021
PRIMARY
DRUG CENTRAL
1229
Created by admin on Fri Jun 25 22:02:40 UTC 2021 , Edited by admin on Fri Jun 25 22:02:40 UTC 2021
PRIMARY