Discussions that mention fluvastatin

High Cholesterol board

I started on LescolXL (80mg timed-release fluvastatin) an athlete, and quit it a near-invalid ... and went downhill even after that from acquired hypogonadism (low Testosterone) that I blame largely on the Lescol.

I was on Lescol (with layoffs due to becoming ill) for about a year and a half until I finally became so foggy I fell and hit my head on a big wheeled trash bin and needed 25 staples to close my scalp.

During my time on the drug I had several incidents of gastrointestinal distress that resulted each time in passing black pigment stones--once I even had pancreatitis. This had actually happened once or twice in the years before I began taking Lescol (I believe while taking erythromycin and either OJ or nefazodone or paxil, none of which I tolerated well), and therein lies the tale. I amassed more than 500 pages of research from Google scholar before I was drawn inevitably to the conclusion that my hypogonadism was not genetic, or from hitting my head, or an early sign of the lymphoma that killed my father, or associated with CFIDS/HHV-6/EBV/CMV or Hep C (all viable candidates), it was in fact due to 10 years of overconsumption of Lacroix lemon and lime sparkling waters that interacted with just about every prescription I've been on in the last 10 years. To make a long story short, I believe they contain furanocoumarins that accumulated in my liver and prevented my body from clearing Lescol as it should have. The really acute effects didn't kick in, however, until I either drank orange juice (which has flavonoids but not furanocoumarins and hence won't cause the "grapefruit juice effect" on its own) or used say clarithromycin, also a potent inhibitor of P-glycoprotein like the flavonoids (as well as CYP3A4).

While the grapefruit juice effect can happen with statins that use the CYP3A4 enzyme route for clearance, Lescol is supposed to not be subject to it because it uses mainly CYP2C9. Well guess what? Bergamottin, one of the furanocoumarins, inhibits that one too, and another furanocoumarin knocks out the third supposed P450 metabolic pathway. A lot of these furanocoumarins are broken down by citric acid in juices and sodas so they're not so bad. Guess what's missing from sparkling water ... citric acid!

In short, at 80mg a day, by virtue of the sparkling water mangling my P450 metabolic pathways I was giving myself a chronic overdose that I occasionally spiked with a mega-overdose (perhaps by virtue of P-glycoprotein inhibition shutting Lescol's last escape route through the kidneys instead of the liver--my lower back really hurt during these attacks). It was "The Perfect Storm", and I'm pretty sure it damaged something (perhaps irreversibly) in the anterior pituitary or the gonads.

In short, this is less a report about a deficiency in Lescol than it is a plea to get some research done so that people understand that lemon and lime flavorings contain the half of the grapefruit juice effect that can accumulate silently in the liver, while waiting for something to come along and trigger the rest of the effect by inhibiting P-glycoprotein.

And if you're on Lescol, don't accidentally assemble the same dieteray components I did.
Nice research. Lescol (even in XL form) is the least potent of the statin drugs. Having said that, be very wary of ever taking another statin drug, since little published research has shown that if you have a reaction to one, you will more than likely have the same, or equally unpleasant in another form, with any of the others.

The insert papers on every statin that I have tried has said that male sexual dysfuntion and hypogonadism are possible side effects. Fluvastatin is one of the two I haven't tried--all with unsatisfactory results. I lost a kidney to lipitor. Thank your lucky stars that you didn't end up with a seriously damaged internal organ like I did.

The hypogonadism may or may not go away. Find a doctor, preferably an endocrinologist, that you can trust and will work with you to get this back to where you need to be.

Good luck, and keep us informed on how things go. :D