Is Lescol affected by genetics?

Yes — the active ingredient is metabolized by a gene known to vary between individuals.

Relevant genes: CYP2C9, SLCO1B1

Lescol is affected by pharmacogenetics through the CYP2C9 and SLCO1B1 genes. Your genotype for these genes can change how your body processes Lescol, which can affect both how well it works and how well you tolerate it. The strongest evidence level on this page is Strong, based on CPIC or FDA guidelines.

What's in Lescol

fluvastatin affected by CYP2C9, SLCO1B1

Affected by CYP2C9, SLCO1B1 · CPIC · Strong evidence

Read the full fluvastatin genetics guide →

Fluvastatin phenotype recommendations

Published guidance from CPIC on how fluvastatin should be dosed or substituted based on your SLCO1B1, CYP2C9 phenotype.

Phenotype	What it means	Recommendation	Evidence
Increased Function SLCO1B1	Your genetic result suggests you should respond typically to this statin with standard dosing.	CPIC Prescribe desired starting dose and adjust doses of fluvastatin based on disease-specific guidelines.	Strong
Normal Function SLCO1B1	Your genetic result suggests you should respond typically to this statin with standard dosing.	CPIC Prescribe desired starting dose and adjust doses of fluvastatin based on disease-specific guidelines.	Strong
Decreased Function SLCO1B1	Your genetics suggest you may need caution at higher doses, but standard doses are generally considered safe.	CPIC Prescribe desired starting dose and adjust doses of fluvastatin based on disease-specific guidelines. Prescriber should be aware of possible increased risk for myopathy especially for doses >40 mg per day.	Strong
Possible Decreased Function SLCO1B1	Your genetics suggest you may need caution at higher doses, but standard doses are generally considered safe.	CPIC Prescribe desired starting dose and adjust doses of fluvastatin based on disease-specific guidelines. Prescriber should be aware of possible increased risk for myopathy especially for doses >40 mg per day.	Strong
Poor Function SLCO1B1	Your genetics suggest you may be at higher risk of muscle side effects; your doctor may lower the dose or choose a safer alternative.	CPIC Prescribe ≤40 mg per day as a starting dose and adjust doses based on disease-specific guidelines. If the patient tolerates 40 mg but higher potency is needed, consider switching to an alternative lower-risk statin such as atorvastatin (10–20 mg), pravastatin (40 mg), or rosuvastatin (5–10 mg), or adding combination therapy (e.g., fluvastatin plus nonstatin guideline-directed medical therapy). Prescriber should be aware of increased risk for myopathy especially with fluvastatin doses >40 mg per day.	Strong
Possible Poor Function SLCO1B1	Your genetics suggest you may be at higher risk of muscle side effects; your doctor may lower the dose or choose a safer alternative.	CPIC Prescribe ≤40 mg per day as a starting dose and adjust doses based on disease-specific guidelines. If the patient tolerates 40 mg but higher potency is needed, consider switching to an alternative lower-risk statin such as atorvastatin (10–20 mg), pravastatin (40 mg), or rosuvastatin (5–10 mg), or adding combination therapy (e.g., fluvastatin plus nonstatin guideline-directed medical therapy). Prescriber should be aware of increased risk for myopathy especially with fluvastatin doses >40 mg per day.	Strong
Indeterminate SLCO1B1	The impact of your genotype on response to this drug is unknown.	CPIC Initiate therapy with recommended starting dose.	—
Not available SLCO1B1	The impact of your genotype on response to this drug is unknown.	CPIC Initiate therapy with recommended starting dose.	—
Normal Metabolizer CYP2C9	Your genetics suggest you process fluvastatin normally, so standard doses are appropriate.	CPIC Prescribe desired starting dose and adjust doses of fluvastatin based on disease-specific guidelines.	Strong
Intermediate Metabolizer CYP2C9	You may process fluvastatin more slowly, which can raise side effect risk; lower doses or alternative approaches might be needed.	CPIC + CPIC Prescribe ≤40 mg per day as a starting dose and adjust doses of fluvastatin based on disease-specific guidelines. If dose >40 mg is needed for desired efficacy, consider an alternative statin or combination therapy (i.e., fluvastatin plus nonstatin guideline-directed medical therapy).	Strong
Poor Metabolizer CYP2C9	You process fluvastatin much more slowly, which increases side effect risk; a lower dose or alternative treatment is often recommended.	CPIC + CPIC Prescribe ≤20 mg per day as a starting dose and adjust doses of fluvastatin based on disease-specific guidelines. If dose >20 mg is needed for desired efficacy, consider an alternative statin or combination therapy (i.e., fluvastatin plus nonstatin guideline-directed medical therapy).	Strong
Indeterminate CYP2C9	The impact of your genotype on response to this drug is unknown.	CPIC Initiate therapy with recommended starting dose.	—
Not available CYP2C9	The impact of your genotype on response to this drug is unknown.	CPIC Initiate therapy with recommended starting dose.	—

Source: CPIC

The genes behind the guidance

CYP2C9 Cytochrome P450 2C9

CYP2C9 metabolizes warfarin, phenytoin, celecoxib, and some NSAIDs. Variants that reduce its activity are most consequential for warfarin, where even small changes in drug clearance translate into very different doses (and a real bleeding risk if missed).

Poor metabolizers need substantially lower warfarin doses to hit the same INR target.

See all drugs affected by CYP2C9 →

SLCO1B1 Solute Carrier Organic Anion Transporter 1B1

SLCO1B1 is the transporter that moves statins into liver cells where they work. A common variant (called *5) reduces transporter function and leaves more statin circulating in the bloodstream and muscle tissue. That's directly linked to statin-associated muscle pain and, rarely, more serious muscle damage.

People with reduced SLCO1B1 function are at higher risk of statin myopathy, especially on simvastatin and high-dose atorvastatin. Dose reduction or switching statin usually resolves it.

See all drugs affected by SLCO1B1 →

Browse the full drug-class: Statins.

Related medications

Find out how your genetics affect Lescol

This page describes the general pharmacogenetics. A Gene2Rx report analyzes your own DNA to tell you which metabolizer group you fall into, across every medication.

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Informational only — not medical advice. Pharmacogenetic guidance describes population-level patterns; your individual response depends on many factors. Never start, stop, or change a medication without talking to your prescribing clinician.