Pravastatin

Pravastatin - Use | Dose | Side Effects

Pravastatin prevents the formation of cholesterol in the liver and is used to treat high cholesterol and for the prevention of heart and blood vessels disease. It is sometimes used after organ transplantation, as a cholesterol lowering agent. Studies have shown that this drug can lower blood cholesterol by 25-35% and to reduce the risk of death from cardiovascular complications by 25%1

It is also suitable for use in elderly as it reduces the risk of cardiovascular diseases.2

Safety precautions

Pravastatin is generally well tolerated and rarely cause side effects.

It should be avoided in the following conditions:

  • In patients who have liver damage
  • In patients who have or have had muscle damage/disorders
  • In patients with kidney disease
  • In patients with decreased secretion of thyroid hormones
  • In pregnant women
  • In nursing mothers

Be sure to tell your doctor if you experience unexplained/unexpected muscle cramps, pain in the muscles or a sore muscles. These symptoms may be a sign of myopathy or rhabdomyolysis. Rhabdomyolysis is muscle damage with possible lethal outcome!

If you are diabetic, it is necessary to carefully monitor blood sugar levels while on treatment with this drug.

Pravastatin, pregnancy and lactation

FDA strictly prohibits the use of this drug during pregnancy, placing it in the group X (drugs that are likely to be teratogenic).3 FDA recommends to stop using this drug during pregnancy because the risk of teratogenic effects on the fetus outweighs the risk of cardiovascular complications in the mother.

Use of Pravastatin is contraindicated during breastfeeding.

Dosage

Pravastatin comes into several different dosage forms (10, 20, 40 and 80 mg).

Table 1: Dosage of the pravastatin in adults

Condition Dosage
Elevated cholesterol and lipid levels in the blood The usual dose is 10-40 mg once a day (preferably at bedtime)
Prevention of heart and blood vessels diseases The usual dose is 40 mg once a day (preferably at bedtime)
After transplantation 20 mg once a day

The maximum daily dose is 40 mg and may be exceeded only in patients with extremely high levels of cholesterol, and only if recommended by experienced doctor. Careful monitoring of the patient taking larger doses is necessary.

Pravastatin can be applied in children with familial hypercholesterolemia.

Table 2: Dosage of Pravastatin in children with familial hypercholesterolemia

Age Dosage
8-13 years 10-20 mg once daily
14-18 years 10-40 mg once daily

In patients who have impaired kidney function, the starting dose should be minimal (10 mg daily).

This drug must be taken regularly, even if you feel better. Duration of therapy is usually long-term.

Interactions

Pravastatin may interact with the following medications:

  • Drugs used for rheumatoid arthritis treatment (leflunomide, lenalidomide and teriflunomide). These drugs can damage the liver, just like Pravastatin, and because of that concomitant use is contraindicated.
  • Other drugs that lower cholesterol and triglycerides (fenofibrate, gemfibrozil, clofibrate, lovastatin, fluvastatin, atorvastatin, simvastatin, rosuvastatin, niacin, lomitapid, mipomersen and others). Concomitant use increases the risk of myopathy and liver damage.
  • Cyclosporine - a drug used to prevent rejection of the organ transplants, or for the treatment of psoriasis and rheumatoid arthritis. Cyclosporine increases the concentration of the Pravastatin in the blood, which increase the risk of side effects.
  • Drugs used to treat hepatitis C (paritaprevir). This drug significantly increases the level of Pravastatin in the blood.

Tell your doctor if you are using any other medicines.

Side effects

Occasional side effects of Pravastatin are the following:

  • Eye problems
  • Pain or discomfort in the abdomen
  • Insomnia
  • Pain in the joints and muscles
  • The appearance of acne
  • Skin rash
  • Gas and bloating
  • Painful and frequent urination
  • Problems with the bladder

Very rare side effects of Pravastatin are the following:

  • Syndrome similar to lupus erythematosus
  • Inflammation of the liver and / or pancreas
  • Fulminant hepatic necrosis (the phenomenon that liver cells are dying at very high speed)
  • Myositis and polymyositis
  • Inflammation of the joints
  • Rupture of the joints
  • Pain in the muscles or muscle weakness

Other side effects of pravastatin are:

  • Depression
  • Memory loss
  • Nightmares

References

  1. NCBI link 1
  2. NCBI link 2