Pravastatin

Brand Name: Pravachol

Generic Name: pravastatin

Drug Class: Lipid-Lowering Agents, Statins; HMG-CoA Reductase Inhibitors

What Is Pravastatin and How Does It Work?

Pravastatin is indicated for prevention of cardiovascular disease, and to treat hyperlipidemia.

In hypercholesterolemic patients without clinically evident coronary heart disease (CHD), pravastatin is indicated to:

• reduce the risk of myocardial infarction (MI)
• reduce the risk of undergoing myocardial revascularization procedures
• reduce the risk of cardiovascular mortality with no increase in death from non-cardiovascular causes

In patients with clinically evident CHD, pravastatin is indicated to:

• reduce the risk of total mortality by reducing coronary death
• reduce the risk of heart attack (myocardial infarction, or MI)
• reduce the risk of undergoing myocardial revascularization procedures
• reduce the risk of stroke and stroke/transient ischemic attack (TIA)
• slow the progression of coronary atherosclerosis

In the treatment of hyperlipidemia, pravastatin is indicated:

• as an adjunct to diet to reduce elevated total cholesterol (Total-C), low-density lipoprotein cholesterol (LDL-C), apolipoprotein B (ApoB), and triglyceride (TG) levels and to increase high-density lipoprotein cholesterol (HDL-C) in patients with primary hypercholesterolemia and mixed dyslipidemia (Fredrickson Types IIa and IIb).1 as an adjunct to diet for the treatment of patients with elevated serum TG levels (Fredrickson Type IV). for the treatment of patients with primary dysbetalipoproteinemia (Fredrickson Type III) who do not respond adequately to diet. as an adjunct to diet and lifestyle modification for treatment of heterozygous familial hypercholesterolemia (HeFH) in children and adolescent patients ages 8 years and older if after an adequate trial of diet the following findings are present:
• LDL-C remains 190 mg/dL or greater, or
• LDL-C remains 160 mg/dL or greater, and:
• there is a positive family history of premature cardiovascular disease (CVD) or
• two or more other CVD risk factors are present in the patient

Pravastatin is available under the following different brand names: Pravachol.

Dosages of Pravastatin:

Adult and Pediatric Dosage Forms and Strengths

Tablet as potassium

• 10 mg (generic only)
• 20 mg
• 40 mg
• 80 mg

Dosage Considerations – Should be Given as Follows:

Hyperlipidemia, Primary Prevention of Coronary Events, Secondary Prevention of Cardiovascular Events

• May be beneficial for prophylaxis of cardiovascular events in at-risk patients, even if patients have normal levels of cholesterol
• 10-40 mg orally once/day; not to exceed 80 mg/day
• Initiate with 10 mg at bedtime if taking immunosuppressants like cyclosporine concurrently; not to exceed 20 mg/day
• Limit maximum to 40 mg/day if taking concurrently with clarithromycin
• Dose adjustments should be made at intervals of 4 weeks or more; individualize dosing according to baseline LDL cholesterol levels

Heterozygous Familial Hypercholesterolemia

• Children 8-13 years: 20 mg orally once/day
• Children 14-18 years: 40 mg orally once/day
• Co-administration with cyclosporine: Initiate with 10 mg at bedtime; not to exceed 20 mg/day
• Limit maximum to 40 mg/day if taking concurrently with clarithromycin
• Dose adjustments should be made at intervals of 4 weeks or more; individualize dosing according to baseline LDL cholesterol levels

Dosing Considerations

Overdose management

• Adverse drug reactions from overdose may include peripheral neuropathy, diarrhea, increased potassium, myopathy, rhabdomyolysis, acute renal failure, elevated liver function tests (LFTs), eye lens opacities
• Treatment is supportive

Dosing Modifications

Renal impairment

• 10 mg orally once/day initially

Hepatic impairment

• Contraindicated if active liver disease or unexplained persistent elevations of serum transaminases