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Pravastatin

  • Medical and Pharmacy Editor: John P. Cunha, DO, FACOEP
    John P. Cunha, DO, FACOEP

    John P. Cunha, DO, FACOEP

    John P. Cunha, DO, is a U.S. board-certified Emergency Medicine Physician. Dr. Cunha's educational background includes a BS in Biology from Rutgers, the State University of New Jersey, and a DO from the Kansas City University of Medicine and Biosciences in Kansas City, MO. He completed residency training in Emergency Medicine at Newark Beth Israel Medical Center in Newark, New Jersey.

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:

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

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

Dosing Modifications

Renal impairment

  • 10 mg orally once/day initially

Hepatic impairment

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

QUESTION

What is cholesterol? See Answer

What Are Side Effects Associated with Using Pravastatin?

Side effects associated with use of Pravastatin, include the following:

Other side effects of pravastatin include:

  • Muscle disease
  • Muscle wasting (rhabdomyolysis)

This document does not contain all possible side effects and others may occur. Check with your physician for additional information about side effects.

What Other Drugs Interact with Pravastatin?

If your doctor has directed you to use this medication, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider or pharmacist first.

Severe interactions of pravastatin include:

Serious Interactions of pravastatin include:

Pravastatin has moderate interactions with at least 53 different drugs.

Mild Interactions of pravastatin include:

This information does not contain all possible interactions or adverse effects. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share this information with your doctor and pharmacist. Check with your health care professional or doctor for additional medical advice, or if you have health questions, concerns or for more information about this medicine.

SLIDESHOW

Lower Your Cholesterol, Save Your Heart See Slideshow

What Are Warnings and Precautions for Pravastatin?

Warnings

  • This medication contains pravastatin. Do not take Pravachol if you are allergic to pravastatin or any ingredients contained in this drug
  • Keep out of reach of children. In case of overdose, get medical help or contact a Poison Control Center immediately

Contraindications

Effects of Drug Abuse

  • No information provided

Short-Term Effects

  • See "What Are Side Effects Associated with Using Pravastatin?"

Long-Term Effects

  • See "What Are Side Effects Associated with Using Pravastatin?"

Cautions

  • Non-serious and reversible cognitive side effects may occur
  • Increased blood sugar and glycosylated hemoglobin (HbA1c) levels reported with statin intake
  • Risk of rhabdomyolysis; predisposing factors include advanced age (65 years or older), uncontrolled hypothyroidism, and renal impairment; discontinue if myopathy develops
  • Rare reports of immune-mediated necrotizing myopathy (IMNM), characterized by increased serum creatine kinase that persists despite discontinuation of statin
  • Maximum response 4-6 weeks
  • Recent liver disease, symptoms of liver disease
  • Heavy alcohol use
  • Use caution with other drugs that increase risk of myopathy (e.g., fibrates)
  • Rule out secondary causes of hyperlipedemia before initiating therapy
  • Monitor liver function periodically
  • Postmarketing Reports:

Pregnancy and Lactation

  • Administer pravastatin to women of childbearing age only when patients are highly unlikely to conceive and have been informed of potential hazards; if the patient becomes pregnant while taking this class of drug, discontinue therapy immediately and apprise patient of the potential hazard to a fetus
  • Pravastatin enters breast milk; its use is contraindicated while breastfeeding


SOURCE:
Medscape. Pravastatin.
https://reference.medscape.com/drug/pravachol-pravastatin-342460

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