Skip to Content

Pravastatin Side Effects

In Summary

Commonly reported side effects of pravastatin include: chest pain. Other side effects include: dizziness, cough, skin rash, increased serum alanine aminotransferase, influenza, and increased creatine phosphokinase. See below for a comprehensive list of adverse effects.

For the Consumer

Applies to pravastatin: oral tablet

As well as its needed effects, pravastatin may cause unwanted side effects that require medical attention.

Severity: Major

If any of the following side effects occur while taking pravastatin, check with your doctor immediately:

More common:
  • Difficulty with moving
  • muscle or bone pain
  • muscle stiffness
  • pain in the joints
  • pain, localized
Less common:
  • Arm, back, or jaw pain
  • chest pain or discomfort
  • chills
  • cough
  • dark-colored urine
  • diarrhea
  • difficult or labored breathing
  • ear congestion
  • fast or irregular heartbeat
  • fever
  • general feeling of discomfort or illness
  • headache
  • loss of appetite
  • muscle cramps or spasms
  • muscular tenderness, wasting, or weakness
  • nasal congestion
  • nausea
  • runny nose
  • shivering
  • sneezing
  • sore throat
  • sweating
  • swollen joints
  • tightness in the chest
  • trouble with sleeping
  • unusual tiredness or weakness
  • vomiting

Severity: Minor

Some pravastatin side effects may not need any medical attention. As your body gets used to the medicine these side effects may disappear. Your health care professional may be able to help you prevent or reduce these side effects, but do check with them if any of the following side effects continue, or if you are concerned about them:

More common:
  • Stomach pain
Less common:
  • Acid or sour stomach
  • belching
  • bloated or full feeling
  • blurred vision or other changes in vision
  • difficult or painful urination
  • difficulty having a bowel movement (stool)
  • dizziness
  • double vision
  • fear or nervousness
  • feeling sad or empty
  • increased urge to urinate during the night
  • irritability
  • loss of interest or pleasure
  • pain in the chest below the breastbone
  • passing gas
  • rash
  • stomach discomfort or upset
  • tiredness
  • trouble concentrating

For Healthcare Professionals

Applies to pravastatin: oral tablet


Hepatic side effects of pravastatin have included elevated in liver function tests (1.3%). HMG-CoA reductase inhibitors have reported hepatic side effects of hepatitis, including chronic active hepatitis, cholestatic jaundice, fatty change in the liver, cirrhosis, and fulminant hepatic necrosis.[Ref]

Persistent elevations in liver function tests three times normal values have been reported in up to 1.3% of patients in clinical trials. In one review of 1,142 patients, elevations in serum transaminases led to discontinuation of pravastatin in 1% of patients. Clinical monitoring of hepatic function is recommended and pravastatin should be discontinued in patients with persistent, significant elevations (three times normal) in liver function parameters.[Ref]


HMG-CoA reductase inhibitors (statins) have been associated with rare cases of severe myopathy and rhabdomyolysis, accompanied by increases in creatine kinase, myoglobinuria, proteinuria, and renal failure. Concomitant use with gemfibrozil (fibric acid derivatives), niacin, cyclosporine, erythromycin (macrolides) or azole antifungals may increase the incidence and severity of musculoskeletal side effects. Other variables associated with an increased risk of statin-induced myopathy include, advanced age, small body stature, female gender, renal and/or hepatic dysfunction, perioperative periods, hypothyroidism, diabetes mellitus, and alcoholism.

Milder forms of myotoxicity (i.e., myalgia) are commonly reported and occur in approximately 5% to 7% of patients taking a statin drug.

One case of myopathy and one of dermatomyositis associated with pravastatin have been reported in the literature.

Patients should be instructed to promptly report symptoms of muscle pain, weakness, or tenderness. If such symptoms develop, creatine kinase should be measured and if markedly elevated, pravastatin should be discontinued. The value of routine monitoring of creatine kinase is not known.

A case of asymptomatic pravastatin-induced rhabdomyolysis has been reported in a patient receiving the drug for 3 years. Following discontinuation of pravastatin, the patient's serum creatine kinase levels returned to normal after 3 weeks.[Ref]

Musculoskeletal side effects of pravastatin have included elevations in creatine kinase, myopathy, and a case report of dermatomyositis. Musculoskeletal side effects reported with HMG-CoA reductase inhibitors have included rhabdomyolysis, arthralgia, and tendon rupture.

In addition, some data have suggested that exposure to HMG-CoA reductase inhibitors is associated with a decreased risk of bone fractures in persons older than 50 years of age.[Ref]


Gastrointestinal side effects of pravastatin have included nausea and vomiting (0.5% to 7.3%), diarrhea (2.0% to 6.2%), abdominal pain (0.3% to 5.4%), constipation, flatulence, and heartburn. Gastrointestinal side effects reported with HMG-CoA reductase inhibitors have included pancreatitis and anorexia.[Ref]

Gastrointestinal side effects have been among the most common symptoms reported by patients on pravastatin. These symptoms tended to be mild and transient in nature and resolved with continued therapy.[Ref]


Hematologic side effects including hemolytic anemia, thrombocytopenia, thrombotic thrombocytopenic purpura (TTP), and leukopenia have occurred with some HMG-CoA reductase inhibitors. These effects may be manifestations of a hypersensitivity reaction.[Ref]

Nervous system

Nervous system side effects of pravastatin have included headache (0.6% to 6.2%), dizziness, drowsiness, and weakness. Cranial nerve dysfunction, tremor, vertigo, fatigue, weight loss, memory loss, decline in cognitive function, paresthesias, peripheral neuropathy, and peripheral nerve palsy have been reported with HMG-CoA reductase inhibitors.[Ref]


Renal side effects of HMG-CoA reductase inhibitors have included myoglobinuria and acute renal failure secondary to rhabdomyolysis.[Ref]


Dermatologic side effects of pravastatin have included rash (0.9% to 4.0%) and a case report of bullous erythematous lesions. Erythema multiforme, Stevens-Johnson syndrome, toxic epidermal necrolysis, photosensitivity, purpura, and alopecia have occurred with HMG-CoA reductase inhibitors.[Ref]


Endocrine side effects of gynecomastia and thyroid function abnormalities have been reported. Endocrine side effects associated with other HMG-CoA reductase inhibitors have included hypospermia. In addition, acid maltase deficiency (the genetic disorder also referred to as Pompe's Disease) has been revealed following HMG-CoA therapy in at least one presymptomatic patient.[Ref]


Hypersensitivity reactions have rarely occurred with HMG-CoA reductase inhibitors. Anaphylaxis, angioedema, urticaria, fever, chills, flushing, malaise, and dyspnea have been reported.[Ref]


Immunologic side effects of HMG-CoA reductase inhibitors have included a lupus-like syndrome, positive ANA, elevated ESR, polymyalgia rheumatica, and vasculitis.[Ref]


Ocular side effects of HMG-CoA reductase inhibitors have included progression of cataracts and ophthalmoplegia. There are no data associating pravastatin with lens opacities in humans.[Ref]


Psychiatric side effects of pravastatin have included insomnia and other sleep disturbances. Other psychiatric side effects of HMG-CoA reductase inhibitors have included decreased libido, anxiety, depression, suicidal thoughts, delusions, paranoia, agitation, and nightmares.[Ref]


Genitourinary side effects of HMG-CoA reductase inhibitors have included erectile dysfunction, impotence and testicular pain.[Ref]

Halkin, et al report a case in which use of both lovastatin and pravastatin on different occasions in the same patient lead to reversible impotence. The impotence resolved within 2 weeks after discontinuation of the HMG-CoA reductase inhibitor.[Ref]


Oncologic side effects including hepatocellular carcinomas and malignant lymphomas have been associated with pravastatin in animal studies. Long-term clinical trials are needed to define the cancer risk in humans.[Ref]


1. Hartleb M, Rymarczyk G, Januszewski K "Acute cholestatic hepatitis associated with pravastatin." Am J Gastroenterol 94 (1999): 1388-90

2. McGovern ME, Mellies MJ "Long-term experience with pravastatin in clinical research trials." Clin Ther 15 (1993): 57-64

3. Raasch RH "Pravastatin sodium, a new HMG-CoA reductase inhibitor." DICP 25 (1991): 388-94

4. "Product Information. Pravachol (pravastatin)." Bristol-Myers Squibb, Princeton, NJ.

5. McTavish D, Sorkin EM "Pravastatin: a review of its pharmacological properties and therapeutic potential in hypercholesterolaemia." Drugs 42 (1991): 65-89

6. Jungnickel PW, Cantral KA, Maloley PA "Pravastatin: a new drug for the treatment of hypercholesterolemia." Clin Pharm 11 (1992): 677-89

7. "A multicenter comparative trial of lovastatin and pravastatin in the treatment of hypercholesterolemia. The Lovastatin Pravastatin Study Group." Am J Cardiol 71 (1993): 810-5

8. Iliadis EA, Rosenson RS "Long-term safety of pravastatin-gemfibrozil therapy in mixed hyperlipidemia." Clin Cardiol 22 (1999): 25-8

9. Sinzinger H, O'Grady J "Professional athletes suffering from familial hypercholesterolaemia rarely tolerate statin treatment because of muscular problems." Br J Clin Pharmacol 57 (2004): 525-8

10. "Summaries for patients. Muscle abnormalities in four patients taking statins to treat unfavorable cholesterol levels." Ann Intern Med 137 (2002): I45

11. Graham DJ, Staffa JA, Shatin D, et al. "Incidence of hospitalized rhabdomyolysis in patients treated with lipid-lowering drugs." JAMA 292 (2004): 2585-90

12. Schalke BB, Schmidt B, Toyka K, Hartung H-P "Pravastatin-associated inflammatory myopathy." N Engl J Med 327 (1992): 649-50

13. Schindler C, Thorns M, Matschke K, Tugtekin SM, Kirch W "Asymptomatic statin-induced rhabdomyolysis after long-term therapy with the hydrophilic drug pravastatin." Clin Ther 29 (2007): 172-6

14. Wiklund O, Angelin B, Bergman M, et al. "Pravastatin and gemfibrozil alone and in combination for the treatment of hypercholesterolemia." Am J Med 94 (1993): 13-20

15. Arora R, Liebo M, Maldonado F "Statin-induced myopathy: the two faces of Janus." J Cardiovasc Pharmacol Ther 11 (2006): 105-12

16. Alayli G, Cengiz K, Canturk F, Durmus D, Akyol Y, Menekse EB "Acute myopathy in a patient with concomitant use of pravastatin and colchicine." Ann Pharmacother 39 (2005): 1358-61

17. Watanabe S, Fukumoto S, Takeuchi Y, Fujita H, Nakano T, Fujita T "Effects of 1-year treatment with fluvastatin or pravastatin on bone." Am J Med 110 (2001): 584-7

18. Omar MA, Wilson JP "FDA adverse event reports on statin-associated rhabdomyolysis." Ann Pharmacother 36 (2002): 288-95

19. Meier CR, Schlienger RG, Kraenzlin ME, Schlegel B, Jick H "HMG-CoA reductase inhibitors and the risk of fractures." JAMA 283 (2000): 3205-10

20. Mukhtar RY, Reckless JP "Statin-induced myositis: a commonly encountered or rare side effect?" Curr Opin Lipidol 16 (2005): 640-7

21. Sinzinger H, Wolfram R, Peskar BA "Muscular side effects of statins." J Cardiovasc Pharmacol 40 (2002): 163-71

22. Rosenberg AD, Neuwirth MG, Kagen LJ, Singh K, Fischer HD, Bernstein RL "Intraoperative rhabdomyolysis in a patient receiving pravastatin, a 3-hydroxy-3-methylglutaryl coenzyme a (HMG coa) reductase inhibitor." Anesth Analg 81 (1995): 1089-91

23. Finsterer J, Zuntner G "Rhabdomyolysis from Simvastatin triggered by infection and muscle exertion." South Med J 98 (2005): 827-9

24. Gonyeau MJ "Statins and osteoporosis: a clinical review." Pharmacotherapy 25 (2005): 228-43

25. Grundy SM "Can statins cause chronic low-grade myopathy?" Ann Intern Med 137 (2002): 617-8

26. Pan HY "Clinical pharmacology of pravastatin, a selective inhibitor of HMG- CoA reductase." Eur J Clin Pharmacol 40 (1991): s15-8

27. Sundram F, Roberts P, Kennedy B, Pavord S "Thrombotic thrombocytopenic purpura associated with statin treatment." Postgrad Med J 80 (2004): 551-2

28. Wagstaff LR, Mitton MW, Arvik BM, Doraiswamy PM "Statin-associated memory loss: analysis of 60 case reports and review of the literature." Pharmacotherapy 23 (2003): 871-80

29. Galatti L, Polimeni G, Salvo F, Romani M, Sessa A, Spina E "Short-term memory loss associated with rosuvastatin." Pharmacotherapy 26 (2006): 1190-2

30. Padala KP, Padala PR, Potter JF "Simvastatin-induced decline in cognition." Ann Pharmacother 40 (2006): 1880-3

31. Muldoon MF, Ryan CM, Sereika SM, Flory JD, Manuck SB "Randomized trial of the effects of simvastatin on cognitive functioning in hypercholesterolemic adults." Am J Med 117 (2004): 823-9

32. Gaist D, Jeppesen U, Andersen M, Garcia Rodriguez LA, Hallas J, Sindrup SH "Statins and risk of polyneuropathy: a case-control study." Neurology 58 (2002): 1333-7

33. van Puijenbroek EP, Du Buf-Vereijken PW, Spooren PF, van Doormaal JJ "Possible increased risk of rhabdomyolysis during concomitant use of simvastatin and gemfibrozil." J Intern Med 240 (1996): 403-4

34. Alvarez JM, Rawdanowiz TJ, Goldstein J "Rhadbdomyolysis after coronary artery bypass grafting in a patient receiving simvastatin." J Thorac Cardiovasc Surg 116 (1998): 654-5

35. Vanpuijenbroek EP, Dubufvereijken PWG, Spooren PFMJ, Vandoormaal JJ "Possible increased risk of rhabdomyolysis during concomitant use of simvastatin and gemfibrozil." J Intern Med 240 (1996): 403-4

36. Jonvillebera AP, Zakian A, Bera FJ, Carre P, Autret E "Possible pravastatin and diuretics-induced diabetes-mellitus." Ann Pharmacother 28 (1994): 964-5

37. Gregoor PJ "Atorvastatin may cause nightmares." BMJ 332 (2006): 950

38. Morales K, Wittink M, Datto C, et al. "Simvastatin causes changes in affective processes in elderly volunteers." J Am Geriatr Soc 54 (2006): 70-6

39. Bernini GP, Brogi G, Argenio GF, Moretti A, Salvetti A "Effects of long-term pravastatin treatment on spermatogenesis and on adrenal and testicular steroidogenesis in male hypercholesterolemic patients." J Endocrinol Invest 21 (1998): 310-7

40. Halkin A, Lossos IS, Mevorach D "HMG-CoA reductase inhibitor-induced impotence." Ann Pharmacother 30 (1996): 192

41. Linnebur SA, Hiatt WH "Probable Statin-Induced Testicular Pain (January)." Ann Pharmacother (2007):

42. Bjerre LM, LeLorier J "Do statins cause cancer? A meta-analysis of large randomized clinical trials." Am J Med 110 (2001): 716-23

43. Newman TB, Hulley SB "Carcinogenicity of lipid-lowering drugs." JAMA 275 (1996): 55-60

It is possible that some side effects of pravastatin may not have been reported. These can be reported to the FDA here. Always consult a healthcare professional for medical advice.

Disclaimer: Every effort has been made to ensure that the information provided is accurate, up-to-date and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. This material does not endorse drugs, diagnose patients, or recommend therapy. This information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill , knowledge, and judgement of healthcare practitioners in patient care. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate safety, effectiveness, or appropriateness for any given patient. does not assume any responsibility for any aspect of healthcare administered with the aid of materials provided. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the substances you are taking, check with your doctor, nurse, or pharmacist.