Pravastatin Dosage

Medically reviewed on August 23, 2016.

Usual Adult Dose for Hyperlipidemia

Initial dose: 40 mg orally once a day
Maintenance dose: 40 mg to 80 mg orally once a day

Comments:
-Since maximal effect of a given dose is seen within 4 weeks, periodic lipid determinations should be performed at this time and dosage adjusted accordingly.

Uses: As an adjunct to diet in the following conditions: to reduced total cholesterol (total-C), low density lipoprotein (LDL-C), apolipoprotein B (Apo B), and triglyceride (TG) levels, and to increase high density lipoprotein (HDL-C) in patients with primary hypercholesterolemia and mixed dyslipidemia (Fredrickson Types IIa and IIb); for the treatment of elevated TG levels (Fredrickson Type IV); and for the treatment of primary dysbetalipoproteinemia (Fredrickson Type III) in patients who do not respond adequately to diet

Usual Adult Dose for Hyperlipoproteinemia Type IIa (Elevated LDL)

Initial dose: 40 mg orally once a day
Maintenance dose: 40 mg to 80 mg orally once a day

Comments:
-Since maximal effect of a given dose is seen within 4 weeks, periodic lipid determinations should be performed at this time and dosage adjusted accordingly.

Uses: As an adjunct to diet in the following conditions: to reduced total cholesterol (total-C), low density lipoprotein (LDL-C), apolipoprotein B (Apo B), and triglyceride (TG) levels, and to increase high density lipoprotein (HDL-C) in patients with primary hypercholesterolemia and mixed dyslipidemia (Fredrickson Types IIa and IIb); for the treatment of elevated TG levels (Fredrickson Type IV); and for the treatment of primary dysbetalipoproteinemia (Fredrickson Type III) in patients who do not respond adequately to diet

Usual Adult Dose for Hyperlipoproteinemia Type IIb (Elevated LDL + VLDL)

Initial dose: 40 mg orally once a day
Maintenance dose: 40 mg to 80 mg orally once a day

Comments:
-Since maximal effect of a given dose is seen within 4 weeks, periodic lipid determinations should be performed at this time and dosage adjusted accordingly.

Uses: As an adjunct to diet in the following conditions: to reduced total cholesterol (total-C), low density lipoprotein (LDL-C), apolipoprotein B (Apo B), and triglyceride (TG) levels, and to increase high density lipoprotein (HDL-C) in patients with primary hypercholesterolemia and mixed dyslipidemia (Fredrickson Types IIa and IIb); for the treatment of elevated TG levels (Fredrickson Type IV); and for the treatment of primary dysbetalipoproteinemia (Fredrickson Type III) in patients who do not respond adequately to diet

Usual Adult Dose for Hyperlipoproteinemia Type III (Elevated beta-VLDL + IDL)

Initial dose: 40 mg orally once a day
Maintenance dose: 40 mg to 80 mg orally once a day

Comments:
-Since maximal effect of a given dose is seen within 4 weeks, periodic lipid determinations should be performed at this time and dosage adjusted accordingly.

Uses: As an adjunct to diet in the following conditions: to reduced total cholesterol (total-C), low density lipoprotein (LDL-C), apolipoprotein B (Apo B), and triglyceride (TG) levels, and to increase high density lipoprotein (HDL-C) in patients with primary hypercholesterolemia and mixed dyslipidemia (Fredrickson Types IIa and IIb); for the treatment of elevated TG levels (Fredrickson Type IV); and for the treatment of primary dysbetalipoproteinemia (Fredrickson Type III) in patients who do not respond adequately to diet

Usual Adult Dose for Hyperlipoproteinemia Type IV (Elevated VLDL)

Initial dose: 40 mg orally once a day
Maintenance dose: 40 mg to 80 mg orally once a day

Comments:
-Since maximal effect of a given dose is seen within 4 weeks, periodic lipid determinations should be performed at this time and dosage adjusted accordingly.

Uses: As an adjunct to diet in the following conditions: to reduced total cholesterol (total-C), low density lipoprotein (LDL-C), apolipoprotein B (Apo B), and triglyceride (TG) levels, and to increase high density lipoprotein (HDL-C) in patients with primary hypercholesterolemia and mixed dyslipidemia (Fredrickson Types IIa and IIb); for the treatment of elevated TG levels (Fredrickson Type IV); and for the treatment of primary dysbetalipoproteinemia (Fredrickson Type III) in patients who do not respond adequately to diet

Usual Adult Dose for Hypertriglyceridemia

Initial dose: 40 mg orally once a day
Maintenance dose: 40 mg to 80 mg orally once a day

Comments:
-Since maximal effect of a given dose is seen within 4 weeks, periodic lipid determinations should be performed at this time and dosage adjusted accordingly.

Uses: As an adjunct to diet in the following conditions: to reduced total cholesterol (total-C), low density lipoprotein (LDL-C), apolipoprotein B (Apo B), and triglyceride (TG) levels, and to increase high density lipoprotein (HDL-C) in patients with primary hypercholesterolemia and mixed dyslipidemia (Fredrickson Types IIa and IIb); for the treatment of elevated TG levels (Fredrickson Type IV); and for the treatment of primary dysbetalipoproteinemia (Fredrickson Type III) in patients who do not respond adequately to diet

Usual Adult Dose for Prevention of Cardiovascular Disease

Initial dose: 40 mg orally once a day
Maintenance dose: 40 mg to 80 mg orally once a day

Comments:
-Since maximal effect of a given dose is seen within 4 weeks, periodic lipid determinations should be performed at this time and dosage adjusted accordingly.

Uses:
-In hypercholesterolemic patients without clinically evident coronary heart disease (CHD) to reduce the risk of myocardial infarction (MI); to reduce the risk of undergoing myocardial revascularization procedures; and to reduce the risk of cardiovascular (CV) mortality with no increase in death from non-CV causes

-In patients with clinically evident CHD to reduce the risk of total mortality by reducing coronary death; to reduce the risk of MI; to reduce the risk of undergoing myocardial revascularization procedures; to reduce the risk of stroke and stroke/transient ischemic attack; and to slow the progression of coronary atherosclerosis

Usual Pediatric Dose for Heterozygous Familial Hypercholesterolemia

8 to 13 years: 20 mg orally once a day; doses greater than 20 mg have not been studied in this patient population.

14 to 18 years: 40 mg orally once a day; doses greater than 40 mg have not been studied in this patient population.

Use: As an adjunct to diet and lifestyle modification for the treatment of heterozygous familial hypercholesterolemia 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 2 or more other CVD risk factors are present in the pediatric patient

Renal Dose Adjustments

Significant renal dysfunction:
-Initial dose: 10 mg orally once a day

Liver Dose Adjustments

Active liver disease (including unexplained persistent elevations in hepatic transaminase levels): Contraindicated

Dose Adjustments

Concomitant use with Clarithromycin:
-Maximum dose: 40 mg/day

Concomitant use with Immunosuppressive Drugs (e.g., cyclosporine):
-Initial dose: 10 mg orally once a day at bedtime; titrate with caution
-Maximum dose: 20 mg/day

Concomitant use with Bile Acid Resins (e.g., cholestyramine, colestipol):
-This drug should be given either 1 hour or more before or at least 4 hours following the resin.

Precautions

Safety and efficacy have not been established in patients younger than 8 years.

Consult WARNINGS section for additional precautions.

Dialysis

Data not available

Other Comments

Administration advice:
-Take orally once a day, at any time of day, with or without food

Storage requirements:
-Keep tightly closed; protect from moisture and light.

General:
-Prior to initiating therapy, patients should be placed on a standard cholesterol-lowering diet and continued on this diet throughout therapy.
-This drug has not been studied in conditions where the major lipoprotein abnormality is elevation of chylomicrons (Fredrickson Types I and V), nor has it been studied in homozygous familial hypercholesterolemia.
-Drug therapy should only be one component of multiple risk factor intervention in individuals at significantly increased risk for atherosclerotic vascular disease due to hypercholesterolemia; patients should be placed on this drug only when a diet restricted in saturated fat and cholesterol and other nonpharmacologic measures have proven inadequate.

Monitoring:
-Hepatic: Measure liver function tests prior to initiating therapy and repeat as clinically indicated.
-Metabolic: Monitor lipid levels 4 weeks after beginning therapy and adjust dosage accordingly.

Patient advice:
-Advise patients to report immediately any unexplained muscle pain, tenderness, or weakness, especially if accompanied by malaise or fever, or if muscle signs/symptoms persist after discontinuing therapy.
-Counsel patients to report any symptoms that may indicate liver injury, including fatigue, anorexia, right upper abdominal discomfort, dark urine, or jaundice.
-Counsel patients on the importance of contraceptive methods while taking this drug.
-Patients should talk to their health care provider if they are pregnant, planning to become pregnant, or breastfeeding; this drug is not recommended for use during pregnancy or lactation.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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