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Pravastatin Patient Tips

Medically reviewed on Sep 27, 2017 by C. Fookes, BPharm.

How it works

  • Pravastatin may be used for the treatment of high cholesterol.
  • Pravastatin works by blocking an enzyme, called HMG-CoA reductase, in the liver that makes different types of lipids (this is the collective term for fats and cholesterol). Pravastatin also boosts the breakdown of lipids.
  • Pravastatin belongs to the class of medicines known as statins. Pravastatin is also known as an HMG-CoA reductase inhibitor.

Upsides

  • Pravastatin in conjunction with dietary measures is used to treat high cholesterol in people at increased risk of cardiovascular disease if initial dietary measures fail to lower cholesterol.
  • Pravastatin is also used to lower the risk of coronary events (includes heart attack, stroke, and angina) in patients at high risk of these events - such as people with pre-existing coronary heart disease, diabetes, peripheral vessel disease, a previous history of stroke and stroke-like events or heart attack, or with multiple risk factors (such as older age, smoking, high blood pressure, low HDL-C, family history of heart disease).
  • Grapefruit products or juice have little effect on blood levels of pravastatin.
  • Generic pravastatin is available.

Downsides

If you are between the ages of 18 and 60, take no other medication or have no other medical conditions, side effects you are more likely to experience include:

  • Diarrhea, rhinitis, tiredness, headache, nausea. Pravastatin is generally well tolerated; discontinuation rates due to adverse effects have been similar to placebo (a nonactive pill).
  • Muscle pain, tenderness, or weakness - initially needs further investigation to rule out more serious muscle effects (such as rhabdomyolysis - the destruction of muscle cells). People aged older than 65, taking certain medications (for example cyclosporine, colchicine), who drink more than two alcoholic drinks per day or with kidney disease appear more at risk.
  • Pravastatin, like other statins, may affect liver function, manifesting as changes in liver function tests or jaundice (yellowing of the skin) requiring dosage reduction or discontinuation. Liver function tests are recommended prior to starting therapy and at periodic intervals throughout therapy.
  • May not be suitable in those with liver or kidney disease.
  • Rarely, has been associated with memory loss, forgetfulness, amnesia, memory impairment, and confusion. These symptoms typically resolve with discontinuation.
  • May interact with a number of other medications including clarithromycin, colchicine, cyclosporine, gemfibrozil, other fibrates, niacin, and paroxetine.

Notes: In general, seniors or children, people with certain medical conditions (such as liver or kidney problems, heart disease, diabetes, seizures) or people who take other medications are more at risk of developing a wider range of side effects. For a complete list of all side effects, click here.

Bottom Line

Pravastatin is effective at lowering cholesterol; however, it may not be as effective as atorvastatin. Grapefruit products do not affect pravastatin to the same extent as atorvastatin.

Tips

  • Take once daily, with or without food. May be taken at any time of the day (morning or night); however, it is best to be consistent with the time you take your tablets.
  • The dosage of pravastatin needs to be individualized but initially should start at 40 mg/day and be guided by the results of cholesterol tests taken 4 weeks later. Take pravastatin exactly as directed by your doctor. Do not increase or decrease the dosage without his or her advice.
  • Seek prompt medical advice if you have any acute muscle pain, tenderness or weakness that persists after discontinuing pravastatin, particularly if accompanied by sickness or fever. Also report any unexplained fatigue, shortness of breath, unexplained cough, weight loss, abdominal pain, dark urine or yellowing of the skin.
  • Take once daily. Grapefruit juice has less of an effect on pravastatin compared to atorvastatin. May be taken with or without food.
  • Adhere to the National Cholesterol Education program diet or a similar recommended diet while taking pravastatin.
  • Plan to do exercise regularly and stop smoking if you smoke. Try to avoid second-hand smoke.
  • Dosage needs to be individualized but initially should start at 40mg/day and be guided by the results of cholesterol tests taken at least 4 weeks later.
  • Pravastatin should not be taken during pregnancy or while breastfeeding. Ensure you use effective contraception while taking pravastatin if you are a woman of childbearing age and talk to your doctor if you intend to become pregnant before you actually become pregnant.

Response and Effectiveness

  • Peak levels of pravastatin are seen within one to one and a half hours following administration; however, may take one to two weeks of regular dosing before improvements in your cholesterol levels are seen, and up to four weeks before the maximal cholesterol-lowering effects of pravastatin are apparent.  
  • Pravastatin is moderate potent at reducing LDL cholesterol.

References

  • Pravastatin [Package Insert] Revised: 06/2017. Zydus Pharmaceuticals (USA) Inc. https://www.drugs.com/pro/pravastatin.html
  • Schaefer EJ, McNamara JR, Tayler T, et al. Comparison of the effects of statins (atorvastatin, fluvastatin, lovastatin, pravastatin, and simvastatin) on fasting and postprandial lipoproteins in patients with coronary heart disease versus control subjects. Am J Cardiol. 2004 Jan 1;93(1):31-9.
  • Freeman DJ, Norrie J, Sattar N, et al. Pravastatin and the Development of Diabetes Mellitus. Evidence for a Protective Treatment Effect in the West of Scotland Coronary Prevention StudyCirculation. 2001; 103: 357-362 doi: 10.1161/01.CIR.103.3.357
  • Grapefruit juice and statins. Harvard Health Publishing. Harvard Medical School. https://www.health.harvard.edu/heart-health/grapefruit-juice-and-statins
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use pravastatin only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that this information is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. This drug information does not endorse drugs, diagnose patients or recommend therapy. It is an informational resource designed as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Drugs.com does not assume any responsibility for any aspect of healthcare administered with the aid of this information. 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 drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2017 Drugs.com. Revision Date: 2017-10-27 00:38:01

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