Medications and Drugs
Pharmacy Author: Omudhome Ogbru, Pharm.D.
Medical Editor: Jay Marks, M.D.
GENERIC NAME: pravastatin
BRAND NAME: Pravachol
DRUG CLASS AND MECHANISM: Pravastatin is an oral drug for
lowering cholesterol in the blood. It has been shown to reduce the occurrence of heart
attacks, strokes and death caused by coronary heart disease. It belongs to a
class of drugs called HMG-CoA reductase Inhibitors, commonly called "statins".
Other statins include simvastatin (Zocor), lovastatin (Mevacor), atorvastatin
(Lipitor) and fluvastatin (Lescol). Statins reduce cholesterol by inhibiting an
enzyme in the liver (HMG-CoA reductase) that is necessary for the production of
cholesterol. In the blood, statins lower total and LDL ("bad") cholesterol
as well as triglycerides. They also increase HDL ("good") cholesterol. LDL
cholesterol is believed to be an important cause of coronary artery disease.
Lowering LDL cholesterol levels slows and may even reverse coronary artery
disease. Raising HDL cholesterol levels also may slow coronary artery disease.
Scientists have discovered that inflammation of the coronary arteries also
may contribute to coronary heart disease. Inflammation is associated with
elevated levels of a protein called C-reactive protein. This C-reactive protein
in blood can be measured by a test, referred to as the "highly sensitive"
C-reactive protein test (Hs-CRP). Elevated levels of Hs-CRP predict the
occurrence of heart attacks, strokes and death. In fact, Hs-CRP is a better
predictor of heart attacks, strokes and death than cholesterol levels.
Pravastatin reduces the levels of Hs-CRP and it has been suggested that
pravastatin may reduce coronary artery disease by reducing inflammation rather
than, or in addition to, lowering levels of cholesterol. Pravastatin was
approved by the FDA in October 1991.
PRESCRIPTION: Yes
GENERIC AVAILABLE: No
PREPARATIONS: Tablets: 10, 20, 40, and 80 mg
STORAGE: Pravastatin should be stored at room temperature, between
20-25 C (68-77 F).
PRESCRIBED FOR: Pravastatin is used for the reduction of total and LDL
cholesterol as well as triglycerides and to increase HDL cholesterol.
Pravastatin reduces the occurrence of heart attacks, strokes and death caused by
coronary artery disease.
DOSING: The starting dose for most adults is 40 mg once daily. The maximum
dose is 80 mg per day.
DRUG INTERACTIONS: Bile acid sequestrants such as cholestyramine (Questran)
may significantly reduce the absorption of pravastatin and therefore reduce its
effect. Therefore, pravastatin should be taken 1-4 hours after bile acid
sequestrants.
The use of pravastatin with nicotinic acid, gemfibrozil (Lopid) or other
drugs that may cause liver or muscle problems may increase the incidence of such
side effects.
PREGNANCY: Although there is no data in pregnant women, statins should not be
used by pregnant women because there is an increased risk of muscle
malformations when statins are given to pregnant animals.
NURSING MOTHERS: A small amount of pravastatin is excreted in
breast milk.
Because of the risk of toxicity to the infant, nursing mothers should not nurse
while taking pravastatin.
SIDE EFFECTS: Like most statins, the most common side effects of pravastatin
are headache, nausea, vomiting, diarrhea, muscle pain, and
abnormal liver tests.
The most serious potential side effects are liver damage and muscle inflammation
or breakdown.
Report Problems to the Food and Drug Administration
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.
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