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.
Serious liver damage with statins is rare. More often, statins cause
abnormalities of liver tests, and, therefore, periodic measurement of liver
tests in the blood is recommended for all statins. Abnormal tests usually return
to normal even if a statin is continued, but if the abnormal test is greater
than three times normal, the statin usually is stopped. Liver tests should be
measured before therapy is started, whenever the dose of the statin is
increased, or if there is a medical concern. Measurement of liver tests is
recommended with pravastatin even though in long-term studies abnormalities of
liver tests with pravastatin was similar to a sugar pill.
Inflammation of the muscles caused by statins can lead to a serious breakdown
of muscle cells called rhabdomyolysis. When used alone, statins cause
rhabdomyolysis in less than one percent of patients. Rhabdomyolysis causes the
release of muscle protein (myoglobin) into the blood. Myoglobin can cause kidney
failure and even death. To prevent the development of rhabdomyolysis, patients
taking statins, including pravastatin, should contact their healthcare provider
immediately if they develop unexplained muscle pain, weakness, or tenderness.
Since pravastatin prevents heart attacks, strokes and death, its benefit usually
outweighs its serious but rare side effects.
Reference: FDA Prescribing Information
Last Editorial Review: 2/7/2003
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.
- Statins - Read about statins, cholesterol lowering medications like Levacor, Zocor, Pravachol, Lipitor, Crestor, and more. Side effects, drug interactions, and patient information is also provided.
- Liver Blood Tests - Learn about liver blood tests used to detect liver damage disease such as fatty liver, cirrhosis, hepatitis, Tylenol liver damage, and more. This includes measuring the aminotransferases enzymes (AST and ALT levels)
- Heart Attack - Overview on heart attack (myocardial infarction) and heart attack symptoms including jaw pain, headache, shortness of breath, nausea, vomiting, heartburn, sweating, and more.
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