- What is pravastatin, and how does it work (mechanism of action)?
- What are the side effects of pravastatin?
- What is the dosage for pravastatin?
- Which drugs or supplements interact with pravastatin?
- Is pravastatin safe to take if I'm pregnant or breastfeeding?
- What else should I know about pravastatin?
What is pravastatin, and how does it work (mechanism of action)?
Pravastatin is an oral drug for lowering the cholesterol in the blood that contributes to the formation of plaques in the walls of arteries that obstruct the flow of blood, known as arteriosclerotic vascular disease. Obstruction of the flow of blood to the heart causes heart attacks. Obstruction of flow to the brain causes strokes. Pravastatin has been shown to reduce the occurrence of heart attacks, strokes and death caused by arteriosclerotic vascular 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), rosuvastatin (Crestor) 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. LDL cholesterol is believed to be an important cause of arteriosclerotic vascular disease. Lowering LDL cholesterol levels slows progression or reduces the size of cholesterol-containing plaques in the arteries of the heart and brain as well as other tissues. Statins also increase HDL ("good") cholesterol, and higher levels of HDL cholesterol are associated with reduced arteriosclerotic vascular disease. Raising HDL cholesterol levels may slow the progression of arteriosclerotic vascular disease.
Scientists have discovered that inflammation of the coronary arteries also may contribute to arteriosclerotic vascular disease. Inflammation is associated with elevated levels of a protein called C-reactive protein in the blood. This C-reactive protein 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. Statins reduce the levels of Hs-CRP, and it has been suggested that statins may reduce arteriosclerotic vascular disease by reducing inflammation in addition to lowering levels of cholesterol. Pravastatin was approved by the FDA in October 1991.
What brand names are available for pravastatin?
Pravachol, Pravigard PAC (discontinued)
Is pravastatin available as a generic drug?
Do I need a prescription for pravastatin?
What are the side effects of pravastatin?
Like most statins, the most common side effects of pravastatin are:
The most serious potential side effects are liver damage and muscle inflammation or breakdown. Serious liver damage with statins is rare, however. More often, statins cause abnormalities of liver tests. Abnormal tests usually return to normal even if a statin is continued, but if the abnormal test is greater than three times the upper limit of normal, the statin usually is stopped. Liver tests should be measured before therapy is started and whenever there is a medical concern.
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 proteins from muscle (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 health care professional 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. Other important side effects include post-marketing reports such as:
Symptoms may start one day to years after starting treatment and resolve within a median of three weeks after stopping the statin.
What is the dosage for pravastatin?
The dose range of pravastatin is 10-80 mg daily. The usual starting dose in adults is 40 mg once daily. The maximum dose is 80 mg per day. The starting dose for patients with major liver or kidney dysfunction is 10 mg daily.
The dose for children (8-13 years old) is 20 mg daily, and the dose for adolescents (14-18 years old) is 40 mg daily.
Which drugs or supplements interact with pravastatin?
Bile acid sequestrants such as cholestyramine (Questran) may reduce the absorption of pravastatin from the intestine and thereby reduce its effects. Therefore, pravastatin should be taken one hour before or four hours after bile acid sequestrants. The use of pravastatin with nicotinic acid, gemfibrozil (Lopid) or other drugs that cause liver or muscle problems may increase the risk of muscle problems.
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Is pravastatin safe to take if I'm pregnant or breastfeeding?
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.
What else should I know about pravastatin?
What preparations of pravastatin are available?
Tablets: 10, 20, 40, and 80 mg
How should I keep pravastatin stored?
Pravastatin should be stored at room temperature, between 15-30 C (58-86 F).
Pravastatin (Pravachol) is a drug that belongs to the drug class of statins and is prescribed for the treating individuals at risk of the consequences of arteriosclerotic vascular disease, strokes, transient ischemic attacks (TIAs or mini-strokes), and heart attacks. Side effects, dosing, drug interactions, and warnings and precautions should be reviewed prior to taking any medication.
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Related Disease Conditions
A stroke is an interruption of the blood supply to part of the brain caused by either a blood clot (ischemic) or bleeding (hemorrhagic). Symptoms of a stroke may include: weakness, numbness, double vision or vision loss, confusion, vertigo, difficulty speaking or understanding speech. A physical exam, imaging tests, neurological exam, and blood tests may be used to diagnose a stroke. Treatment may include administration of clot-busting drugs, supportive care, and in some instances, neurosurgery. The risk of stroke can be reduced by controlling high blood pressure, high cholesterol, diabetes, and stopping smoking.
Heart disease (coronary artery disease) occurs when plaque builds up in the coronary arteries, the vessels that supply blood to the heart. Heart disease can lead to heart attack. Risk factors for heart disease include: Smoking High blood pressure High cholesterol Diabetes Family history Obesity Angina, shortness of breath, and sweating are just a few symptoms that may indicate a heart attack. Treatment of heart disease involves control of heart disease risk factors through lifestyle changes, medications, and/or stenting or bypass surgery. Heart disease can be prevented by controlling heart disease risk factors.
Rhabdomyolysis is a rapid deterioration and destruction of skeletal muscle. Some of the causes of rhabdomyolysis include: severe burns, muscle trauma, coma, seizures, electrolyte imbalance, medications (statins), viruses, and bacteria. Treatment of rhabdomyolysis depends on the cause.
Heart Attack (Myocardial Infarction)
A heart attack happens when a blood clot completely obstructs a coronary artery supplying blood to the heart muscle. A heart attack can cause chest pain, heart failure, and electrical instability of the heart.
Angina is chest pain due to inadequate blood supply to the heart. Angina symptoms may include chest tightness, burning, squeezing, and aching. Coronary artery disease is the main cause of angina but there are other causes. Angina is diagnosed by taking the patient's medical history and performing tests such as an electrocardiogram (EKG), blood test, stress test, echocardiogram, cardiac CT scan, and heart catheterization. Treatment of angina usually includes lifestyle modification, medication, and sometimes, surgery. The risk of angina can be reduced by following a heart healthy lifestyle.
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Transient Ischemic Attack (TIA, Mini-Stroke)
When a portion of the brain loses blood supply, through a blood clot or embolus, a transient ischemic attack (TIA, mini-stroke) may occur. If the symptoms do not resolve, a stroke most likely has occurred. Symptoms of TIA include: confusion, weakness, lethargy, and loss of function to one side of the body. Risk factors for TIA include vascular disease, smoking, high blood pressure, high cholesterol, and diabetes. Treatment depends upon the severity of the TIA, and whether it resolves.
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Heart Attacks in Women
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Heart Attack Treatment
A heart attack involves damage or death of part of the heart muscle due to a blood clot. The aim of heart attack treatment is to prevent or stop this damage to the heart muscle. Heart attack treatments included medications, procedures, and surgeries to protect the heart muscle against injury.
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