Pravastatin

What is Pravastatin?

Pravastatin, sold under the brand name Pravachol, is a drug prescribed alongside a healthy diet to lower cholesterol levels in the blood (Hypercholesterolemia). Hypercholesterolemia can be sporadic - which means that it occurs with no family history - or familial - which means that it is genetic and runs in the family. Pravastatin is also prescribed as a preventive medicine if you have had a heart attack or angina (chest pain) in order to prevent further heart disease, angina, or stroke. Doctors at Medzino can issue a prescription for this medicine if you are suitable.

What are statins?

Pravastatin belongs to a class of drugs called “statins”, which work by blocking the enzyme in the liver that is responsible for producing cholesterol, consequently reducing the levels of cholesterol and other fats (triglycerides) in your body. This enzyme is called hydroxy-methylglutaryl-coenzyme A reductase (HMG-CoA reductase). High levels of cholesterol in the blood can lead to an accumulation of cholesterol on the walls of blood vessels and in turn block them (atherosclerosis). The latter can lead to serious conditions such as angina pectoris (chest pain that arises when a blood vessel in the heart is partially blocked), a heart attack (when the heart muscle doesn't receive enough oxygen because fo a blocked artery) or a stroke (when the brain doesn't receive enough oxygen because of a blocked artery). This medication works better if taken alongside a healthy diet and a healthy lifestyle including weight loss, regular exercise, and no smoking.

How does Pravastatin work?

Pravastatin, and other Statins, work by inhibiting the liver from making cholesterol. It works by inhibiting one of the body’s enzymes called HMG-CoA Reductase. HMG-CoA Reductase is the key enzyme in the metabolic pathway producing cholesterol in the body. It is made by the liver, and Pravastatin works to inhibit the enzyme therefore reducing cholesterol production.

How effective is Pravastatin?

Pravastatin can lower LDL (bad cholesterol) between 19-40%, depending on the intensity of the dose you are taking. 

Active ingredients

The active ingredient in Pravastatin is pravastatin sodium at a concentration of 10mg, 20mg, or 40mg.

Inactive ingredients

Pravastatin contains the following inactive ingredients: croscarmellose sodium, lactose, magnesium oxide, magnesium stearate, microcrystalline cellulose, and povidone.

The 20 mg and 80 mg tablets also contain Yellow Ferric Oxide.

The 40 mg tablet also contains Green Lake Blend (mixture of D&C Yellow No. 10-Aluminum Lake and FD&C Blue No. 1-Aluminum Lake).

(Please note: inactive ingredients may vary between different generic manufacturers)

Which ingredients can cause an allergic reaction?

It is rare for Pravastatin to cause a severe allergic reaction in people. However, Pravastatin does contain D&C Yellow No. 10-Aluminum Lake and FD&C Blue No. 1-Aluminum Lake which are dyes that have been linked to an allergic reaction. Signs of a severe allergic reaction are lip swelling, finding it hard to breathe, a rash and severe dizziness. You need to get emergency medical attention as soon as possible if you notice any of these symptoms. 

How to take Pravastatin

Always take Pravastatin exactly as indicated by your doctor, and do not interrupt you treatment without your doctor’s advice.

Take this medicine at about the same time each day. Pravastatin tablets can be taken with or without food, but for best results, take it on an empty stomach (two or more hours after your last meal). Swallow your prescribed dosage with water, and do not chew, break, or crush the tablet(s).

If you are using this medicine to treat high levels of cholesterol and fats in the blood, the recommended dosage for an adult and adolescent (14-18 years) is Pravastatin Sodium 10-40mg once a day, preferably in the evening.

If you are taking this medicine to prevent heart and blood vessel diseases, the usual recommended dose is 40mg once a day, preferably in the evening.

Do not exceed the daily dosage recommended by your doctor.

What should I do if I miss a dose of Pravastatin?

If you miss a dose, and it is almost time for the next dose, do not double the dose. Skip the missed dose, and continue taking the next dose. If you have missed a dose by several hours or up to 12 hours, you may take the missed dose. In general, missing one dose will not significantly impact cholesterol. 

Should Pravastatin be taken at night?

Pravastatin should be taken once a day, at any time of the day. It does not have to be taken at night. It also does not have to be taken with or without food. 

Pravastatin side effects

Some common side effects may include:

• Nausea (feeling sick)
• Upset stomach
• Diarrhea
• Gas
• Constipation
• Headache
• Dizziness

Get immediate medical attention if you experience any of the following rare but serious side effects:

• Allergic reaction (rash, itching or swelling of the tongue/face/throat, difficulty     breathing, severe dizziness)
• Unexplained muscle pain
• Muscle tenderness or weakness
• Fever
• Jaundice (yellowish skin or eyes)
• Chest pain
• Dark urine
• Weight loss
• Confusion
• Memory problems
• Increased thirst
• Clay-colored stools

Drug Interactions

Some medicines may interfere with the effects of Pravastatin. Therefore, always inform your doctor of the medicines you are taking. Do not take Pravastatin in combination with the following drugs:

• Gemfibrozil, Fenofibrate, and other cholesterol lowering drugs called “fibrates”, or nicotinic acid
• Cyclosporine (immunosuppressant)
• Antibiotics such as Erythromycin or Clarithyromycin
• Cholestyramine or Colestipol (a resin type lipid-lowering agent)
• Other medicines that lowers cholesterol levels in the blood
• Warfarin and other blood thinners (anticoagulants)
• Product metabolized by cytochrome P450 (diltiazem, verapamil, itraconazole, ketoconazole, protease inhibitors and CYP2C9 inhibitors like fluconazole).
• Drugs used to treat and prevent the formation of blood clots called “vitamin K antagonist”. Inform your doctor that you are taking these before using Pravastatin
• If you are taking oral fusidic acid to treat a bacterial infection.

Contraindications

Pravastatin is contraindicated if:

• You suffer from liver disease, or have shown abnormal functioning of your liver, such as increased levels of liver enzymes in the blood
• You are allergic or have ever had an allergic reaction to pravastatin sodium or any of Pravastatin’s other ingredients. An allergic reaction may involve rash, itching or swelling of the tongue/face/throat, difficulty breathing, severe dizziness. Get immediate medical attention if this happens
• If you are pregnant, trying to become pregnant, or breastfeeding
• If you have experienced muscle pain from any other medicine used to treat high cholesterol

Precautions

Before taking Pravastatin, always inform your doctor if:

• You are taking other medicines or treatment
• If you have kidney disease
• If you have a history of liver disease
• If you drink alcohol regularly
• If you are or may become pregnant
• If you are breastfeeding
• If you have hereditary muscle disorder in yourself or a blood relative (including pain, tenderness, or weakness)
• If you have an underactive thyroid (hypothyroidism)
• If you suffer from hormonal disorders
• If you suffer from allergies
• If you suffer from central nervous system vascular lesions
• If you have increased triglycerides in your blood
• If you suffer from homozygous familial hypercholesterolaemia (genetic elevated cholesterol)