Pravastatin

What is Pravastatin?

Pravastatin is used for treating high cholesterol. It belongs to a group of lipid-regulating medicines known as statins which, in combination with a healthy diet and lifestyle, lower the level of ‘bad’ cholesterol and raise the level of good ‘cholesterol’ in the blood.

How does Pravastatin work?

The liver produces a substance called cholesterol, which is vital to the functioning of all cells in the body. A high level of high-density  lipoprotein (HDL), or ‘good’ cholesterol is good for you, but high levels of low-density lipoprotein (LDL) in the blood can build up in the arteries and lead to heart disease, such as heart attack or stroke. 

How do I know if Pravastatin is working?

You will not be able to feel Pravastatin working, although your doctor may choose to conduct regular blood tests to monitor your cholesterol level. It is more important to concentrate on maintaining a healthy lifestyle while taking this medication, including eating a healthy diet and exercising regularly.

How long does it take for Pravastatin to work?

Pravastatin is intended for long-term use and is only effective if accompanied by the correct lifestyle changes. If statins are taken correctly, your cholesterol levels should begin to drop noticeably within 4 weeks.

Active ingredients

The active ingredient in Pravastatin is pravastatin sodium.

Inactive ingredients

The inactive ingredients in Pravastatin are lactose monohydrate, microcrystalline cellulose, croscarmellose sodium and magnesium stearate.

Pravastatin 10 mg tablets also include red iron oxide (E172). The 20 mg tablets also include yellow iron oxide (E172), and the 40 mg tablets also include yellow iron oxide (E172) and brilliant blue FCF aluminium lake (E133).  

Pravastatin dosage

For adults and adolescents above 14 years of age, the usual dose is 10-40 mg taken once daily.

When use in children to treat heterozygous familial hypercholesterolaemia, the usual dose is 10-20 mg taken once daily.   

Can Pravastatin be crushed or split?

Pravastatin should not be crushed or split, but should be swallowed whole with a small glass of water.

What time of day should I take Pravastatin?

Pravastatin should be taken once daily in the evening.

How to take Pravastatin

Always take Pravastatin as instructed by a doctor. Swallow one tablet whole with water once a day. This medication is best taken in the evening, as your body body produces most cholesterol while you are asleep. If you forget to take a dose, don’t worry, just take your next dose at the normal time. Never take a double dose to make up for a missed one.   

Pravastatin side effects

Like all medications, Pravastatin can cause side effects in some patients. If you experience any of the following rare but severe side effects, stop taking this medication and contact a doctor immediately:

• Signs of a severe allergic reaction, including swelling of the face, lips, tongue or throat, difficulty breathing or severe skin rashes
• Unexplained muscle pain, tenderness, weakness or cramps, combined with dark red or brown coloured urine.

Uncommon side effects, affecting between 1 and 10 people in 1000, include:

• Dizziness, headache, insomnia or nightmares
• Blurred or double vision
• Indigestion, sickness, diarrhoea or constipation, wind
• Skin reactions such as itching and rashes
• Scalp or hair problems (including hair loss)
• Bladder problems such as painful or frequent urination
• Sexual difficulties
• Tiredness

Very rare side effects affect less than 1 in 1000 people and include:

• Problems with sensibility including burning or tingling sensations and numbness
• Liver disorders such as jaundice, characterised by a yellowing of the skin or the whites of the eyes
• Inflammation of the liver or pancreas
• Muscle and joint pain

The following side effects have been reported, although their frequency is unknown:

• Memory loss
• Sexual difficulties
• Depression
• Problems with breathing, including persistent cough, shortness of breath or fever  

Contraindications

Do NOT take Pravastatin if:

• You are allergic to any of the ingredients of this medication
• You are pregnant or there is a possibility that you may be pregnant
• You are breastfeeding
• You have or have ever had liver problems

Tell your doctor and take extra caution with Pravastatin if:

• You have thyroid problems
• You have kidney problems
• You have had muscle problems with a statin or fibrate before
• You have a personal or family history of hereditary muscle problems
• You drink a lot of alcohol or have a history of alcohol abuse
• You have diabetes
• You have severe respiratory failure

Drug interactions

Before taking Pravastatin, tell your doctor if you are taking any other medications, including those purchased over the counter without a prescription. In particular, tell your doctor if you are taking any of the following:

• Fibrates, including  bezafibrate, ciprofibrate, fenofibrate and gemfibrozil
• Ciclosporin (immunosuppressant)
• The antibiotics erythromycin or clarithromycin
• Resin-type lipid-lowering agents such as cholestyramine or colestipol. Pravastatin should not be taken within an hour of taking these medications as its absorption may be affected.

Pravastatin and alcohol

You can drink alcohol while taking Pravastatin, but try and stick to the recommended guidelines of no more than 14 units per week. Drinking too much alcohol may increase the risk of experiencing muscle and liver related side effects of Pravastatin.

Pravastatin and Foods to Avoid

Unlike with other statins, it is safe to drink grapefruit juice while taking Pravastatin,  and you can eat and drink normally during treatment.

Switching statins

There are several different types of statins and the main difference between them is their lowering effect on cholesterol levels. To start with, your doctor will usually prescribe a low-intensity statin which can be increased over time. A doctor may chose to switch your prescription over to a high-intensity statin if necessary, or change the type of statin you are taking if you are experiencing any troublesome side effects. You should never stop taking statins, or switch between types of statins without the guidance of a doctor.

Lifestyle changes to make when taking Pravastatin

Pravastatin will only be effective if accompanied by the appropriate lifestyle changes. Whatsmore, making changes to your diet and lifestyle is the best way to reduce your cholesterol levels. Before starting this medication, your doctor will place you on a low-cholesterol diet and recommend that you cut down on food that are high in saturated fats, such as fatty or processed meats, butter and lard, cream and ice cream, cheese (particularly hard cheese), cakes, biscuits, chocolate and products containing coconut or palm oil. It is also recommended that you exercise regularly and lose weight if you are overweight. Try and cut down on caffeine and alcohol and, if you haven’t already done so, quit smoking.

Should I be worried about bad cholesterol?

High levels of ‘bad cholesterol’ can be dangerous and eventually lead to a stroke or heart attack if left untreated. The risk of such occurring are increased for those who are overweight or obese, consume high levels of alcohol, have an unhealthy diet, smoke, or have a family history of heart disease or stroke. Pravastatin lowers levels of ‘bad cholesterol’ by inhibiting its production to control the levels of cholesterol in the body.

Will I have to take Pravastatin for ever?

Statins are recommended for long-term use and are often taken for life. Coming off of statins can be dangerous for patients at high risk of heart disease, such as those with a history of heart attack or stroke, as cholesterol levels tend to rise again once treatment has stopped. It is imperative that you never stop taking statins without the instruction of your doctor, who will help you find an alternative cholesterol-lowering treatment.

Is Pravastatin safe?

Pravastatin is considered to be a safe and effective medication with relatively few side effects.

How is Pravastatin cleared from the body?

When you stop taking statins, the effects will wear off after around 24 hours and the drug is cleared via the kidneys and leave the body in the urine. Side effects of statins can take longer to clear up. Never stop taking statins without first consulting a doctor, as this can cause a dangerous rise in cholesterol.   

Sources

• Patient Information Leaflet
• NHS > Pravastatin