Pravastatin

What is pravastatin?

Pravastatin is used for treating high cholesterol. It belongs to a group of medications 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 beneficial, but high levels of low-density lipoprotein (LDL) in the blood can build up in the arteries and lead to heart disease, heart attack or stroke. Pravastatin helps to reduce the levels of “bad” LDL cholesterol.

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 four weeks.

Active ingredients

The active ingredient in pravastatin tablets is pravastatin sodium.

Inactive ingredients

The inactive ingredients in pravastatin are typically lactose monohydrate, microcrystalline cellulose, croscarmellose sodium and magnesium stearate, light magnesium oxide, microcelac, povidone and yellow ferric oxide (E172).

Please note: different generic brands and different doses may contain different inactive ingredients.

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 produces the 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 dosage

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

When used in children aged 8–14 to treat heterozygous familial hypercholesterolaemia, the usual dose is 10–20 mg taken once daily. Always take pravastatin as directed by your doctor.

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 the day should I take pravastatin?

Pravastatin should be taken once daily in the evening.

Pravastatin side effects

If you experience any of the following side effects, stop taking this medication immediately and consult a doctor:

• Signs of allergy, e.g. swelling of the face, lips, tongue or throat, difficulty breathing, wheezing, rash, itching or a high temperature
• Joint pain
• Skin changes such as rash, inflammation, hives or sudden sunlight sensitivity
• Sudden muscle aches or weakness
• Unexplained bleeding or bruising
• Yellowing of the skin or eyes, itching, dark-coloured urine or pale-coloured stool
• Abdominal pain

Common or very common side effects (occur in up to 1 in 10 people)

• Weakness (asthmenia)
• Constipation or diarrhoea
• Dizziness
• Flatulence
• Abdominal discomfort
• Headache
• Muscle aches (myalgia)
• Nausea
• Sleep disorders
• Thrombocytopenia (low platelets in the blood, causing you to bruise easily)

Uncommon side effects

• Changes to hair including alopecia (hair loss)
• Liver disorders
• Memory loss
• Pancreatitis (inflammation of the pancreas, manifested by upper abdominal pain)
• Numbness (paraesthesia)
• Sexual dysfunction
• Skin reactions
• Vomiting
• Scalp irritation
• Problems passing urine
• Changes in vision

Rare or very rare side effects

• Muscle soreness (myopathy)
• Peripheral neuropathy (symptoms such as tingling or pins and needles)
• Painful tendons (tendinopathy)

Frequency not known

• Depression
• Diabetes (in those at increased risk of diabetes)
• Interstitial lung disease

Contraindications

Do NOT take Simvastatin if you are:

• Allergic to any of the ingredients in this medication
• Pregnant or planning on becoming pregnant (you should carefully use contraception for the duration of treatment and one month after stopping)
• Breastfeeding
• Taking any medications that interact with pravastatin
• Liver problems

Before taking Simvastatin, tell your doctor and take special care if you:

• Have any kidney problems
• Have any thyroid problems
• Have ever had muscle problems, e.g. myopathy or rhabdomyolysis
• Have a personal or family history of muscle disorder
• Drink a lot of alcohol or have a history of alcohol abuse
• Have diabetes
• Have severe respiratory failure

Drug interactions

Before taking pravastatin, tell your doctor if you take any other medications, including those purchased over the counter and herbal remedies. In particular, tell your doctor if you are taking any of the following:

• Fibrates, including  bezafibrate, ciprofibrate, fenofibrate and gemfibrozil
• Colestyramine or colestipol
• Ciclosporin (an immunosuppressant)

Pravastatin and alcohol

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

Pravastatin and foods to avoid

Unlike with other statins, there is no significant interaction between grapefruit juice and pravastatin. You should aim to maintain a healthy low-cholesterol diet, but there are no specific foods you must avoid.

Lifestyle changes to make when taking pravastatin

Pravastatin will be most effective if accompanied by appropriate lifestyle changes. Therefore, making changes to your diet and lifestyle is the best way to reduce your cholesterol levels. Before starting this medication, your doctor will recommend a low-cholesterol diet and advise that you cut down on foods that are high in saturated fats, such as fatty or processed meats, butter and lard, cream and ice cream, 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. In addition, try and cut down on caffeine and alcohol and, if you haven’t already done so, quit smoking.

Switching statins

There are several different types of statins, which can be differentiated by the amount they will lower your cholesterol. To start with, your doctor will usually prescribe a low-intensity statin at a dose which can be increased over time. If necessary, a doctor may choose to switch your prescription over to a high-intensity statin or to change the type of statin you are taking if you are experiencing troublesome side effects. You should never stop taking your statin, or switch between types of statins without the guidance of a doctor.

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 these events occurring is 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 reduces levels of “bad cholesterol” by impeding its production in the liver.

Will I have to take pravastatin forever?

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. You must never stop taking statins without your doctor’s instruction. Your doctor will help you find an alternative cholesterol-lowering treatment if you still need it.

Is pravastatin safe?

All medications carry risk, but 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 cholesterol-lowering effects will wear off after around 24 hours. The drug is cleared via the kidneys and leaves the body in the urine, so 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.