Pitavastatin
LIVALO
Pronunciation: pit-a-va-STAT-in
“Pita statin lives alone”
What it isHMG-CoA reductase inhibitor; hyperlipidemia.
Why this oneMinimal CYP metabolism, so it is an option with protease inhibitors and other strong inhibitors where most statins are restricted.
What limits itModerate potency only. Cyclosporine is contraindicated; cost is higher than the generics.
Pitavastatin prescription history
Animated chart of estimated U.S. prescriptions per year, Lipid-lowering meds (1955–2026). Pitavastatin enters in 2010 (estimated).
FDA-approved for
- hyperlipidemia (2009)
Principal riskMyopathy; contraindicated with cyclosporine
Classes and tags
Clinical profile
Legacy pregnancy categoryX
Defining liabilityMyopathy/rhabdomyolysis and hepatotoxicity; interaction burden varies by agent.
FDA label
Read the full label on DailyMed ↗
NO BOXED WARNINGS
| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| Primary hyperlipidemia / mixed dyslipidemia (LDL-C lowering) | Adults & peds ≥8 yr | 2 mg QD | 2–4 mg QD | 4 mg QD |
Titration Reassess LDL-C after ≥4 weeks before adjusting
Renal Moderate/severe impairment & ESRD on HD: start 1 mg QD, max 2 mg QD
Hepatic Contraindicated in acute liver failure or decompensated cirrhosis
Instructions
- Take once daily with or without food, at the same time daily
- If LDL-C goal not met on 4 mg, switch to an alternative LDL-C-lowering treatment
Available strengths
- tab 1, 2, 4 mg
Contraindications
- Concomitant cyclosporine
- Acute liver failure or decompensated cirrhosis
Cautions
- Myopathy and rhabdomyolysis (risk ↑ with age ≥65, hypothyroidism, renal impairment, interacting drugs, higher dose)
- Immune-mediated necrotizing myopathy
- Hepatic dysfunction / transaminase elevations
- Increases in HbA1c and fasting glucose
Adverse reactions
- Myalgia
- Constipation
- Diarrhea
- Back pain
- Pain in extremity
Pregnancy Discontinue when pregnancy recognized; may cause fetal harm (mechanism-based)
Lactation Breastfeeding not recommended during treatment
Cost
Generic entry2031 est.
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Memory aids: interaction avatars
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Self-check
- Pitavastatin: Why can it be useful with strong CYP inhibitors?
Minimal CYP metabolism. - Pitavastatin: Which immunosuppressant is contraindicated?
Cyclosporine.