Pravastatin
PRAVACHOL
What it isHMG-CoA reductase inhibitor for hyperlipidemia and ASCVD prevention; a moderate-intensity statin.
Why this oneIt avoids CYP3A4 metabolism, making it useful when atorvastatin or simvastatin interactions dominate.
What limits itIts lower potency often fails when a large LDL reduction is needed; renal impairment and cyclosporine can still raise exposure.
FDA-approved for
- hyperlipidemia (1991)
FDA label
Read the full label on DailyMed ↗
| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| Hyperlipidemia (LDL-C lowering) | Adults | 40 mg QD | 40–80 mg QD | 80 mg QD |
| Heterozygous familial / primary hyperlipidemia | Peds 8–13 yr | 20 mg QD | 20 mg QD | 20 mg QD |
| Heterozygous familial / primary hyperlipidemia | Peds 14–18 yr | 40 mg QD | 40 mg QD | 40 mg QD |
Titration Reassess LDL-C after ≥4 weeks before adjusting
Renal Severe renal impairment: start 10 mg QD, max 40 mg QD
Hepatic Contraindicated in acute liver failure or decompensated cirrhosis
Instructions
- Take once daily at any time, with or without food
- If LDL-C goal not met on 80 mg, switch to an alternative LDL-C-lowering treatment
Contraindications
- Acute liver failure or decompensated cirrhosis
Cautions
- Myopathy and rhabdomyolysis
- Immune-mediated necrotizing myopathy
- Hepatic dysfunction / transaminase elevations
- Increases in HbA1c and fasting glucose
Adverse reactions
- Musculoskeletal pain
- Nausea/vomiting
- Upper respiratory infection
- Diarrhea
- Headache
Pregnancy Discontinue when pregnancy recognized; may cause fetal harm (mechanism-based)
Lactation Breastfeeding not recommended during treatment
NO BOXED WARNINGS
Principal riskMyopathy, rarely rhabdomyolysis
Cost, est. cash$4–$80/month
Generic entry2006
Classes and tags
Clinical profile
Legacy pregnancy categoryX
Defining liabilityMyopathy/rhabdomyolysis and hepatotoxicity; interaction burden varies by agent.
Mechanism of action: Pravastatin ballicule
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