Uses

Pravastatin is indicated to reduce the risk of myocardial infarction, revascularisation procedures, and cardiovascular mortality in adults with elevated LDL-cholesterol, with or without clinically evident coronary heart disease. It is also used as an adjunct to diet to reduce LDL-C, total cholesterol, and triglycerides, and to raise HDL-C in primary hyperlipidaemia.

Do not use if

Contraindicated in patients with acute liver failure or decompensated cirrhosis, and in those with known hypersensitivity to pravastatin or any excipients. Contraindicated during pregnancy and breastfeeding.

Side effects

Common adverse effects include myalgia, headache, and gastrointestinal symptoms. Serious adverse effects include myopathy and rhabdomyolysis, immune-mediated necrotising myopathy, and hepatic dysfunction. Small increases in HbA1c and fasting glucose may occur.

Warnings

Risk of myopathy and rhabdomyolysis increases with age over 65, uncontrolled hypothyroidism, renal impairment, and concomitant use of certain drugs. Discontinue if markedly elevated CK levels or symptoms of myopathy develop. Monitor liver function periodically.

How it works

Pravastatin is a reversible, competitive inhibitor of HMG-CoA reductase, the rate-limiting enzyme in cholesterol biosynthesis. By inhibiting this enzyme it reduces hepatic cholesterol synthesis, upregulates LDL receptors, and increases clearance of LDL from plasma, thereby lowering circulating LDL-C levels.

Storage

Store at controlled room temperature, typically 15°C to 30°C (59°F to 86°F), in a dry place protected from moisture and light.