Pravastatin

Pravastatin is a prescription medication in the statin class used to lower low-density lipoprotein (LDL) cholesterol and reduce cardiovascular risk. It is a hydrophilic HMG-CoA reductase inhibitor that acts primarily in the liver to limit cholesterol production.

Mechanism of action: Pravastatin inhibits hepatic HMG-CoA reductase, decreasing cholesterol synthesis. This prompts upregulation of LDL receptors, increasing clearance of LDL from the bloodstream. The drug can also produce modest changes in HDL cholesterol and triglycerides.

Indications: It is prescribed to lower elevated cholesterol and triglyceride levels in adults with primary hyperlipidemia or mixed dyslipidemia and to reduce cardiovascular risk in selected patients. It may be used as part of a long-term program of diet, weight control, and physical activity.

Dosage and administration: Pravastatin tablets are taken orally, usually once daily. Typical starting doses range from 10 to 20 mg, with a maximum of 40 mg daily, adjusted based on response and tolerance. The medication can be taken with or without food, and the timing is flexible for most patients.

Safety and side effects: Common adverse effects include headache, digestive upset, and fatigue. Rare but serious risks include myopathy and rhabdomyolysis, particularly at higher doses or when combined with certain other medications. Liver enzyme elevations can occur; discontinue therapy if signs of liver injury appear (such as jaundice) and monitor liver function tests as recommended.

Contraindications and cautions: Contraindicated in active liver disease, pregnancy, and breastfeeding. Use with caution in liver or kidney impairment and in older adults. Baseline and periodic monitoring of liver enzymes and lipid levels are advised.

Interactions: Pravastatin has fewer drug interactions than some other statins but can interact with cyclosporine, certain protease inhibitors, fibrates, and warfarin. Grapefruit juice is not a major concern with pravastatin.