pravastatine

Pravastatin, also known as pravastatin sodium and sold under brand names such as Pravachol, is a prescription medication in the class of statins used to lower cholesterol. It is indicated for hyperlipidemia and for reducing the risk of cardiovascular events in certain patients with elevated cholesterol or established atherosclerotic disease. By lowering low-density lipoprotein cholesterol (LDL-C) and modestly affecting other lipid levels, it helps reduce the overall burden of vascular disease.

Mechanism of action is that pravastatin inhibits HMG-CoA reductase, the enzyme responsible for converting HMG-CoA to mevalonate in cholesterol synthesis. This decreases hepatic cholesterol production and increases expression of LDL receptors on liver cells, promoting uptake of LDL from the blood and lowering circulating LDL-C. The drug is hydrophilic, with limited penetration into muscle, which may influence its safety profile relative to more lipophilic statins.

Common indications include primary hyperlipidemia, mixed dyslipidemia, and heterozygous familial hypercholesterolemia, as well as secondary prevention in adults at risk for cardiovascular events. The lipid-lowering effect typically begins within 1–2 weeks, with the maximum effect after about 4 weeks. Dosing is usually once daily, commonly 10–20 mg, with a usual range of 10–40 mg; the maximum recommended daily dose is 40 mg. Dosing may be adjusted for renal impairment.

Safety and adverse effects are generally manageable, but can include muscle pain or weakness, elevations in liver enzymes, and, rarely, myopathy or rhabdomyolysis, especially with certain drug interactions. Contraindications include active liver disease, pregnancy, and breastfeeding. Interactions are possible with fibrates, cyclosporine, certain antibiotics and antifungals, and other agents that affect muscle or liver metabolism.