Pravastatin
Unchecked
Pravastatin
Pravachol
Experience
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Summary
Classes
Common uses
Hyperlipidemia0, Cardiovascular risk reduction0
Pharmacy
Starting dose
40 mg PO once daily (10-20 mg in elderly, hepatic impairment, or strong drug interactions)
Preparations
10 mg, 20 mg, 40 mg, 80 mg tablets
US FDA Max
80 mg/d
Pharmacology
Routes
Oral
Onset
LDL lowering at 2 weeks, max by 4 weeks
Duration
24 hours
Half-life
~2-3 hours (parent); pharmacodynamic effect 24 hours via target turnover[2]
Bioavailability
~17% (oral; food slightly reduces absorption)[2]
Pregnancy
Previously Category X; FDA removed the blanket statin contraindication in pregnancy in 2021.[citation needed]
Legal status
Rx-only in US
Purported mechanism
Pravastatin is a hydrophilic competitive HMG-CoA reductase inhibitor; unlike simvastatin and atorvastatin it undergoes minimal CYP metabolism (mostly sulfation), giving it the lowest drug-interaction profile in the statin class and making it the typical choice for patients on strong CYP3A4 inhibitors (HIV protease inhibitors, calcineurin inhibitors).0 SLCO1B1 polymorphism affects exposure but is most clinically actionable for simvastatin[1].
References
[edit | edit source]- ↑ CPIC Guideline for SLCO1B1, ABCG2, and CYP2C9 and Statin-Associated Musculoskeletal Symptoms, 2022. https://cpicpgx.org/guidelines/cpic-guideline-for-simvastatin-and-slco1b1/
- ↑ 2.0 2.1 FDA Prescribing Information, Pravachol (pravastatin sodium), Bristol-Myers Squibb, current revision. https://www.accessdata.fda.gov/drugsatfda_docs/label/2016/019898s073lbl.pdf