Pravachol: Advanced Cholesterol Management for Cardiovascular Risk Reduction
Pravachol
| Product dosage: 10 mg | |||
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| Product dosage: 20 mg | |||
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Synonyms | |||
Pravachol (pravastatin sodium) is a trusted HMG-CoA reductase inhibitor, commonly referred to as a statin, specifically formulated to manage elevated cholesterol levels and support cardiovascular health. As a cornerstone in lipid-lowering therapy, it functions by inhibiting a key enzyme in the liver responsible for cholesterol production, thereby reducing low-density lipoprotein (LDL) cholesterol and triglycerides while modestly increasing high-density lipoprotein (HDL) cholesterol. Its well-established efficacy and favorable safety profile make it a first-line option for both primary and secondary prevention of atherosclerotic cardiovascular disease. Clinicians value Pravachol for its predictable pharmacokinetics and evidence-based outcomes in diverse patient populations.
Features
- Active ingredient: pravastatin sodium
- Available in tablet strengths: 10 mg, 20 mg, 40 mg, and 80 mg
- Mechanism: selective, competitive inhibition of HMG-CoA reductase
- Administration: oral, once daily, with or without food
- Bioavailability: approximately 18%, with peak plasma concentration achieved in 1-1.5 hours
- Half-life: approximately 1.8 hours
- Metabolism: minimal cytochrome P450 3A4 involvement; primarily metabolized in the liver
- Excretion: predominantly via renal route (approximately 47%)
- Prescription-only medication, not available over-the-counter
Benefits
- Significantly reduces LDL cholesterol levels, decreasing the risk of plaque formation in arteries
- Lowers triglyceride concentrations, contributing to improved overall lipid profile
- Moderately increases HDL cholesterol, aiding in reverse cholesterol transport
- Proven to reduce the incidence of myocardial infarction, stroke, and revascularization procedures
- Supports long-term cardiovascular health with a well-documented safety record across clinical trials
- Suitable for a broad range of patients, including those with mild to moderate renal impairment
Common use
Pravachol is primarily indicated for the treatment of hypercholesterolemia, including heterozygous familial and non-familial forms, as well as mixed dyslipidemia. It is also approved for the reduction of cardiovascular events in individuals with established coronary heart disease or at high risk for such events, such as those with diabetes or a history of stroke. It may be used in pediatric patients aged 8 years and older with heterozygous familial hypercholesterolemia, following appropriate diagnostic confirmation and under specialist supervision.
Dosage and direction
The recommended starting dose for most adults is 40 mg once daily, which may be adjusted based on individual response and tolerability, within a range of 10 mg to 80 mg daily. For pediatric patients (8–13 years), the recommended dose is 20 mg daily, and for adolescents (14–18 years), it is 40 mg daily. Administration can occur with or without food, preferably at the same time each day to maintain consistent plasma levels. Dosage adjustments are necessary in patients with renal impairment or those taking concomitant medications that may interact; in severe renal impairment (creatinine clearance <30 mL/min), the recommended starting dose is 10 mg daily. Regular monitoring of lipid levels is advised to assess efficacy and guide dosage titration.
Precautions
Prior to initiating therapy, perform a lipid panel and liver function tests. Use with caution in patients who consume substantial quantities of alcohol or have a history of liver disease. Monitor for muscle pain, tenderness, or weakness, as these may be signs of myopathy. Pravastatin may increase HbA1c and fasting serum glucose levels; monitor patients for hyperglycemia, especially those with risk factors for diabetes. Avoid in pregnancy and breastfeeding, as cholesterol is crucial for fetal development. Consider discontinuation temporarily if a patient becomes critically ill or undergoes major surgery.
Contraindications
Pravachol is contraindicated in patients with active liver disease or unexplained persistent elevations of serum transaminases. It must not be used during pregnancy, in women who may become pregnant, or while breastfeeding. Hypersensitivity to pravastatin sodium or any component of the formulation is an absolute contraindication. Concomitant use with cyclosporine is contraindicated due to increased risk of myopathy/rhabdomyolysis.
Possible side effect
Common adverse reactions (≥2% and more frequent than placebo) include headache, fatigue, dizziness, rash, nausea/vomiting, diarrhea, flatulence, and myalgia. Less frequently, elevated liver enzymes, arthralgia, and insomnia may occur. Rare but serious side effects include myopathy, rhabdomyolysis with renal dysfunction, hepatic failure, and immune-mediated necrotizing myopathy. Some patients may experience memory loss or confusion, though these are generally reversible upon discontinuation.
Drug interaction
Pravachol has a lower potential for cytochrome P450 interactions compared to some other statins, but caution is still advised. Concomitant use with fibrates (e.g., gemfibrozil) or niacin may increase the risk of myopathy. Cyclosporine is contraindicated. Erythromycin and other macrolides may increase pravastatin exposure. Use with warfarin may potentiate anticoagulant effect; monitor INR closely. Colchicine may increase myopathy risk. Avoid with strong CYP3A4 inhibitors only if high doses are used, though pravastatin is not primarily metabolized by this pathway.
Missed dose
If a dose is missed, it should be taken as soon as remembered, unless it is almost time for the next scheduled dose. In that case, skip the missed dose and resume the usual dosing schedule. Do not double the dose to make up for a missed one, as this may increase the risk of adverse effects.
Overdose
There is no specific antidote for pravastatin overdose. Treatment should be supportive and symptomatic. In cases of suspected overdose, contact a poison control center or seek emergency medical attention immediately. Hemodialysis is unlikely to be effective due to high protein binding, but general measures such as monitoring vital signs and providing supportive care are recommended.
Storage
Store Pravachol tablets at room temperature, between 20°C to 25°C (68°F to 77°F), in a tightly closed container, and protect from light and moisture. Keep out of reach of children and pets. Do not use beyond the expiration date printed on the packaging.
Disclaimer
This information is intended for educational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional for diagnosis, treatment decisions, and personalized recommendations. Do not initiate, adjust, or discontinue any medication without professional guidance. Individual responses to therapy may vary.
Reviews
Pravachol has been extensively studied in clinical trials such as the landmark WOSCOPS and CARE studies, demonstrating significant reductions in cardiovascular events and mortality. In real-world use, it is often praised for its tolerability and efficacy, particularly in elderly patients and those with renal impairment. Some clinicians note its utility in patients who experience adverse effects with other statins. However, as with all medications, individual experiences vary, and adherence to monitoring protocols is essential for optimal outcomes.