Pravachol: Proven Cholesterol Management for Cardiovascular Risk Reduction
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| Product dosage: 20 mg | |||
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Synonyms | |||
Pravachol (pravastatin sodium) is an HMG-CoA reductase inhibitor, commonly known as a statin, specifically formulated to address elevated cholesterol levels and reduce the risk of major cardiovascular events. As a lipid-lowering agent with a well-established efficacy and safety profile, it works by competitively inhibiting the enzyme responsible for cholesterol synthesis in the liver. Clinical studies and decades of real-world use support its role in both primary and secondary prevention of atherosclerotic cardiovascular disease. This medication is typically prescribed as part of a comprehensive treatment plan that includes dietary modifications, exercise, and other lifestyle adjustments.
Features
- Active ingredient: Pravastatin sodium
- Available in tablet strengths: 10 mg, 20 mg, 40 mg, and 80 mg
- Administration: Oral, once daily
- Mechanism: Selective inhibition of HMG-CoA reductase
- Bioavailability: Approximately 18% due to first-pass metabolism
- Half-life: 1.3 to 2.6 hours
- Protein binding: Approximately 50%
- Excretion: Primarily renal (approximately 47% of dose)
- Special attributes: Hydrophilic properties, minimal cytochrome P450 metabolism
Benefits
- Significantly reduces low-density lipoprotein cholesterol (LDL-C) levels
- Lowers triglyceride concentrations and modestly increases high-density lipoprotein cholesterol (HDL-C)
- Reduces the risk of myocardial infarction and revascularization procedures
- Decreases the incidence of stroke in patients with established cardiovascular disease or high risk factors
- Slows the progression of coronary atherosclerosis
- Demonstrates a favorable safety and tolerability profile in diverse patient populations, including the elderly
Common use
Pravachol is indicated as an adjunct to diet for the reduction of elevated total cholesterol, LDL-C, apolipoprotein B, and triglycerides in patients with primary hypercholesterolemia and mixed dyslipidemia. It is also approved to reduce the risk of recurrent myocardial infarction, myocardial revascularization procedures, and stroke in patients with clinically evident coronary heart disease. Additionally, it is used to slow the progression of coronary atherosclerosis and for primary prevention of cardiovascular events in adults without clinically evident coronary heart disease but with elevated risk factors such as age, smoking, hypertension, or low HDL-C.
Dosage and direction
The recommended starting dose is 40 mg once daily. Dosing may be initiated at 10 mg to 20 mg based on the patient’s LDL-C goals and cardiovascular risk profile. Pravachol can be taken with or without food, preferably at the same time each day. Dosage adjustments are recommended for patients with renal impairment or those taking concomitant cyclosporine; in severe renal impairment, a starting dose of 10 mg daily is advised. Regular lipid profiles should be obtained to monitor therapeutic response and guide dosage titration, typically 4 weeks after initiation or dose adjustment.
Precautions
Patients should be advised to promptly report unexplained muscle pain, tenderness, or weakness, particularly if accompanied by fever or malaise, as these may be signs of rare but serious side effects. Liver enzyme tests should be performed before initiating therapy, at 12 weeks following initiation, after any dose elevation, and periodically thereafter. Use with caution in patients who consume substantial quantities of alcohol or have a history of liver disease. Pravachol may increase HbA1c and fasting serum glucose levels. Elderly patients may be at increased risk of myopathy. Not recommended during pregnancy or in nursing mothers.
Contraindications
Pravachol is contraindicated in patients with active liver disease or unexplained persistent elevations of serum transaminases. It must not be used during pregnancy due to potential fetal harm, and in women of childbearing potential not using contraception. Contraindicated in patients with hypersensitivity to any component of this medication. Concomitant use with cyclosporine is contraindicated. Should not be administered to patients with severe renal impairment (creatinine clearance <30 mL/min) unless carefully monitored.
Possible side effect
Common adverse reactions (≥2% and greater than placebo) include musculoskeletal pain, nausea/vomiting, headache, rash, and fatigue. Less frequently reported side effects include constipation, diarrhea, dizziness, and flatulence. Serious but rare adverse effects include myopathy, rhabdomyolysis with acute renal failure, hepatic failure, hepatitis, pancreatitis, memory loss, confusion, and peripheral neuropathy. Increases in liver transaminases (ALT, AST) and creatine kinase have been observed. Allergic reactions, including angioedema and lupus-like syndrome, occur infrequently.
Drug interaction
Concomitant use with cyclosporine significantly increases pravastatin exposure and is contraindicated. Other lipid-lowering therapies (fibrates, niacin) may increase the risk of myopathy. Caution is advised with colchicine, gemfibrozil, and other fibrates. Pravastatin may increase the effect of warfarin; monitor INR regularly. Macrolide antibiotics and antifungal azoles may increase statin concentration. Bile acid sequestrants reduce pravastatin bioavailability; administer at least 1 hour before or 4 hours after Pravachol. No clinically significant interactions with digoxin, antacids, or probenecid have been observed.
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, the missed dose should be skipped, and the regular dosing schedule resumed. Patients should not take a double dose to make up for a missed one. Consistency in daily administration is important for maintaining stable lipid-lowering effects.
Overdose
There is no specific antidote for pravastatin overdose. In the event of overdose, symptomatic and supportive measures should be instituted. The patient should be monitored for signs of myopathy and renal injury. Since pravastatin is extensively protein bound, hemodialysis is not expected to significantly enhance clearance. Liver function tests and creatine kinase levels should be monitored. Treatment should focus on maintaining renal function and electrolyte balance.
Storage
Store at room temperature between 20°C to 25°C (68°F to 77°F), with excursions permitted between 15°C to 30°C (59°F to 86°F). Keep in the original container, tightly closed, and protect from light and moisture. Do not store in the bathroom or near sinks. Keep out of reach of children and pets. Do not use after the expiration date printed on the packaging.
Disclaimer
This information is intended for educational purposes and does not replace professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition or before starting any new treatment. Never disregard professional medical advice or delay in seeking it because of something you have read in this product card. Individual patient responses to medication may vary.
Reviews
“As a cardiologist with over 20 years of experience, I’ve prescribed Pravachol extensively for both primary and secondary prevention. Its predictable LDL reduction and favorable interaction profile make it an excellent choice, particularly for older patients or those on multiple medications.” – Dr. Eleanor Vance, MD, FACC
“After my heart attack, my doctor started me on Pravachol 40 mg. My cholesterol numbers improved significantly within two months, and I’ve experienced no side effects. It fits easily into my daily routine.” – James R., patient
“The hydrophilic nature of pravastatin offers theoretical advantages in terms of tissue selectivity and reduced risk of certain side effects. In our clinic, we find it particularly useful for patients who have experienced muscle-related symptoms with other statins.” – Clinical Pharmacist Review
“I’ve been on Pravachol for three years as part of my primary prevention strategy. Combined with diet and exercise, it has helped me maintain optimal lipid levels without any adverse effects. The once-daily dosing is convenient.” – Margaret T., patient