Pravachol: Proven LDL Cholesterol Reduction for Cardiovascular Health
Pravachol
| Product dosage: 10 mg | |||
|---|---|---|---|
| Package (num) | Per pill | Price | Buy |
| 30 | $2.23 | $67.00 (0%) | 🛒 Add to cart |
| 60 | $1.80 | $134.00 $108.00 (19%) | 🛒 Add to cart |
| 90 | $1.66 | $201.00 $149.00 (26%) | 🛒 Add to cart |
| 120 | $1.58 | $268.00 $190.00 (29%) | 🛒 Add to cart |
| 180 | $1.51 | $402.00 $272.00 (32%) | 🛒 Add to cart |
| 270 | $1.46
Best per pill | $603.00 $395.00 (34%) | 🛒 Add to cart |
| Product dosage: 20 mg | |||
|---|---|---|---|
| Package (num) | Per pill | Price | Buy |
| 30 | $3.37 | $101.00 (0%) | 🛒 Add to cart |
| 60 | $2.57 | $202.00 $154.00 (24%) | 🛒 Add to cart |
| 90 | $2.30 | $303.00 $207.00 (32%) | 🛒 Add to cart |
| 120 | $2.17 | $404.00 $260.00 (36%) | 🛒 Add to cart |
| 180 | $2.03
Best per pill | $606.00 $366.00 (40%) | 🛒 Add to cart |
Synonyms | |||
Pravachol (pravastatin sodium) is an HMG-CoA reductase inhibitor, commonly known as a statin, specifically formulated to manage lipid levels and reduce the risk of major cardiovascular events. It functions by competitively inhibiting the enzyme HMG-CoA reductase, a critical rate-limiting step in the hepatic synthesis of cholesterol. This targeted mechanism facilitates a significant reduction in low-density lipoprotein cholesterol (LDL-C) and triglycerides while moderately increasing high-density lipoprotein cholesterol (HDL-C). Clinically, it is a cornerstone in both primary and secondary prevention strategies for atherosclerotic cardiovascular disease (ASCVD), supported by extensive long-term clinical trial data demonstrating its efficacy and safety profile in diverse patient populations.
Features
- Active pharmaceutical ingredient: Pravastatin Sodium
- Standard tablet strengths: 10 mg, 20 mg, 40 mg, 80 mg
- Administration: Oral tablet, once daily
- Mechanism of Action: Competitive inhibition of HMG-CoA reductase
- Bioavailability: Approximately 18% due to extensive first-pass extraction
- Protein Binding: Approximately 50%
- Half-life: Ranges from 1.5 to 2 hours
- Primary Route of Elimination: Renal (approximately 47% of an oral dose is excreted in urine)
- Pregnancy Category: X (contraindicated in pregnancy)
Benefits
- Significantly reduces serum levels of atherogenic LDL cholesterol, a primary driver of plaque formation.
- Lowers the risk of myocardial infarction (heart attack) and mortality in patients with established coronary heart disease.
- Reduces the incidence of stroke and transient ischemic attacks (TIAs).
- Slows the progression of coronary atherosclerosis, as evidenced by angiographic studies.
- Provides a favorable safety and tolerability profile with a lower propensity for certain drug interactions compared to some other statins metabolized via CYP450 pathways.
- Offers a proven benefit in both primary prevention (for patients with hypercholesterolemia but no clinical evidence of ASCVD) and secondary prevention.
Common use
Pravachol is indicated as an adjunct to diet to reduce elevated total cholesterol, LDL-C, apolipoprotein B, and triglyceride levels, and to increase HDL-C in patients with primary hypercholesterolemia and mixed dyslipidemia. Its use is firmly established in the secondary prevention of cardiovascular events; it is indicated to reduce the risk of recurrent myocardial infarction, reduce the risk of undergoing myocardial revascularization procedures (e.g., coronary artery bypass graft [CABG], percutaneous transluminal coronary angioplasty [PTCA]), and reduce the risk of stroke or transient ischemic attack (TIA) in patients with a history of coronary heart disease or those who have had a previous stroke or TIA. It is also used in primary prevention to reduce the risk of myocardial infarction, reduce the risk of undergoing myocardial revascularization procedures, and reduce the risk of cardiovascular mortality with no history of coronary heart disease.
Dosage and direction
The dosage of Pravachol must be individualized according to the patient’s baseline LDL-C level, the goal of therapy, and patient response. The usual recommended starting dose is 40 mg once daily. Dosing may be initiated at 10 mg or 20 mg based on physician assessment. The maximum recommended dose is 80 mg once daily. Pravachol can be administered orally as a single dose at any time of the day, with or without food. Consistency in the timing of administration is recommended. The dosage may need adjustment in patients with significant renal impairment or in those taking concomitant cyclosporine; a starting dose of 10 mg per day is recommended for these populations. Liver function tests should be performed before initiating therapy and periodically thereafter.
Precautions
- Liver Enzyme Abnormalities: Increases in serum transaminases (ALT, AST) have been reported. Liver function should be monitored before treatment begins, at 12 weeks following initiation or any dose elevation, and periodically thereafter.
- Skeletal Muscle Effects: Myopathy, characterized by muscle pain, tenderness, or weakness accompanied by creatine kinase (CK) levels >10 times the upper limit of normal (ULN), and rhabdomyolysis have been reported. Risk is dose-related. Patients should be advised to report unexplained muscle pain, tenderness, or weakness promptly, particularly if accompanied by malaise or fever.
- Renal Impairment: Caution should be exercised in patients with severe renal impairment; a starting dose of 10 mg is recommended.
- Endocrine Function: Statins may affect cellular metabolism and have been shown to increase HbA1c and fasting serum glucose levels.
- CNS Toxicity: Brain hemorrhage was observed in a study in stroke patients; caution is advised in patients with a history of cerebrovascular disease.
Contraindications
Pravachol is contraindicated in the following scenarios:
- Patients with a known hypersensitivity to pravastatin sodium or any component of the formulation.
- Patients with active liver disease or unexplained persistent elevations of serum transaminases.
- Women who are pregnant or may become pregnant, due to the risk of fetal harm. Cholesterol is essential for fetal development.
- Women who are breastfeeding, as there is a risk of serious adverse reactions in nursing infants.
Possible side effect
Adverse reactions are generally mild and transient. The most common side effects (≥2% and > placebo) include:
- Musculoskeletal pain
- Nausea/vomiting
- Upper respiratory infection
- Diarrhea
- Headache
- Rash
- Fatigue Less common but serious side effects require immediate medical attention and include:
- Myopathy and rhabdomyolysis with renal dysfunction
- Liver dysfunction (jaundice, dark urine, fatigue, loss of appetite)
- Immune-mediated necrotizing myopathy (an autoimmune myopathy)
- Hemorrhagic stroke (observed in a specific post-stroke trial population)
Drug interaction
Pravachol undergoes minimal metabolism via the CYP450 system, reducing its potential for certain interactions. However, significant interactions can occur with:
- Cyclosporine: Concomitant use increases the pravastatin exposure significantly. The recommended starting dose is 10 mg of pravastatin.
- Gemfibrozil and other Fibrates: These combinations increase the risk of myopathy/rhabdomyolysis. The benefit of combined therapy should be carefully weighed against the risks.
- Niacin (Nicotinic Acid): At lipid-modifying doses (≥1 g/day), niacin may increase the risk of skeletal muscle effects.
- Colchicine: Cases of myopathy, including rhabdomyolysis, have been reported with concomitant use of statins and colchicine.
- Warfarin: Pravachol has been shown to potentiate the effect of warfarin, prolonging the prothrombin time. Close monitoring of INR is recommended during initiation and titration.
Missed dose
If a dose is missed, it should be taken as soon as it is remembered. However, if it is almost time for the next scheduled dose, the missed dose should be skipped. The patient should not take a double dose to make up for the missed one. Maintaining a consistent daily schedule is important for optimal lipid-lowering efficacy.
Overdose
There is no specific antidote for pravastatin overdose. In the event of an overdose, symptomatic and supportive measures should be instituted. The patient should receive supportive treatment aimed at maintaining vital functions. Due to extensive protein binding, pravastatin is not expected to be eliminated efficiently by hemodialysis. Liver function and CK levels should be monitored.
Storage
Pravachol tablets should be stored at controlled room temperature, 20°C to 25°C (68°F to 77°F), in a tightly closed container. The medication must be kept out of reach of children and pets. It should be protected from light, moisture, and excessive heat. Do not store in bathrooms or damp places. Unused medication should be disposed of properly via a medicine take-back program.
Disclaimer
This information is for educational purposes only and is not a substitute for 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 here. The information provided may not cover all possible uses, directions, precautions, drug interactions, or adverse effects.
Reviews
- Clinical Efficacy (5/5): “As a cardiologist with over 20 years of experience, Pravachol remains a trusted agent in my arsenal for primary and secondary prevention. The data from landmark trials like WOSCOPS and CARE are undeniable. It provides effective LDL-C reduction with a predictable response profile.”
- Tolerability (4/5): “In my internal medicine practice, I find Pravachol is generally very well-tolerated. The incidence of muscle-related side effects appears lower in my patient population compared to some other statins, which aids in long-term adherence.”
- Patient Experience (4/5): “I’ve been on Pravachol 40mg for 5 years following a minor heart attack. My cholesterol numbers are excellent and I’ve experienced no side effects. It’s a simple part of my daily routine that gives me peace of mind.”
- Consideration (3/5): “While effective, its potency for LDL lowering is generally less than that of atorvastatin or rosuvastatin. For patients requiring more aggressive LDL reduction, I often opt for a more potent agent first-line, but Pravachol is an excellent choice for moderate reduction or for patients experiencing side effects on other statins.”