Why does Pravastatin have less interactions?

Pravastatin is hydrophilic and is not degraded via the cytochrome-P450 enzyme system. Therefore, it hardly interacts with drugs that are metabolized via CYP3A4. This makes it particularly suitable for patients with polymedication.

Is Pravastatin weaker than Atorvastatin?

Yes, Pravastatin has a lower LDL lowering potency. 40 mg of Pravastatin reduces the LDL by about 30–35%, while 10 mg of Atorvastatin already reaches about 30%. If a stronger reduction is necessary, a change to a more potent statin can be useful.

Can I take Pravastatin with grapefruit juice?

Yes, Pravastatin has no interaction with grapefruit juice, as it is not degraded via CYP3A4. You can drink grapefruit juice without memory.

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What is prvastatin?

Pravastatin is a hydrophilic statin that is characterized by particularly few interactions with other drugs. It is NOT dismantled via the cytochrome P450 system, which makes it ideal for patients who take many other medicines.

Pravastatin was known as Pravastatin® and Pravasin® and is now widely available as a generic. In the major studies WOSCOPS and CARE, Pravastatin has demonstrated the effectiveness of statin therapy both in primary and secondary prevention.

Compared to Atorvastatin and Rosuvastatin, the LDL lowering effect is more moderate, making Pravastatin an option for slightly to moderately increased cholesterol.

Active Ingredients & Mechanism of Action

Active ingredient: Pravastatin (als Natriumsalz)

Pravastatin inhibits cholesterol synthesis:

Active mechanism:

Directly effective substance (no prodrug)
inhibits HMG-CoA reductase
Reduces hepatic cholesterol biosynthesis
Compensatory LDL receptor high regulation

Lipid effect:

LDL cholesterol: 20–35 % reduction
Triglycerides: 10-15 % reduction
HDL cholesterol: 3-8 % increase

Special features:

Hydrophile: Low absorption in non-hepatic tissue (less muscle problems)
NO CYP3A4-Metabolism → no interactions with CYP inhibitors
No problem with grapefruit juice
Is not dismantled via the Cytochrome P450 system

Initiation of action: LDL lowering measurable after 1–2 weeks. Maximum effect after 4 weeks.

Who is it suitable for?

Pravastatin is suitable for:

Adults with hypercholesterinemia
Primary prevention at increased cardiovascular risk
secondary prevention after heart attack
Patients with many accompanying medications

Especially recommended at:

Polymedication (many simultaneous medications)
When muscle problems occurred under lipophilic statins
Organ transplantation (exchange with ciclosporin controllable)
Light to moderate cholesterol increase

Not suitable:

Pregnancy and breastfeeding
Active liver disease
If a strong LDL lowering (> 35 %) is required

Available Dosages

Start dose:

10–20 mg once a day

Other dose:

20–40 mg once a day

Maximum balances:

40 mg daily

Available starches:

10 mg, 20 mg, 40 mg tablets

LDL reduction after dose:

10 mg: approx. 20–25 %
20 mg: approx. 25–30 %
40 mg: approx. 30-35 %

Dosis adjustment:

Kidney insufficiency: start dose 10 mg in severe kidney failure
Liver failure: contraindicated with active disease
Ciclosporin: Max. 20 mg Pravastatin

How to Take

Intake:

Once a day, preferably in the evening (cholesterol synthesis at night highest)
Independent meals
Swallow tablet with water

Important notes:

Regular laboratory control (leverages, lipid profile) after 4–12 weeks
In case of muscle pain or dark urine: inform doctor
No problem with grapefruit juice (other than Simvastatin/Atorvastatin)
Alcohol in dimensions

For forgotten dose: Repeat if it's not too late a day. Next regular dose.

Contraindications

**Pravastatin must not be taken at:* *

Active liver disease or unexplained transaminase increase
Pregnancy and breastfeeding
Hypersensitivity to Pravastatin

Preview at:

Kidney insufficiency (dose adjustment)
Hypothyroidism
Muscle diseases in history
High alcohol consumption
Simultaneous therapy with fibrates

pregnant: Contraindicated. Safe prevention required.

Possible Side Effects

Family (1–10 %):

Headaches
Gastrointestinal complaints (abuse, diarrhea, bloating)
muscle pain
fatigue

** Occasionally (0.1-1 %):* *

Squeeze
Sleep disorders
Skin rash
visual disorders

Selten:

Myopathy, Rhabdomyolysis (similar to lipophilic stamina)
Hepatitis
Peripheral neuropathy
Pancreatitis

General: Pravastatin is considered to be one of the best tolerated statistics. The hydrophilic nature reduces absorption in muscle cells, which theoretically leads to less muscle problems.

Interactions

Other advantage: Pravastatin is NOT mined via CYP3A4 or CYP2C9 → hardly any interactions with CYP inhibitors.

Preview at:

Ciclosporin: Pravastatin max. 20 mg (increased mirror)
Fibrates (Gemfibrozil): Increased myopathy risk
Fusidic acid: Temporarily pausate statin
Colchicin: Increased myopathy risk

No relevant interaction with:

Grapefruit juice
CYP3A4 inhibitors (Itraconazole, Erythromycin, Verapamil etc.)
Amiodarone
Diltiazem

** Pravastatin has the most favorable interaction profile of all statins and is therefore particularly suitable for patients who take many other medicines.

Frequently Asked Questions

Similar Medications

Atorvastatin

Simvastatin

Fluvastatin

Rosuvastatin (Crestor®)

Is prvastatin right for you?

A licensed doctor will review your information and issue a prescription if suitable. Discreet and secure.

Start therapy

Important Notice

This information does not replace medical advice. If you have questions about your health or the suitability of this medication, please consult a doctor. Read the package leaflet before use.