Pravastatin
A statin used to lower LDL cholesterol and to reduce heart attacks, strokes and deaths in people with or at risk of coronary disease.
Drug card
- Class
- Statin
- How it works
- Blocking HMG-CoA reductase, so the liver makes less cholesterol
- Used for
- Lowering heart attack, stroke and death in coronary disease
- High LDL cholesterol and mixed dyslipidemia
- High triglycerides
- Known for
- Muscle and joint aches
- Myopathy and rhabdomyolysis (rare)
- Its name
- -vastatin means a statin (HMG-CoA reductase inhibitor)
Study it as a flashcard, and it comes back before you forget it.
Mechanism of action
How does pravastatin work?
A reversible HMG-CoA reductase inhibitor that is swallowed in its active form rather than as a prodrug; besides lowering LDL it reduces VLDL and triglycerides and raises HDL. The liver extracts much of it on first pass, so only about 17% of a dose reaches the circulation; it is changed by isomerization and ring hydroxylation.
Like other statins: Statins competitively inhibit HMG-CoA reductase, the enzyme that sets the pace of cholesterol synthesis by turning HMG-CoA into mevalonate. Short of cholesterol, liver cells put more LDL receptors on their surface and take up more LDL from the blood, and the liver releases less VLDL. Plasma LDL cholesterol falls, and with it the risk of heart attack and stroke.
Uses
What is pravastatin used for?
- Lowering heart attack, stroke and death in coronary disease
- High LDL cholesterol and mixed dyslipidemia
- High triglycerides
Side effects
Side effects of pravastatin
- Muscle and joint achesKnown for
- Myopathy and rhabdomyolysis (rare)Known forSerious
- Kidney failure from rhabdomyolysisSerious
- Immune-mediated necrotizing myopathy (rare)Serious
- Raised liver enzymes
- Nausea and vomiting
- Diarrhea
- Headache
- Dizziness
- Rash
- Tiredness
Known for marks what an exam expects you to know it for.
Watch for
Cautions and what sets it apart
- Cyclosporine and clarithromycin raise its levels, so its dose is capped; fibrates, niacin and erythromycin add to muscle risk.
- Contraindicated in active liver disease or with unexplained, persistently raised transaminases.
- Kidney impairment raises the risk of rhabdomyolysis, so muscle effects are watched more closely.
- Not used in pregnancy or while breastfeeding.
Good to know: Swallowed in its active form, not as a prodrug; it has been shown to cut heart attacks and deaths both in people with known coronary disease and in those without.
Remember it
A way to remember it
Statins shut the cholesterol factory, and the liver goes shopping for LDL.
With HMG-CoA reductase blocked, liver cells make less cholesterol and add LDL receptors to pull LDL out of the blood. The harms to watch for are in the muscles (myalgia, rhabdomyolysis) and the liver.
Written for biofideX
Its name
-vastatin means statin (HMG-CoA reductase inhibitor)
Atorvastatin, simvastatin, rosuvastatin and pravastatin block HMG-CoA reductase. WHO files the stem under -stat (enzyme inhibitors); nystatin, an antifungal, is not a statin.
- Every drug name stem
Its class
Statins
Other statins with a card:
Easily mixed up with fibrates and cholesterol absorption inhibitors.
Sources
Checked against
Written for biofideX in plain words, after checking these references:
For learning pharmacology, not for treatment decisions: no doses are given, and a prescriber, pharmacist or the product's own label is the word on any one patient. Spotted a mistake? Tell us and we'll correct it.
Blood clots and cholesterol
Pravastatin is one of 19 drugs practiced together here: their classes, how they work, what they treat and what they're known for.
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