Pravastatin Sodium

Medically Reviewed by Dr. Harshi Dhingra, M.D.

Last Reviewed: Oct 17, 2023

Warnings

Pravastatin Risks, Warnings, and Complications

Pravastatin can cause or worsen health problems in some people. Talk to your doctor about alternative treatment for high cholesterol if you are at an increased risk of complications from pravastatin use. Some of the potential risks of taking pravastatin include:

SERIOUS MUSCLE PROBLEMS: Pravastatin can cause serious muscle problems like rhabdomyolysis and myopathy. The risk is higher in older adults and those taking higher doses of the medicine. Tell your doctor immediately if you develop unexplained muscle pain, tenderness, weakness, or other muscle symptoms, for example, muscle weakness or pain that is not due to exercise.
LIVER DAMAGE: Taking pravastatin can lead to a temporary increase in liver enzymes. This is most likely to occur soon after starting treatment. It does not typically cause symptoms and usually goes away when the medicine is discontinued. However, people with heavy alcohol use or active liver disease are at an increased risk of liver injury from pravastatin use. Keep all your lab appointments while on statin therapy - your provider may want to keep an eye on your liver function. Tell your doctor immediately if you develop yellowing of the skin or eyes, dark urine, right upper stomach pain, fever, nausea, loss of appetite, or fatigue while on pravastatin.
HIGH BLOOD SUGAR: Pravastatin can increase your blood glucose (sugar) levels and hemoglobin A1c (HbA1c). If you have diabetes and measure your blood glucose at home, tell your doctor if you notice higher than usual blood sugars while on pravastatin. Your provider may change your dose or switch you to another medicine.
RISK DURING PREGNANCY: Pravastatin carries the risk of causing serious birth defects and even infant death if it is taken during pregnancy. However, it is not contraindicated during pregnancy. Tell your doctor if you're pregnant or planning a pregnancy or breastfeeding. Most pregnant patients are asked to discontinue statin therapy. However, if you are at a very high risk of cardiovascular events, your doctor may continue you on a statin while you’re pregnant.
ALLERGIC REACTIONS: A small number of people can develop serious hypersensitivity reactions to pravastatin. Seek emergency medical help if you develop signs and symptoms such as skin rash, hives, itching, swelling, or difficulty breathing.

Precautions Before Starting Pravastatin

Tell your doctor if you have ever had an allergic reaction to pravastatin, any of the active or inactive ingredients in pravastatin tablets, other statins, or any other medications. Your pharmacy can give you a list of ingredients.

Give your doctor and pharmacist a complete list of your medications, including prescription drugs, over-the-counter medicines, vitamins, dietary supplements, and herbal products. This can help avoid possible drug interactions between pravastatin and your other medications.

If you are taking certain other medications, such as cyclosporine, clarithromycin, or erythromycin, your doctor will modify your dose of pravastatin.

Give your doctor a complete medical history. Pravastatin may not be right for people with certain medical conditions, such as low blood pressure, active liver disease, heavy alcohol use (more than two drinks per day), muscle problems, thyroid disease, kidney disease, or seizures.

If you are an older adult (age 65 years and above), discuss the pros and cons of taking pravastatin with your provider.

Pravastatin can be harmful to an unborn baby. You should not become pregnant while on this medicine. Discuss appropriate birth control methods with your provider. Before starting pravastatin, tell your doctor if you are pregnant, could be pregnant, or are planning a pregnancy. Do not nurse an infant on breast milk while on pravastatin.

Precautions During Use of Pravastatin

Keep all your healthcare appointments during treatment with pravastatin. Your doctor may want to adjust your dose and check liver function tests periodically when you are on this medicine. You may need to stop pravastatin if the tests show the medicine is affecting liver function.

If you are taking bile acid sequestrants (bile acid-binding resins) such as colestipol (Colestid) or cholestyramine (Questran), you should take pravastatin at least 1 hour before or 4 hours after the bile acid sequestrant.

Avoid drinking alcohol while on pravastatin. Alcohol can increase your risk of liver damage while on this medication.

Avoid eating grapefruit or drinking grapefruit juice while on pravastatin, as this can increase the risk of side effects.

Stop taking pravastatin and tell your doctor immediately if you become pregnant while taking this medicine.

Tell all your healthcare providers you are on pravastatin, especially before any major surgery or if you have serious injuries or infection.

Pravastatin Drug Interactions

Other medicines can affect how well pravastatin works. Taking pravastatin with certain other drugs can increase the risk of serious adverse reactions. Your doctor may change the dose of your medications, monitor you carefully for adverse effects, or switch you to other medicines if there are known interactions between pravastatin and your other medicines. The following medications can have possible interactions with pravastatin:

Antacids
H2 blockers like cimetidine (Tagamet)
Antifungal medications such as ketoconazole (Nizoral) and fluconazole (Diflucan)
HIV medications such as boceprevir (Victrelis) and ritonavir (Norvir) with darunavir (Prezista)
Antibiotics such as clarithromycin (Biaxin) and erythromycin (E-Mycin, Erythrocin, E.E.S.)
Gout medications such as colchicine (Colcrys)
Immunosuppressants such as cyclosporine (Neoral, Sandimmune)
Heart medications such as digoxin (Lanoxin) and spironolactone (Aldactone)
Calcium channel blockers like diltiazem (Cartia, Cardizem, Tiazac, Taztia) and verapamil (Calan, Verelan, Covera)
Other cholesterol-lowering medications such as gemfibrozil (Lopid), fenofibrate (Tricor), and niacin (Niacor, nicotinic acid, Niaspan)
Anticoagulants like warfarin (Coumadin)

The above list may not include all the possible interactions of pravastatin. Give your doctor or pharmacist a complete list of your medications, including prescription drugs, over-the-counter medicines, dietary supplements, and herbal remedies. Also, tell your healthcare provider if you smoke, drink alcohol, or use recreational drugs because some of these substances can cause serious health complications when used with prescription and over-the-counter medicines.

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