Pravastatin is a prescription medication belonging to the class of drugs known as HMG-CoA reductase inhibitors, or statins. It is primarily prescribed for the management of high cholesterol and related cardiovascular risk reduction. Pravastatin works by inhibiting the enzyme HMG-CoA reductase in the liver, thereby reducing endogenous cholesterol production. This decreases levels of low-density lipoprotein (LDL, or “bad cholesterol”) and triglycerides while modestly raising high-density lipoprotein (HDL, or “good cholesterol”). These combined effects help slow or reverse the progression of atherosclerosis and reduce the likelihood of major cardiovascular events such as heart attacks and strokes.
Approved in the early 1990s, pravastatin became one of the widely used second-generation statins because of its favourable safety profile and lower potential for drug–drug interactions compared with lipophilic statins such as simvastatin or atorvastatin. Unlike some other statins, pravastatin is more hydrophilic, meaning it does not penetrate tissues as extensively, which may explain its lower incidence of muscle-related side effects in some patients.
Pravastatin is taken orally, usually once daily, and is available in multiple strengths. It has a relatively short half-life (about 1.5 to 2 hours), but its cholesterol-lowering effects persist because of its impact on hepatic cholesterol synthesis. It is eliminated through both renal and hepatic routes, which is important when considering patients with kidney or liver impairment. Despite being less potent than some newer statins, pravastatin remains an important option in patients who require cholesterol reduction but are intolerant to higher potency alternatives.
Pravastatin is not a cure but a long-term treatment that must be continued indefinitely to maintain benefits. Stopping therapy can result in cholesterol levels rising again and increased cardiovascular risk.
Overall, pravastatin is well tolerated. Many side effects resolve with time or dose adjustment. Patients should not stop pravastatin abruptly without medical guidance, as doing so may increase their risk of cardiovascular events.
Before starting pravastatin, patients should provide a full medical history, including all other medications and supplements, so the clinician can assess risks and interactions.
Patients should always keep an updated list of medications, including supplements and herbal products, and share it with every healthcare provider they see.
Overdose: Large overdoses of pravastatin are rare but can cause significant liver or muscle toxicity. Symptoms may include severe muscle pain, weakness, confusion, or jaundice. Treatment is supportive, with monitoring of liver and kidney function and symptom management.
Accidental double dose: If a patient accidentally takes two doses in one day, they should skip the next scheduled dose and resume the regular schedule the following day. They should not take extra medication to compensate for a missed dose.
Missed dose: If remembered within a few hours, the dose may be taken. If it is nearly time for the next scheduled dose, the missed dose should be skipped. Double dosing should be avoided.
Patients should always follow the directions on their prescription label and consult a healthcare professional with any concerns about missed or extra doses.
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