Pravastatin (Pravastatin Sodium)
Also sold as: Pravachol, Prava, Pravex
Pregnancy
Cat X
Lactation
Avoid
Schedule
OTC
Forms
Tablet 10mg, 20mg, 40mg, 80mg
Indications
- Hypercholesterolemia
- Primary prevention of CVD (high-risk)
- Secondary prevention post-MI/stroke
- Dyslipidemia
- Cardiovascular risk reduction
Adult Dosing
Hypercholesterolemia / CVD prevention
10-40 mg PO once daily (preferably evening)
Daily, long-term
Post-MI / secondary prevention
40-80 mg PO daily
Long-term
Pediatric Dosing
Monitor liver and renal function
Renal Dose Adjustment
| CrCl / eGFR | Dose Adjustment |
|---|---|
| CrCl > 60 mL/min | No adjustment |
| CrCl 30-60 mL/min | Start 10 mg daily; max 20 mg daily |
| CrCl < 30 mL/min | Start 10 mg daily; max 10-20 mg daily |
Hepatic Adjustment
Active liver disease or ALT >3× ULN: contraindicated.
Pregnancy & Lactation
Pregnancy: Category X
Contraindicated; teratogenic.
Lactation: Avoid
Unknown if excreted; avoid.
Top Drug Interactions
| Interacting Drug | Effect | Severity |
|---|---|---|
| Cyclosporine | Increased pravastatin levels | Major |
| Fibrates | Increased myopathy risk | Major |
| Warfarin | Slight increase in INR (less than atorvastatin) | Moderate |
| Erythromycin | Increased pravastatin levels | Moderate |
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Side Effects
Common
- Myalgia
- Headache
- Nausea
- Fatigue
- Dyspepsia
Serious / Discontinue If
- Myopathy / rhabdomyolysis
- Liver enzyme elevation
- Diabetes (new-onset)
- Immune-mediated necrotizing myopathy
Contraindications
- Active liver disease
- Pregnancy
- Lactation
- Unexplained ALT elevation
Available Indian Brands
| Brand | Manufacturer | Price (approx) |
|---|---|---|
| Pravachol 20 | BMS | 10 tab ₹190 |
| Prava 20 | Cipla | 10 tab ₹110 |
| Pravex 20 | Intas | 10 tab ₹95 |
Monitoring Required
- LFT at baseline, 12 weeks, then annually
- Lipid panel 4-12 weeks
- CK if myalgia develops
- Fasting glucose (diabetes risk)
Patient Counseling Points
- Take once daily in the evening
- Report muscle pain or weakness
- Regular liver function tests required
- Maintain diet and exercise
- Less drug interactions than atorvastatin (older statin)
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Clinically reviewed by: Dr. Vijay Reddy, MD (Cardiovascular Medicine), Preventive Cardiology
Last reviewed: 2026-04-11
References
- BNF — Pravastatin
- WOSCOPS Trial Monograph
- Indian Cardiology Guidelines