Pravastatin
- Class: Statin
- Used for: high cholesterol
- Say it: PRAV-uh-stat-in
- Forms: tablet
Pravastatin is water-loving and is not metabolised by CYP3A4, the enzyme most drug interactions run through. That makes it the statin of choice alongside clarithromycin, ciclosporin or HIV protease inhibitors.
The stem is the whole message: -statin means HMG-CoA reductase is blocked, so the liver makes less cholesterol and pulls LDL out of the blood to make up the difference. Learn the suffix once and every member here is the same mechanism at a different strength. All drug suffixes ›
Side effects
Common: muscle aches, headache, nausea
Serious: rhabdomyolysis (rare)
Typical dose
10–40 mg once daily
No dose cap alongside CYP3A4 inhibitors, unlike simvastatin and atorvastatin. Take it at night if the dose is at the lower end.
Check yourself
Why is pravastatin preferred for a patient who also takes clarithromycin?
- It is not metabolised by CYP3A4, so clarithromycin cannot raise its level
- It lowers LDL more powerfully than other statins
- It blocks cholesterol absorption instead of synthesis
- Clarithromycin inactivates every other statin
Show answer
A. It is not metabolised by CYP3A4, so clarithromycin cannot raise its level
Clarithromycin is a strong CYP3A4 inhibitor. Simvastatin and atorvastatin levels rise sharply alongside it, and with them the risk of muscle breakdown. Pravastatin takes a different route out of the body, so the interaction does not happen.
See it, don't memorize it
The app has the mechanism comic and a patient case for Pravastatin – plus the name link, the class mnemonic, pronunciation you can hear, and a self-check, for the top 100 drugs. One purchase, no subscription, no account.