Pravastatin sodium (Pravachol), commonly called pravastatin, is a member of the statin family of drugs. It is commonly prescribed to treat high cholesterol levels. Pravastatin is usually started at 40 mg, a dosage that has been found to significantly lower the risk and recurrence of heart disease and stroke. This dose of pravastatin is generally well tolerated. People taking this drug may experience less serious side effects, such as nausea, diarrhea, dizziness, rash or muscle aches, though this is uncommon. Some statins have serious but rare side effects, including increased diabetes risk, muscle breakdown and liver injury; however, pravastatin is less likely to cause these problems.
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Most Common Side Effects
The majority of people taking the 40 mg dose of pravastatin do not experience significant side effects. The most common side effects associated with this drug are generally not severe. According to the prescribing information, mild digestive system symptoms such as upset stomach, nausea, vomiting or diarrhea occur in approximately 4 percent of people who take this dose of pravastatin. Other slightly less common side effects include headache, mild skin rash, dizziness and anxiety. Nausea and dizziness are examples of some of the more common reasons people decide to stop the medication.
Statin drugs sometimes cause an increase in blood liver enzyme levels. This is usually due to leakage of the enzymes from liver cells rather than liver injury. In rare cases, however, a spike in liver enzyme levels while taking pravastatin might signal liver inflammation. A study known as the Prospective Pravastatin Pooling Project, or PPP, did not find an increased risk for significantly elevated liver enzyme levels associated with the 40 mg dose of pravastatatin, according to a April 2002 “Circulation” study. However, if a person has liver disease or if pravastatin is taken in combination with certain medications, the risk of liver injury is present.
Because some statins may cause muscle aches and even severe muscle breakdown, the PPP project specifically examined pravastatin and muscle side effects. This study reported that muscle side effects were no more common in people taking pravastatin compared to placebo. While muscle aches are a commonly reported side effect of statins in general, this research indicates that muscle side effects are unlikely to occur with this dose of pravastatin. Severe muscle breakdown is an exceedingly rare, but possible, side effect of pravastatin use.
About Diabetes Risk
A July 2013 study published in "Circulation" reported an increased diabetes risk associated with extended statin use, especially when prescribed in high doses. However, the researchers found no significant increase in diabetes risk with pravastatin use. In fact, pravastatin is the only statin drug that does not carry a warning about a possible risk of high blood sugar levels associated with its use. It's still a good idea for people with diabetes who start pravastatin to keep an eye on blood sugar levels and report any changes to their doctor.
Immediate medical attention is needed for symptoms such as rash, itching or shortness of breath, as this may indicate an allergic reaction. Side effects such as frequent urination, extreme thirst, prolonged vomiting or diarrhea, and severe muscle pain or weakness also require urgent medical evaluation. Pravastatin is not safe to take during pregnancy or while breastfeeding. Because pravastatin can interact with other medications, people taking pravastatin need to relay all medical concerns and problems, including all prescription and over-the-counter medication use, to their health care team.