Paired with diet and lifestyle changes, medication can help lower dangerously high levels of low-density lipoprotein (LDL) cholesterol, known as the bad type. One popular medication, called pravastatin, can be an effective option, but there are potential side effects to bear in mind.
Pravastatin (Pravachol) falls into a class of drugs called statins. According to Johns Hopkins Health, more than 200 million people worldwide take statins to reduce their risk for heart attack, stroke or other health problems. Statins work by drawing cholesterol out of the plaque that builds up in the walls of your arteries.
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Statins and Weight
"Pravastatin is one of the best tolerated statin medications," says Dennis Bruemmer, MD, PhD, director of the Cleveland Clinic Center for Cardiometabolic Health in Ohio. But it is not a dieting aid. "Weight loss is not a frequent side effect that is observed with pravastatin," he states.
Indeed, as the Food and Drugs Administration points out, the drug itself is not associated with any significant changes in weight, based on clinical trial data cited on the pravastatin label. However, researchers have noted that some people do end up gaining weight while taking statins, simply because they view the drug as a free pass to eat unhealthily.
According to an editor's letter published in 2014 in JAMA Internal Medicine, statins provide a false sense of reassurance to many people who believe taking the drug can make up for a poor diet and lack of exercise. It cited a research analysis that compared people who take statins with those who don't and found that statin users ate more fat and calories and had a higher body mass index (BMI).
With this tendency in mind, it's important to remember that medications are only part of the package when it comes to lowering cholesterol, according to the Cleveland Clinic. Pravastatin needs to be paired with a low-cholesterol and low-fat diet.
Read more: What You Need to Know About Cholesterol
Side Effects and Interactions
Dr. Bruemmer cautions that pravastatin can cause side effects, including muscle pain called myalgia, as well as gastrointestinal problems such as nausea, vomiting, diarrhea and an increase in liver enzymes. The potential muscular side effects occur in about 10 to 20 percent of people who take statins, but he says that "pravastatin is probably the statin with the least frequency of muscle-related side effects."
Some people who take statins might experience an increase in blood sugar, which, over time, can lead to type 2 diabetes, according to the Mayo Clinic. But this side effect tends to occur more often in people who are already at a higher risk of diabetes.
According to the Cleveland Clinic, potential interactions can occur when taking pravastatin alongside the anti-inflammatory drug colchicine, the immunosuppressive drug cyclosporine or certain antibiotics such as azithromycin, clarithromycin, erythromycin and telithromycin, among others. Because of this, be sure your doctor is aware of all drugs you take, including any that have been prescribed by other physicians, if pravastatin is being considered.
It's worth noting that it's fine to drink moderate amounts of alcohol while taking pravastatin, but drinking in excess can increase the likelihood that you will experience the drug's side effects, according to the Mayo Clinic.
Alternatives for High Cholesterol
Pravastatin is far from the only cholesterol drug available. There's a long list of other medications that your doctor may prescribe, including other statins, such as the popular drug Lipitor. Drugs called bile acid binding resins, including cholestyramine (Prevalite) and colesevelam (Welchol), can work to decrease LDL levels, too, according to the Mayo Clinic, as can the cholesterol absorption inhibitor drug ezetimibe (Zetia) and various combinations of these drugs.
Potential side effects differ across the different categories of cholesterol drugs, making it important to read all the packaging information carefully and talk to your doctor about potential interactions.
- Johns Hopkins Health: “How Statin Drugs Protect the Heart”
- Dennis Bruemmer, MD, PhD, director, Cleveland Clinic Center for Cardiometabolic Health, Cleveland
- Food and Drug Administration: “Prescribing Information for Pravastatin”
- JAMA Internal Medicine: “Editor’s Note: Statins and Weight Gain”
- Cleveland Clinic: “Pravastatin Tablets”
- Mayo Clinic: “Statin Side Effects: Weigh the Benefits and Risks”
- Mayo Clinic: "Cholesterol Medications: Consider the Options"