pitavastatin
Pitavastatin calcium, also known by its brand name, Livalo, is a moderate-intensity statin for people with high cholesterol. It lowers "bad" cholesterol and triglycerides (fats) and raises "good" cholesterol in the body. Pitavastatin calcium (Livalo) is a tablet that's taken by mouth once per day at any time of day. It's important to follow a heart-healthy diet while taking the medication to get the most benefits from treatment. Side effects include muscle pain, back pain, and constipation. Pitavastatin calcium (Livalo) is available as a brand-name and generic medication.
What is Pitavastatin calcium (Livalo)?
What is Pitavastatin calcium (Livalo) used for?
High cholesterol in adults
Heterozygous familial hypercholesterolemia (HeFH, a genetic condition that causes high cholesterol) in people age 8 years and older
How Pitavastatin calcium (Livalo) works
Pitavastatin calcium (Livalo) is a statin. The main way it works is by blocking a protein) in the liver that makes cholesterol. By blocking this protein, pitavastatin calcium (Livalo) affects different types of cholesterol and fats in the body.
It lessens the amount of "bad" cholesterol in the blood. "Bad" cholesterol is also called low-density lipoprotein or LDL.
It also lowers the amount of triglyceride (a type of fat in the blood).
It helps raise the amount of "good" cholesterol a little bit in the body. "Good" cholesterol is also called high-density lipoprotein or HDL.
Drug Facts
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What are the side effects of Pitavastatin calcium (Livalo)?
Common Side Effects
- Back pain (up to 4%)
- Constipation (up to 4%)
- Muscle pain (up to 3%)
- Diarrhea (up to 3%)
- Pain in the arm or leg (up to 2%)
Serious Side Effects
- Severe muscle damage (rhabdomyolysis): severe muscle weakness or pain, dark brown urine, fever, extreme tiredness
- Liver problems: swelling of your stomach, yellowing of your skin or the whites of your eyes, dark or brown urine, confusion
Source: DailyMed
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The following side effects have also been reported
Side effects that you should report to your care team as soon as possible:
- Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
- High blood sugar (hyperglycemia)—increased thirst or amount of urine, unusual weakness or fatigue, blurry vision
- Liver injury—right upper belly pain, loss of appetite, nausea, light-colored stool, dark yellow or brown urine, yellowing skin or eyes, unusual weakness or fatigue
- Muscle injury—unusual weakness or fatigue, muscle pain, dark yellow or brown urine, decrease in amount of urine
Side effects that usually do not require medical attention (report to your care team if they continue or are bothersome):
- Back pain
- Constipation
- Diarrhea
- Pain in the hands or feet
Pros and cons of Pitavastatin calcium (Livalo)
Pros
Generally lowers "bad" cholesterol (LDL) by about 30% to 49%
Taken once per day with or without food
Okay for children as young as 8 years old to take for HeFH
Cons
Not the best choice for people who need a high-intensity statin
Can't crush the tablets, so might not be a good option for people who have trouble swallowing pills whole
Not safe to take while pregnant or breastfeeding
Pharmacist tips for Pitavastatin calcium (Livalo)
Get your blood work done when asked by your prescriber while taking pitavastatin calcium (Livalo). They'll check your cholesterol levels to see if the medication is working and if your dose needs adjusting. These blood tests also check your liver health to make sure pitavastatin calcium (Livalo) is still safe to take.
Take pitavastatin calcium (Livalo) once each day at any time of the day. But it's best to take the medication around the same time every day. This helps make taking pitavastatin calcium (Livalo) a part of your daily routine. It can help you remember to take the medication.
You can take pitavastatin calcium (Livalo) with or without food. Try taking it with food if the medication ends up hurting your stomach to ease this side effect. Swallow the tablets whole; don't cut, crush, or chew them.
Avoid alcohol or limit how much you drink while taking pitavastatin calcium (Livalo). Drinking alcohol can raise your risk of serious side effects, like liver problems and muscle pain. It can also make your cholesterol levels go up. Talk to a healthcare professional about how alcohol might affect your treatment.
Get medical help right away if you have severe muscle pain, tenderness, or weakness; dark-colored urine; or fever. These might be signs of rhabdomyolysis. This is a serious condition caused by muscle breakdown.
Tell your prescriber and pharmacist about all the medications you take. Pitavastatin calcium (Livalo) can interact with many medications. These can include gemfibrozil (Lopid), fenofibrate, and colchicine (Colcrys). They can raise the risk for side effects like muscle damage.
Follow a healthy, balanced diet and get regular exercise while taking pitavastatin calcium (Livalo). This helps you get the most benefit out of your treatment. Ask your care team about how to plan your meals and what kind of exercise is best for you.
Let your prescriber know if you become pregnant. Pitavastatin calcium (Livalo) generally isn't recommended during pregnancy. The medication might cause harm to an unborn baby. Your prescriber will weigh the risks from high cholesterol and benefits of treatment to decide if a safer medication is better for you.
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Frequently asked questions about Pitavastatin calcium (Livalo)
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What are the risks and warnings for Pitavastatin calcium (Livalo)?
Pitavastatin calcium (Livalo) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Severe muscle pain and damage
Risk factors: Ages 65 years and older | Hypothyroidism that's not well-controlled | Kidney problems | Taking a higher dose of pitavastatin calcium (Livalo) | Taking other medications that can also cause muscle problems or interact with pitavastatin calcium (Livalo)
Pitavastatin calcium (Livalo) can cause muscle pain, tenderness, and weakness. Rarely, it can cause rhabdomyolysis. This is a serious and life-threatening condition that can lead to kidney damage. You're at higher risk if you take other medications that cause muscle damage or interact with pitavastatin calcium (Livalo).
Although rare, statins like pitavastatin calcium (Livalo) can cause immune-mediated necrotizing myopathy (IMNM). This is an autoimmune condition that causes muscle inflammation and muscle weakness. It might continue even after stopping the medication. You'll need to take other medications to treat IMNM.
Let your care team know if you have unexplained muscle pain, tenderness, or weakness. And get medical help right away if you have severe muscle pain, dark-colored urine, or extreme tiredness. These can be signs of rhabdomyolysis. Depending on your symptoms, you might need to stop taking pitavastatin calcium (Livalo).
Liver problems
Risk factors: History of liver problems | Drinking large amounts of alcohol
Some people who took pitavastatin calcium (Livalo) had elevated liver enzyme levels. This could be a sign of damage to the liver. Most times, this happens soon after starting the medication. But it's usually temporary and doesn't cause symptoms. Rarely, liver failure that's sometimes life-threatening has happened.
Before starting pitavastatin calcium (Livalo), you might need a blood test to check your liver health. People with liver failure or severe liver cirrhosis shouldn't take this medication. You might also need regular blood tests during treatment to make sure it's still safe to take.
Get medical help right away if you have yellowing of the skin or eyes, severe stomach pain, dark or bloody stools, or dark urine. These could be signs of liver damage. You might need to stop taking pitavastatin calcium (Livalo) to prevent more harm to the liver.
Higher blood sugar levels
Risk factors: High blood sugar
Some research suggests that statins like pitavastatin calcium (Livalo) might raise blood sugar levels. This could lead to higher hemoglobin A1C levels (average blood sugar over 3 months). But healthcare professionals believe that the benefits of statins outweigh this risk.
Tell your prescriber if you have diabetes or high blood sugar before you start pitavastatin calcium (Livalo). You might need to check your blood sugar more often. Also, follow a healthy, balanced diet and get regular exercise while you're taking pitavastatin calcium (Livalo).
Possible risk of harm during pregnancy or breastfeeding
Stop taking pitavastatin calcium (Livalo) and tell your prescriber if you're pregnant. This medication isn't recommended during pregnancy unless the benefits are greater than the risks. Statins might harm an unborn baby. Talk to your prescriber about safe treatment options if you're pregnant or thinking of becoming pregnant.
Breastfeeding is also not recommended while you're taking pitavastatin calcium (Livalo). Some statins can get into breast milk and might harm the baby. Talk to your prescriber or a lactation consultant about safe feeding options.
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Pitavastatin calcium (Livalo) dosage forms
Typical dosing for Pitavastatin calcium (Livalo)
The typical dose is 2 mg to 4 mg by mouth once a day.
Your dose might differ if you have kidney problems. Your dose will also differ if you're taking erythromycin or rifampin because of drug interactions.
How much does Pitavastatin calcium (Livalo) cost?
Pitavastatin calcium (Livalo) contraindications
Take with cyclosporine (Neoral, Gengraf, Sandimmune)
Liver failure
What are alternatives to Pitavastatin calcium (Livalo)?
High cholesterol in adults
Heterozygous familial hypercholesterolemia (HeFH, a genetic condition that causes high cholesterol) in people age 8 years and older
Lower "bad" cholesterol levels
Prevention of heart or blood vessel problems (e.g., heart attack) in people at risk for heart disease
Lower the risk of heart or blood vessel problems (e.g., heart attack, stroke) in adults at risk for heart problems
Lower "bad" cholesterol and triglyceride levels in certain adults
Lower "bad" cholesterol levels in children age 8 years and older with heterozygous familial hypercholesterolemia (HeFH)
What is the latest news about Pitavastatin calcium (Livalo)?
Pitavastatin calcium (Livalo) images
References
Best studies we foundAmerican Diabetes Association Professional Practice Committee. (2025). 10. Cardiovascular disease and risk management: Standards of Care in Diabetes–2025. Diabetes Care.
Drugs and Lactation Database (LactMed®). (2023). Pitavastatin. National Institute of Child Health and Human Development.
Family Heart Foundation. (2014). What is heterozygous familial hypercholesterolemia?
Grundy, S. M., et al. (2018). 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the management of blood cholesterol: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation.
Gupta, D., et al. (2018). Salts of therapeutic agents: Chemical, physicochemical, and biological considerations. Molecules.
McTaggart, F., et al. (2008). Effects of statins on high-density lipoproteins: A potential contribution to cardiovascular benefit. Cardiovascular Drugs and Therapy.
Newman, C. B., et al. (2018). Statin safety and associated adverse events: A Scientific Statement from the American Heart Association. Atherosclerosis, Thrombosis, and Vascular Biology.
NorthStar RxLLC. (2024). Pitavastatin calcium- pitavastatin calcium tablet, film coated [package insert]. DailyMed.
Singh, P., et al. (2018). Statins decrease leptin expression in human white adipocytes. Physiological Reports.
Stroie, O. P., et al. (2020). Statin-induced immune-mediated necrotizing myopathy: An increasingly recognized inflammatory myopathy. Cureus.
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