8 Pitavastatin Side Effects You Should Know About

Statins are some of the most commonly prescribed medications in the U.S. These cholesterol-lowering medications can lower your “bad cholesterol” (LDL) by up to 50% or more, depending on what statin you take. One statin, pitavastatin (Livalo, Zypitamag), may lower your LDL by up to 30% to 49%. It’s considered a “moderate-intensity” statin.

Statins like pitavastatin are known to decrease the risk of atherosclerotic cardiovascular disease (ASCVD). Having ASCVD can lead to heart attack and stroke. But even though pitavastatin is effective, side effects are possible. Some are common, while others are more rare (and more serious).

Below, we’ll cover some of the most notable side effects you should know. But keep in mind, this list doesn’t cover all the possible side effects of pitavastatin. Always talk with your healthcare provider about the risks and benefits of pitavastatin before starting it.

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1. Muscle symptoms

Muscle aches and pains are one of the most common side effects associated with statins. But it’s important to know that muscle-related side effects may not always be caused by statins. Some research shows that when people taking statins are compared to those taking placebo (a pill with nothing in it), the number of people who report muscle-related side effects is similar. 

Still, up to 20% of people taking statins report feeling muscle pain and aches. It can happen with pitavastatin, but it’s considered one of the statins that’s less likely to cause muscle problems.

We don’t know exactly what causes statin-associated muscle symptoms (SAMS), but certain risk factors make it more likely. These include being of older age as well as certain genetic factors, including a family history of SAMS.

SAMS usually starts within a few months of starting statin therapy. It’s more likely to happen after dose increases or if you start another medication that can interact with statins. The good news is that these effects are usually temporary and go away on their own. 

If you have muscle pain that hasn’t improved after a few weeks, reach out to your healthcare provider. They can help you determine if your muscle pain is from the statin or something else. If they think it’s from the statin, they may lower your dose. Or they may ask you to stop taking it for a short period of time to see if symptoms improve. 

2. Constipation

Pitavastatin is one of many medications that can cause constipation. If you experience constipation while taking this medication, make sure to drink plenty of water and eat foods that are high in fiber. It also helps to exercise regularly.

If you still experience constipation after these lifestyle changes, talk to your healthcare provider or pharmacist. They may recommend starting an over-the-counter (OTC) medication for constipation. These medications, called laxatives and stool softeners, are found at most drug stores, pharmacies, and grocery stores. Stimulant laxatives are used most often to treat constipation from medications. These include senna (Senokot, Ex-Lax) and bisacodyl (Dulcolax).

3. Diarrhea

Pitavastatin may cause diarrhea. This uncomfortable side effect can be bothersome, so there’s a few things you’ll want to keep in mind.

First, you’re more likely to become dehydrated if you’re having diarrhea. Make sure to drink plenty of water throughout the day to avoid dehydration. Avoid fatty or fried foods. You should also avoid foods that are very high in fiber.

If changes to your diet don’t work, talk to your healthcare provider or pharmacist about trying an OTC anti-diarrheal, like loperamide (Imodium A-D). But if your diarrhea doesn’t improve or worsens, make sure to let your provider know. This could be a sign that something else is going on.

4. Rhabdomyolysis

Statins may cause a rare but severe medical condition called rhabdomyolysis. This happens when your muscles break down and release substances into the blood that can damage your heart and kidneys. Rhabdomyolysis can cause a variety of problems, including:

• Kidney damage

• Seizures

• Nausea and vomiting

• Heart rhythm issues (arrhythmias)

In the most severe cases, it can lead to permanent disability or death. Luckily, rhabdomyolysis from statins is extremely rare. In a study of 1.1 million people, only about 0.01% had statin-induced rhabdomyolysis. But it’s more likely if you’re taking medications that interact with pitavastatin. For example, you shouldn’t take pitavastatin if you take cyclosporine (Sandimmune). It’s also best to avoid taking pitavastatin and gemfibrozil (Lopid) together.

Though it’s rare, it’s important to know the symptoms of rhabdomyolysis. These include:

• Feeling weak and tired

• Muscle aches, stiffness, and weakness

• Dark red or brown urine

• Peeing less than usual 

Seek emergency medical care if you’re experiencing these symptoms. Treating rhabdomyolysis quickly is extremely important. This helps prevent irreversible damage to the kidneys.

5. Liver damage

Pitavastatin can increase your liver enzyme levels. Liver enzymes are proteins produced by the liver. When the liver is damaged, it releases more of these enzymes. 

But elevated liver enzymes don’t always mean that your liver is damaged. This is usually true of liver enzyme elevations with pitavastatin. In most people, it resolves without doing anything. But actual liver damage is still possible with pitavastatin. It’s more common if you’ve experienced liver damage in the past or drink a lot of alcohol. If you have active liver disease, you shouldn’t take pitavastatin.

Your healthcare provider may order blood tests to check your liver enzymes before and during pitavastatin treatment. If you notice that your urine becomes darker or your skin begins looking yellow, contact your provider right away. These could be symptoms of liver damage.

6. High blood sugar

Pitavastatin may cause high blood sugar (hyperglycemia). It may also increase your Hemoglobin A1C (A1C). An A1C test is a blood test that measures your average blood glucose over time. A high A1C means that you have too much glucose in your blood, and may indicate prediabetes or diabetes. 

Some research has shown that statins can increase your risk of developing Type 2 diabetes. But this usually occurs in people who are already at high risk for developing diabetes. 

In fact, many people with diabetes are prescribed statins. Statins are known to reduce the risk of heart attack, stroke, and even death in people with diabetes. Even if you’re diagnosed with diabetes while on statin therapy, it’s usually recommended to continue your statin.

Your healthcare provider may have you check your blood sugar at home, especially if you have diabetes. This can help you catch low blood sugar levels. Even if you don’t check your blood sugar at home, you should still be able to recognize the symptoms of hyperglycemia. If you have any of these symptoms, contact your healthcare provider immediately: 

• Headache

• Blurry vision

• Feeling thirstier than usual

• Needing to pee frequently

7. Interactions with other medications

Statins have many possible drug interactions with other medications and substances. Some of these interactions increase pitavastatin levels in the body. This raises your risk of unwanted pitavastatin side effects like muscle pain or rhabdomyolysis. Examples include:

• Cyclosporine (Sandimmune)

• Gemfibrozil (Lopid) and other fibrates like fenofibrate (Tricor)

• Erythromycin (Ery-tab)

• Rifampin (Rifadin) 

• Niacin (Niacor)

• Colchicine (Colcrys)

Overall, pitavastatin is known to have fewer drug interactions than other statins. For example, many statins interact with HIV medications. Pitavastatin is less likely to interact with these medications.

Talk to your healthcare provider and pharmacist before taking pitavastatin. They can help you check for pitavastatin interactions. It will help if you give them an updated list of your medications, including OTC products and supplements. If one of your medications is known to interact with pitavastatin, your provider might suggest an alternative medication or start you at a lower pitavastatin dose.

8. Potential problems during pregnancy

If you’re pregnant, it’s generally best to avoid pitavastatin and other statins. While research on humans hasn’t shown that statins cause birth defects, it’s possible that statin use may lead to a greater risk of miscarriages if used during pregnancy. Statins should also be avoided if you’re breastfeeding. 

If you become pregnant while taking a statin, talk to your healthcare provider. They’ll probably recommend you stop the statin. And they might recommend paying special attention to your diet and exercise routine during this time.

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Written by:

Alexa Mader, PharmD

Alexa Mader has been a practicing pharmacist since 2018. She earned her Doctor of Pharmacy degree from the University of Georgia College of Pharmacy.

Edited by:

Amy B. Gragnolati, PharmD, BCPS

Amy Gragnolati, PharmD, BCPS, is a pharmacy editor for GoodRx. Amy currently holds her pharmacist license in Georgia and California.

Reviewed by:

Stacia Woodcock, PharmD

Stacia Woodcock, PharmD, is a pharmacy editor for GoodRx. She earned her Doctor of Pharmacy degree from the University of Kentucky and is licensed in New York and Massachusetts.

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