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
Side effects of Pitavastatin calcium (Livalo)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
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%)
Pitavastatin calcium (Livalo) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- 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
More on Pitavastatin calcium (Livalo) side effects
The following Pitavastatin calcium (Livalo) 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
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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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Common questions about Pitavastatin calcium (Livalo)
Yes, pitavastatin calcium (Livalo) is a statin. It helps lower the amount of "bad" cholesterol in the blood. Pitavastatin calcium (Livalo) is called a "moderate-intensity" statin because it lowers "bad" cholesterol by 30% to 49%.
It isn't clear whether pitavastatin calcium (Livalo) can cause weight gain. In some clinical studies, people who took pitavastatin calcium (Livalo) didn't report weight gain. But one study found that people who took statins gained up to 11 pounds over 10 years compared to those who didn't take them. This weight change could be related to changes in diet. How statins play a role isn't clear. But some research suggests that they might lower the levels of a hormone that helps regulate appetite. Remember to follow a heart-healthy diet and exercise regularly to get the most from treatment. Talk to your care team if you notice changes in your eating habits and weight while taking pitavastatin calcium (Livalo).
Hair loss wasn't reported as a side effect of pitavastatin calcium (Livalo). Talk to your prescriber if you see any changes in your hair thickness or growth after starting this medication. Your prescriber can check whether pitavastatin calcium (Livalo) or something else is causing this hair loss.
Yes, constipation is a possible side effect of pitavastatin calcium (Livalo). In clinical studies, up to 4% of people said that they felt constipated. Some ways to prevent constipation are drinking plenty of water and eating fiber-rich foods. Talk to a healthcare professional if constipation keeps bothering you. They can recommend safe laxatives that you can take to relieve this side effect.
Possibly. Clinical studies show that muscle pain isn't common with pitavastatin calcium (Livalo), even though it's a well-known side effect of statins. Just up to 3% of people taking pitavastatin calcium (Livalo) reported muscle pain during these studies. If it happens, it's usually within a few months of starting treatment or after dose increases. But it can also still happen after years of treatment. It often goes away, but still let your prescriber know if you have muscle pain, tenderness, or weakness. They might lower your dose or switch you to another statin to see if that helps. Get medical help right away if the muscle pain is severe or doesn't go away, especially if you also have dark urine or fever. These could be signs of rhabdomyolysis (serious muscle breakdown).
Pitavastatin calcium (Livalo) might raise your blood sugar levels. But healthcare professionals often recommend statins for certain people with diabetes. This is because the benefits, like lowering the risk of heart attack or stroke, usually outweigh the risks. If you have high blood sugar or diabetes, talk to your prescriber about your treatment plan.
It's generally not recommended to take pitavastatin calcium (Livalo) while breastfeeding. There isn't any data about whether the medication gets into breast milk and how safe that is for you and your baby. Talk to your prescriber or lactation consultant about the risks and benefits. They can find safe options for you.
Pitavastatin comes in two forms: pitavastatin calcium (Livalo) and pitavastatin magnesium (Zypitamag). Pitavastatin calcium (Livalo) is approved for adults and certain children 8 years and older. But pitavastatin magnesium (Zypitamag) is only for adults. For adults, the form you take will probably depend on your prescriber's preference and insurance coverage. Ask your prescriber if you have questions about the differences between these medications.
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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.
Pitavastatin calcium (Livalo) dosage
Tablet| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 1mg | 30 tablets | $47.15 | $1.57 |
| 2mg | 90 tablets | $91.84 | $1.02 |
| 4mg | 90 tablets | $91.84 | $1.02 |
Typical dosage 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
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Pitavastatin calcium (Livalo) will not be safe for you to take.
- Take with cyclosporine (Neoral, Gengraf, Sandimmune)
- Liver cirrhosis
- Liver failure
What are alternatives to Pitavastatin calcium (Livalo)?
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