7 Pravastatin Side Effects and How to Manage Them

Pravastatin is a statin medication that’s prescribed for high cholesterol. Like all statins, pravastatin may cause side effects. Fortunately, these are generally mild. And most people taking statins don’t experience any side effects at all.

If you’re prescribed pravastatin, you’ll usually take it long term. So, it’s important to be aware of potential side effects — both common and rare — and what to do if they happen to you. While it’s not an exhaustive list, we cover what you should know about seven pravastatin side effects below.

1. Muscle pain

Statin-associated muscle symptoms, including muscle pain, are one of the most commonly reported statin side effects. They can range in severity from mild aches and cramps to severe muscle breakdown. But compared to other statins, muscle symptoms may be less likely with pravastatin.

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The symptoms, which are commonly in the thighs, back, and shoulders, generally occur in the first few months after you start taking a statin. But they can develop at any time, even if you’ve been taking your statin for a while. Fortunately, they tend to improve over time for many people. 

If you develop muscle pain while taking pravastatin, let your healthcare provider know. It’s possible that the muscle pain you’re experiencing isn’t from your statin at all. But if it is, they can discuss potential options, such as waiting it out, lowering your dose, or taking it every other day. They can also check for interactions that may be contributing to your muscle pain.

If you notice severe muscle pain, dark urine, or sudden weakness, get medical help right away. These are possible signs and symptoms of a more serious condition called rhabdomyolysis, which we’ll discuss later.

2. Nausea and vomiting

Some people feel nauseous after taking pravastatin. Sometimes, nausea can lead to vomiting. These side effects usually fade over time as your body gets used to pravastatin. 

You can take pravastatin with or without food. Try taking your dose with a small snack or meal if you feel nauseous after taking it on an empty stomach. And avoid spicy or overly sweet food as these may upset your stomach. If changes like these aren’t helping your nausea, ask your pharmacist about over-the-counter (OTC) remedies such as bismuth subsalicylate (Pepto-Bismol). 

Let your healthcare provider know if the nausea or vomiting is severe. They may suggest a different dose or switching to a different statin.

3. Upper respiratory tract infection

Upper respiratory tract infections (URTIs) have been reported in some people taking pravastatin. URTIs include a wide range of infections, such as pharyngitis, a sinus infection, or the common cold. Respiratory infections generally go away on their own. Most URTIs are due to viruses, but sometimes bacteria can be the cause. 

If URTI symptoms develop, such as a sore throat, cough, or stuffy nose, make sure to get plenty of rest and drink plenty of water. You can use OTC medications to treat bothersome symptoms when needed. Decongestants, cough medications, or pain relievers may be helpful. Your pharmacist can give recommendations on which products are right for you.

If your URTI doesn’t start clearing up within 10 days, or if your symptoms worsen, talk to your healthcare provider. 

4. Diarrhea

You may experience diarrhea with pravastatin. This is usually mild and goes away as you continue taking it. But it may help to temporarily cut down on foods that can potentially worsen diarrhea, including fried or fatty foods. Be sure to drink plenty of water to avoid dehydration.

You may need OTC remedies to help with diarrhea symptoms. Examples include bismuth subsalicylate and loperamide (Imodium A-D). Talk to your healthcare provider before adding any new medications. If diarrhea lasts more than a few days, or if you have fever or bloody stools at the same time, contact your healthcare provider. 

5. Headache

Some people experience headaches while taking statins, including pravastatin. This is typically a mild side effect that goes away as your body adjusts to the medication. If your headaches are interfering with your work or personal life, an OTC medication may help. Talk to your pharmacist about OTC pain relievers, such as acetaminophen (Tylenol) or ibuprofen (Advil, Motrin).

If your headache is severe or persistent, let your healthcare provider know right away. 

6. Severe muscle damage

While rare, rhabdomyolysis can happen while taking statins. This is a serious muscle-related health condition. Substances from muscle cells can leak into the blood and cause kidney damage or unbalanced blood electrolytes. This condition can be mild or severe. Severe forms can be life-threatening.

While rhabdomyolysis isn’t common with pravastatin, it’s important to recognize the symptoms. Severe muscle pain, weakness, and tea-colored urine are the most common. If these symptoms develop, seek medical attention right away. You may require treatment in a hospital. Rhabdomyolysis could cause serious complications if it's left untreated. 

The risk of rhabdomyolysis tends to go up with higher statin doses. And drug interactions can also increase this risk. So, it’s important that your healthcare team has your current medication list to check for interactions ahead of time.

7. Liver damage

Elevations in liver enzymes (a marker of liver function) are possible with pravastatin. This can be a sign of inflammation or damage. However, most people don’t have any noticeable symptoms, and their liver enzymes improve or return to normal over time. While rare, more serious liver damage is possible. Liver disease and chronic alcohol use increase this risk.

Your healthcare team may check your liver function tests either shortly before or soon after you begin taking pravastatin. Let them know if you develop the following symptoms, which may indicate liver damage:

• Dark urine

• Severe stomach pain

• Feeling extremely weak and tired

• Loss of appetite

• Yellowing of the skin or eyes

When should you contact your healthcare provider about pravastatin side effects?

Most pravastatin side effects are mild and go away as your body gets used to the medication. This may take a few weeks, possibly longer.

But if any side effects are starting to interfere with your daily functioning, reach out to your healthcare provider. However, don’t stop taking your pravastatin without talking to them first. There are several options they may try, such as lowering your dose, to help you stick with treatment.

But if you develop severe muscle pain with weakness and dark-colored urine, get immediate medical attention. This is also the case if any other side effects feel severe or life-threatening.

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Written by:

Julie Adkison, PharmD, BCACP, CDCES

Julie Adkison, PharmD, BCACP, CDCES, is a clinical pharmacist specializing in ambulatory care practice and diabetes care and education. She has worked in a faculty position in family medicine for many years.

Edited by:

Alyssa Billingsley, PharmD

Alyssa Billingsley, PharmD, is the director of pharmacy content for GoodRx. She has over a decade of experience as a pharmacist and has worked in clinical, academic, and administrative roles.

Reviewed by:

Joshua Murdock, PharmD, BCBBS

Joshua Murdock, PharmD, BCBBS, is a licensed pharmacist in Arizona, Colorado, and Rhode Island. He has worked in the pharmacy industry for more than 10 years and currently serves as a pharmacy editor for GoodRx.

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