7 Statin Alternatives You Can Take to Help Lower Your Cholesterol
Statins may not be safe and effective for all people with high cholesterol. Some statin alternatives, like fibrates, may be able to help. Review your options here.
pravastatin
Used for Coronary Artery Disease, High Cholesterol
Used for Coronary Artery Disease, High Cholesterol
Pravastatin is a statin that's used to lower cholesterol in adults and certain children. By lowering your cholesterol levels, the medication helps protect your heart and blood vessels from serious and even life-threatening medical problems, such as heart attack or stroke. Pravastatin should be taken with a heart-healthy diet and a regular exercise routine for it to work as best as possible. It's a tablet that's taken by mouth once per day. Pravastatin side effects include muscle or joint pain, nausea, vomiting, and headache.
What is Pravastatin?
What is Pravastatin used for?
- 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)
How Pravastatin works
Pravastatin is a statin. It works by blocking a protein in your liver that makes cholesterol. This lowers the amount of "bad" cholesterol (called low-density lipoprotein, or LDL) in your blood. Pravastatin might also help raise your "good" cholesterol (called high-density lipoprotein, or HDL) levels and lower your triglyceride levels. As a result, pravastatin helps lower the risk of coronary artery disease, heart attack, and stroke.
Drug facts
| Common Brands | Pravachol |
|---|---|
| Drug Class | Statin |
| Controlled Substance Classification | Not a controlled medication |
| Generic Status | Lower-cost generic available |
| Availability | Prescription only |
More on Pravastatin essentials
Side effects of Pravastatin
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
- Muscle, joint, or bone pain (25%)
- Upper respiratory infection (21%)
- Chest pain (10%)
- Nausea or vomiting (7%)
Less Common Side Effects
- Tiredness
- Headache
- Dizziness
- Cough
- Muscle cramp
- Diarrhea
- Rash
Pravastatin serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Severe muscle damage (rhabdomyolysis): dark brown urine, severe muscle weakness or pain, fever, tiredness
- Liver problems: swelling of your stomach, yellowing of your skin or the whites of your eyes, confusion, dark or brown urine
More on Pravastatin side effects
The following Pravastatin side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
More common
Difficulty with moving
muscle or bone pain
muscle stiffness
pain in the joints
pain, localized
Less common
Arm, back, or jaw pain
chest pain, discomfort, or tightness
chills
dark-colored urine
difficult or labored breathing
ear congestion
fast or irregular heartbeat
general feeling of discomfort or illness
headache
loss of appetite
muscle cramps, spasms, tenderness, wasting, or weakness
runny or stuffy nose
shivering
sweating
swollen joints
trouble sleeping
unusual tiredness or weakness
vomiting
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More common
Stomach pain
Less common
Acid or sour stomach
belching
bloated or full feeling
blurred vision or other changes in vision
difficult or painful urination
difficulty having a bowel movement (stool)
dizziness
double vision
fear or nervousness
feeling sad or empty
increased urge to urinate during the night
irritability
loss of interest or pleasure
pain in the chest below the breastbone
passing gas
rash
stomach discomfort or upset
tiredness
trouble concentrating
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
Get your GoodRx coupon
$99.37
GoodRx discount
$18.32
Pros and cons of Pravastatin
Pros
- Taken by mouth once per day
- Has fewer interactions with other medications than other statins
- Might be safer and better tolerated than other statins
- Available as a lower-cost generic
Cons
- Recommended to take in the evening to work better
- Doesn't replace having a healthy diet and regular exercise routine to lower cholesterol levels
- Not a high-intensity statin
- Not safe to use if you're pregnant or breastfeeding
Pharmacist tips for Pravastatin
- Mark your calendar with your appointments to see your provider and to get any blood work done when you take pravastatin. Your provider will order blood work to check your cholesterol levels and liver function during treatment. Your provider might change your dose of pravastatin based on your lab results.
- You can take pravastatin with or without food. But taking it with food might help prevent possible stomach side effects like nausea.
- Taking pravastatin at night before you go to sleep might help you get the most benefit from the medication. Ask your provider about taking this medication at a time that works best for you if it's challenging for you to take it at bedtime.
- Limit the amount of alcohol you drink while you're taking pravastatin. This is because alcohol can raise your risk of serious liver problems with pravastatin. Ask your provider what's a safe amount of alcohol to drink while you're taking this medication.
- Let your provider know right away if you experience muscle pain or weakness, especially if you also have a fever or feel extremely tired. This can be a sign of rare, but serious muscle damage called rhabdomyolysis.
- Make sure to tell your provider about all of the medications you're taking before and during treatment with pravastatin. Several medications can interact with pravastatin. Some drug interactions can either make the cholesterol medication work less well or put you at risk for side effects like muscle damage.
- If you're taking colesevelam (Welchol), colestipol (Colestid), or cholestyramine (Prevalite), take pravastatin at least 1 hour before or 4 hours after these medications. Taking these medications too close to pravastatin can lower how much cholesterol medication gets into your body, which can make it not work as well.
- Be sure to follow a healthy and balanced diet that's low in fat and maintain a regular exercise routine while you're taking pravastatin. This will help you get the most benefit from the medication. Talk with your provider if you have questions about how to plan your meals and what kind of exercise is appropriate for you.
- Tell your provider as soon as possible if you become pregnant while you're taking pravastatin. This medication can cause harm to unborn babies. You'll need to discuss with your provider about the risks and benefits of continuing the medication and what safe alternatives there are for you.
More on Pravastatin tips
Risks and warnings for Pravastatin
Pravastatin 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: Age 65 years and older | Higher dose of pravastatin | Kidney problems | Taking other medications that can also cause muscle problems or interact with pravastatin | Uncontrolled hypothyroidism (low thyroid hormone)
Pravastatin can cause a rare, but serious and life-threatening muscle problem called rhabdomyolysis. If severe, this muscle problem can lead to kidney injury. Your risk for rhabdomyolysis is higher if you take other medications that can raise the levels of pravastatin in your body or that can also cause muscle damage. For this reason, don't start any new medications without asking your provider or pharmacist first. Stop pravastatin and get medical attention right away if you notice any symptoms of rhabdomyolysis, such as severe muscle pain, muscle tenderness or weakness, dark-colored urine, weakness, and tiredness.
Rarely, statins like pravastatin can cause immune-mediated necrotizing myopathy (IMNM), an autoimmune condition that causes muscle inflammation and muscle weakness. This muscle problem might continue even if you stop taking the statin. If you develop IMNM, your provider will ask you to stop the statin and might treat you with medications to dampen down your immune system.
Worsening liver problems and liver failure
- Risk factors: History of liver problems | Drinking large amounts of alcohol
Though rare, pravastatin can cause serious liver problems that can lead to liver failure. You might need to get blood tests to check your liver health before and during treatment to make sure your liver is working properly. Get medical attention right away if you notice swelling of your stomach; stomach pain; yellowing of your skin or the whites of your eyes; stool changes (black, tarry, or bloody stools); nausea; vomiting; or dark or brown urine. You might need to stop using the medication to prevent further liver damage.
Higher blood sugar levels
- Risk factors: High blood sugar
Some research suggests that statins like pravastatin can raise blood sugar levels, which can lead to higher hemoglobin A1C levels. However, healthcare providers believe that the benefits of statins outweigh their risk for harm. Let your provider know if you have diabetes or high blood sugar before you start pravastatin. You might need to check your blood sugar more often. Also, make sure to follow a healthy, balanced diet and do regular exercise while you're taking pravastatin.
Possible harm during pregnancy or breastfeeding
Pravastatin isn't recommended for use during pregnancy or breastfeeding for most people. This medication can cause harm to unborn and breastfed babies. Talk to your provider about the safest options for you if you're pregnant, thinking of becoming pregnant, or breastfeeding.
More on Pravastatin warnings
Pravastatin dosage
The average cost for 90 tablets of 40mg of Pravastatin is $22.40 with a free GoodRx coupon. This is 81.99% off the average retail price of $124.35. 
Tablet
Tablet| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 10mg | 90 tablets | $20.14 | $0.22 |
| 20mg | 90 tablets | $18.32 | $0.20 |
| 40mg | 90 tablets | $22.40 | $0.25 |
| 80mg | 90 tablets | $28.21 | $0.31 |
Typical dosage for Pravastatin
- Adults: The typical dose ranges from 10 mg to 80 mg by mouth once per day.
- Children age 14 to 18 years with HeFH: The typical starting dose is 40 mg by mouth once per day.
- Children age 8 to 13 years with HeFH: The typical dose is 20 mg by mouth once per day.
Your provider will change your dose depending on different factors, such as your cholesterol levels, kidney function, side effects that you're having, or other medications you might be taking that interact with pravastatin.
More on Pravastatin dosage
Interactions between Pravastatin and other drugs
Pravastatin may interact with certain medications or supplements. Always let your doctor and pharmacist know about any other medications or supplements (including prescribed and over-the-counter medications, vitamins, and dietary or herbal supplements) that you are currently taking. The list below does not include all possible drug interactions with Pravastatin. Please note that only the generic name of each medication is listed below.
More on Pravastatin interactions
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Atazanavir
- Bempedoic Acid
- Bezafibrate
- Ciprofibrate
- Clofibrate
- Colchicine
- Colesevelam
- Cyclosporine
- Dalfopristin
- Daptomycin
- Darolutamide
- Darunavir
- Dasabuvir
- Enasidenib
- Fenofibrate
- Fenofibric Acid
- Fusidic Acid
- Gemfibrozil
- Ombitasvir
- Paritaprevir
- Quinupristin
- Ritonavir
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Amprenavir
- Boceprevir
- Clarithromycin
- Efavirenz
- Eltrombopag
- Fosamprenavir
- Glecaprevir
- Nefazodone
- Nelfinavir
- Oat Bran
- Pectin
- Pibrentasvir
- St John's Wort
- Voxilaprevir
How much does Pravastatin cost?
To access savings, use a GoodRx coupon and pay just a fraction of the retail price.
Pravastatin (generic)
$18.32
Pravastatin 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 Pravastatin will not be safe for you to take.
- Liver problems (such as liver failure and severe liver cirrhosis)
What are alternatives to Pravastatin?
There are a number of medications that your doctor can prescribe in place of Pravastatin. Compare a few possible alternatives below.
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Pravastatin images
