PITVASTATIN

Indications & Dose:

Hypercholesterolamia, familial Hypercholesterolamia

• BY MOUTH 

Adult

1-2mg once daily may be increased to max; 2mg

Children

not recommended

Contraindications:

Active liver disease, unexplained persistent elevated liver function tests 

Side Effects:

Cautions:

Precautions:

History of liver disease, renal function impairment, elderly, children < 18 yr, alcoholism; risk factors predisposing to the development of renal failure secondary to rhabdomyolysis (severe acute infection, trauma, hypotension, uncontrolled seizure disorder, severe metabolic disorders, electrolyte imbalance)

PREGNANCY AND LACTATION: Pregnancy category X: small amounts excreted in breast milk; should probably not be used by women who are nursing

Interaction:

Drugs 

Azole antifungals (fluconazole, itraconazole, ketoconazole, miconazole): Increased plasma pravastatin levels via inhibition of metabolism with increased risk of rhabdomyolysis

Cholestyramine: Reduced bioavailability of pravastatin

Clarithromycin: Increased plasma pravastatin levels via inhibition of metabolism with increased risk of rhabdomyolysis

Clofibrate: Small increased risk of myopathy with combination

Colestipol: Reduced bioavailability of pravastatin

Cyclosporine: Concomitant administration increases risk fo severe myopathy or rhabdomyolysis

Danazol: Increased plasma pravastatin levels via inhibition of metabolism with increased risk of rhabdomyolysis

Erythromycin: Increased pravastatin levels via inhibition of metabolism with increased risk of rhabdomyolysis

Fluoxetine: Increased pravastatin levels via inhibition of metabolism with increased risk of rhabdomyolysis

Gemfibrozil: Small increased risk of myopathy with combination, especially at high doses of statin

Isradipine: May decrease pravastatin plasma concentrations

Niacin: Concomitant administration increases risk of severe myopathy or rhabdomyolysis

Nefazodone: May inhibit hepatic metabolism of pravastatin with risk of rhabdomyolysis 

Troleandomycin: Increased pravastatin levels via inhibition of metabolism with increased risk of rhabdomyolysis

Warnings:

Adverse Effects:

Lactations:

Special Precautions:

Counselling:

Side Effects Or Adverse Reactions:

CNS: Dizziness, headache

CV: Chest pain

GI: Abdominal pain, anorexia, cholestatic jaundice, cirrhosis, constipation, fatty changes in liver, flatulence, heartburn, hepatitis, increased serum transaminase levels, nausea, pancreatitis, vomiting

GU: Erectile dysfunction, loss of libido

MS: Arthralgia, localized pain, myalgia, myopathy, rhabdomyolysis

SKIN: Alopecia, photosensitivity, pruritus, rash

MISC: Fatigue, gynecomastia

Patient And Carer Advice: