Pravastatin - instructions for use, reviews, analogs and forms of release (10 mg and 20 mg tablets) medications to reduce elevated cholesterol and the treatment of hypercholesterolemia and hyperlipidemia in adults, children and pregnancy. Composition

In this article, you can read the instructions for using the drug Pravastatin. There are reviews of visitors to the site - consumers of this medication, as well as opinions of doctors of specialists on the use of Pravastatin in their practice. A big request is to actively add their feedback on the drug: the medicine helped or did not help get rid of the disease, which were observed complications and side effects, possibly not declared by the manufacturer in the annotation. Pravastatin Analogues in the presence of existing structural analogs.Use to reduce elevated cholesterol and treat hypercholesterolemia and hyperlipidemia in adults, children, as well as in pregnancy and lactation. Composition of the preparation.

Pravastatin - a hypolipidemic agent from the group of statins, an inhibitor of the enzyme 3-hydroxy-3-methylglutaryl coenzyme A-reductase (HMG-CoA reductase). According to the principle of competitive antagonism, the statin molecule binds to that part of the coenzyme A receptor where this enzyme is attached. Another part of the statin molecule inhibits the conversion of hydroxymethylglutarate to mevalonate, an intermediate in the synthesis of the cholesterol molecule. Inhibition of the activity of HMG-CoA reductase results in a series of consecutive reactions that result in a decrease in the intracellular cholesterol content and a compensatory increase in the activity of low-density lipoprotein (LDL receptor) receptors and, accordingly, the acceleration of LDL cholesterol (LDL-C) catabolism.

The hypolipidemic effect of statins is associated with a decrease in the level of total cholesterol due to LDL-C. The decrease in LDL is dose-dependent and has a non-linear, but an exponential nature.

According to controlled studies, Pravastatin increases the level of high-density lipoprotein cholesterol (HDL-C) down to 10%.

Statins do not affect the activity of lipoprotein and hepatic lipases, do not have a significant effect on the synthesis and catabolism of free fatty acids, so their effect on triglyceride levels (TG) is secondary and mediated through their main effects on lowering LDL cholesterol.

In addition to lipid-lowering effects, statins have a positive effect on endothelial dysfunction (preclinical signs of early atherosclerosis), on the vascular wall, atheroma state, improve the rheological properties of blood, and possess antioxidant, antiproliferative properties.

Composition

Pravastatin + excipients.

Pharmacokinetics

After oral administration, 30-54% of the administered dose of Pravastatin is quickly absorbed, bioavailability is 15-20%. Pravastatin undergoes the "first pass" effect through the liver. Admission for 1 hour before or along with food reduces systemic bioavailability and specific activity. Binding to plasma proteins is 50%. Excreted in breast milk. 20% of Pravastatin is excreted by the kidneys, 70% through the intestine.In connection with the presence of two ways of excretion, it is possible to increase the excretory excretion in one of them in case of violation of the other, as well as the development of cumulation of Pravastatin and its metabolites in renal and / or hepatic insufficiency.

Indications

• hyperlipoproteinemia 2a and 2b types (with ineffectiveness of diet and exercise);
• combined hypercholesterolemia (elevated blood cholesterol level) and triglyceridemia (elevated triglyceride levels in the blood).

Forms of release

Tablets 10 mg and 20 mg.

Instructions for use and dosing regimen

Dosage regimen is individual. For oral administration - 10-40 mg once a day at night. For elderly patients, as well as for severe violations of the liver or kidneys, it is recommended to start treatment with a dose of 10 mg.

Side effect

• dizziness, headache;
• a taste disorder;
• involuntary movements of the eyes;
• paresis of the facial nerve;
• peripheral polyneuropathy;
• tremor (fast, rhythmic movements of limbs or trunk);
• anxiety, insomnia;
• depression;
• amnesia (loss of memory for recent important events or incomplete memories of what happened);
• paresthesia (a sensitivity disorder characterized by spontaneous sensations of burning, tingling, crawling);
• progression of cataract;
• ophthalmoplegia (paralysis of the eye muscles due to defeat of the oculomotor nerves);
• nausea, vomiting;
• diarrhea, constipation;
• abdominal pain, flatulence (bloating);
• an increase in the activity of hepatic transaminases (2-3 times in comparison with the norm) and alkaline phosphatase (APF);
• Hyperbilirubinemia, hypercreatininaemia (3 times higher than the upper limit of the norm);
• in some cases - hepatitis (including chronic active, cholestatic);
• fatty infiltration of the liver, cirrhosis or necrosis of the liver;
• acute pancreatitis (inflammation of the pancreas);
• Thrombocytopenia, leukopenia, hemolytic anemia, eosinophilia;
• increased activity of creatine phosphokinase (CKF);
• Myalgia (pain in the muscles);
• skin rash, itching;
• anaphylactic shock;
• angioedema;
• toxic epidermal necrolysis (Lyell's syndrome);
• malignant exudative erythema (Stevens-Johnson syndrome);
• alopecia (baldness);
• depigmentation of the skin;
• dry skin and mucous membranes;
• decreased libido and potency.

Contraindications

• liver disease in acute phase;
• persistent increase in the activity of hepatic transaminases of unclear etiology;
• severe violations of liver function;
• hypersensitivity to Pravastatin;
• pregnancy;
• lactation (breastfeeding).

Application in pregnancy and lactation

Pravastatin is contraindicated in pregnancy.

If it is necessary to use during the lactation period, the question of stopping breastfeeding should be solved.

Use in children

Safety and efficacy of pravastatin in children and adolescents under the age of 18 years have not been established.

Application in elderly patients

Elderly patients are advised to start treatment with a dose of 10 mg.

special instructions

With caution apply for liver diseases in history, chronic alcoholism, violations of kidney function.

Before the start of treatment with Pravastatin, secondary hypercholesterolemia should be excluded, in particular with poorly compensated diabetes mellitus, hypothyroidism, nephrotic syndrome, and disproteinemia.

During the treatment, regular monitoring of the lipid spectrum of the blood is necessary.

Drug Interactions

It is impossible to exclude the development of myopathy with simultaneous application with gemfibrozil.

When used simultaneously with colestipol, colestyramine, the concentration of Pravastatin in the blood plasma decreases, while the overall lipid-lowering effect is increased.

A case of development of rhabdomyolysis with prolonged simultaneous application with mianserin is described.

With simultaneous use with orlistatom moderate increase in the concentration of Pravastatin in blood plasma.

With simultaneous application with cyclosporine, a significant increase in the concentration of Pravastatin in blood plasma is possible.

Analogues of the drug Pravastatin

Structural analogs for the active substance:

• Lipostat.

Analogues of the drug Pravastatin by pharmacological group (statins):

• Akorta;
• Aktalipid;
• Anistat;
• Atherostat;
• Atomax;
• Ator;
• Atorvastatin;
• Atorvox;
• Atoris;
• The Vasator;
• Vazilip;
• Zocor;
• Zorstat;
• Cardiolip;
• Cardiostatin;
• The Cross;
• Leskol;
• Lipobay;
• Lipon;
• Lipopraim;
• Lipostat;
• Lipofford;
• Liprimar;
• Liptonorm;
• Lovacor;
• Lovastatin;
• Lovasterol;
• Mevakor;
• Medostatin;
• Mertenil;
• Novostat;
• Ovenkor;
• Reddistatin;
• Rovacor;
• Rosystark;
• Rosuvastatin;
• Rosewood;
• Rosulip;
• Rozufast;
• Roxer;
• Simvakol;
• Simvale;
• Simvastatin;
• Simvastol;
• Symvor;
• Simgal;
• Simlo;
• Sinquard;
• Suvardio;
• Tevastor;
• Torvacard;
• Torvalip;
• Tulip;
• Holvasim;
• Holletar.

Response of a therapist

I prescribe to my patients the hypothyroid medication Pravastatin with about the same frequency as other statins. I do not see any particular difference in the therapeutic effect, but "pobochka" does not long to wait for treatment with any drug from the statin group. Patients very often complain of headaches, stool disorders, dry mouth, insomnia. And sometimes it is very difficult to choose an analogue that a person would tolerate more or less normally. As for Pravastatin, of the unwanted reactions to it in my practice, nausea and upset of the chair are most common.

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