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Pravachol (generic name pravastatin) is prescribed primarily to lower cholesterol. Heart specialists recognize that coronary artery disease is associated with certain risk factors, including high serum cholesterol, bad LDL cholesterol, elevated triglycerides and reduced levels of protective HDL cholesterol.

Diet, exercise and weight control are usually considered important first-line preventive approaches. When they are insufficient, drugs like Pravachol may be important in reducing the risk of heart disease.

This medication has been found to increase good HDL cholesterol while lowering triglycerides and certain other negative blood fats.

Side Effects and Interactions

Pravachol has relatively few side effects and most people tolerate it well.

Some adverse reactions that may occur include nausea, flatulence, constipation, diarrhea, stomachache, fatigue, headache and skin rash.

Less common complications include dizziness, muscle pain, change in the sense of taste, insomnia, and numbness or tingling of the hands or feet.

Muscle aches or weakness could be a sign of a serious reaction called rhabdomyolysis or myopathy, and call for a test of kidney function. Kidney failure might be the outcome of untreated myopathy. Report any symptoms to your physician promptly.

The danger of rhabdomyolysis or myopathy is increased when Mevacor is combined with certain other drugs. Troleandomycin or erythromycin antibiotics such as E.E.S., E-Mycin, Erythrocin or PCE have been involved in several cases.

The new antibiotics Biaxin and Zithromax belong to the same class of drugs, but it is not clear if they have a potential for such an interaction. Because Pravachol is in the same class as Mevacor, this interaction may pose hazards with Pravachol as well.

When Pravachol is combined with other cholesterol-lowering medicines such as Lopid or niacin be alert for muscle pain, weakness, and kidney damage, as rhabdomyolysis may be more common in this situation. The transplant drug Sandimmune might also increase the risk of this dangerous reaction.

Pravachol may also increase the action of the blood thinner Coumadin; prothrombin time should be closely monitored.

Questran or Colestid may reduce the absorption of Pravachol if they are given at the same time. Tagamet also appears to interact with Pravachol.

Check with your physician and pharmacist to make sure Pravachol is safe in combination with any other drug you may take.

Special Precautions

Anyone with liver problems should probably not take Pravachol. Liver enzyme changes have been reported in a small proportion of patients using this medicine, and may indicate serious problems. Liver function should be tested before anyone starts taking Pravachol and every month or so for the first year. Periodic tests are needed thereafter.

Because cholesterol is essential for the developing fetus, pregnant women should not take Pravachol.

Research on animals has also shown stroke-like bleeding in dogs on Pravachol, but only at relatively high doses. Whether there is a risk for humans remains to be determined.

It is important to see an ophthalmologist before starting on Pravachol. An eye test should also be performed annually to make there is no damage to the lens.

Taking the Medicine

The manufacturer recommends that Pravachol be taken at bedtime.

It may be taken without or with meals.

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About the Author
Joe Graedon is a pharmacologist who has dedicated his career to making drug information understandable to consumers. His best-selling book, The People’s Pharmacy, was published in 1976 and led to a syndicated newspaper column, syndicated public radio show and web site. In 2006, Long Island University awarded him an honorary doctorate as “one of the country's leading drug experts for the consumer.” .
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