Pravastatin: uses, side effects and when to take it

Pravastatin is a statin, so it reduces the cholesterol level in the blood. The NHS says it is used to treat high cholesterol and to prevent heart attacks and strokes, and that it can help prevent angina, heart attack, stroke and other complications in people who have cardiovascular disease.

The NHS page for pravastatin does not list a brand name. Some people are prescribed it because it is less affected by certain interacting drugs than some other statins, but your prescriber makes that judgement.

Most adults can take pravastatin and, unusually among statins, the NHS says children aged 8 and over may be prescribed it. That usually means specialist-supervised treatment for inherited high cholesterol.

• Not suitable after a previous allergic reaction or serious side effect from pravastatin or another statin.

• Needs care with liver or kidney problems.

• Needs care with an underactive thyroid.

• Muscle disorders such as myasthenia gravis are a reason to check first.

• A previous brain bleed is on the NHS list.

• Regular heavy drinking is also a concern.

Pravastatin comes as tablets that are swallowed whole with water. The NHS suggests taking it at the same time each day, usually in the evening, and says food does not matter.

A doctor may begin with a low dose and increase it after four weeks if required. No fixed doses are given by the NHS page, so follow your label.

For a missed dose, skip it and take the next at the usual time; do not double up. An extra dose is unlikely to cause problems, but the NHS says to get advice from a pharmacist or NHS 111 if you take too much.

Common effects listed are headache, dizziness, nausea, constipation, diarrhoea, indigestion, wind, muscle aches and sleep problems.

Serious but rare effects are hepatitis, acute pancreatitis, muscle inflammation or damage and anaphylaxis. Anaphylaxis is a 999 emergency; for the others, the NHS suggests NHS 111. Drive only once any dizziness has passed.

The NHS names fibrates, the antifungals itraconazole and fluconazole, the antibiotics fusidic acid, erythromycin and clarithromycin, HIV and hepatitis C medicines, ciclosporin, colchicine and rifampicin. The list is not exhaustive.

Alcohol: try to limit it, because it can increase the risk of side effects such as liver problems.

Pravastatin is not recommended in pregnancy because it can affect how the baby develops; the NHS says to stop it three months before trying to conceive. Breastfeeding is usually possible, but check with a pharmacist or doctor first.

Treatment usually continues long term, sometimes for life. If you stop, cholesterol may rise again, so keep taking it unless your doctor says otherwise. Alternatives within the statin class include atorvastatin, simvastatin and rosuvastatin, and ezetimibe is a non-statin option. Side effects can be reported through the Yellow Card scheme.