Pravastatin Drug Interactions

by on April 20, 2012

When used in conjunction with certain other medicines, Pravastatin may cause adverse intereactions. Usually, these medications affect the metabolism of pravastatin thereby increasing the risk for side effects.

If a patient is taking a drug that weakens the immune system, it is very important that he or she tells their doctor before starting Pravastatin. Such drugs include steroids, cancer medicine and medicines used to prevent organ transplant rejection, such as cyclosporine, sirolimus or tacrolimus.

Patients being prescribed Pravachol should also inform their doctor if they’re taking medicines that contain niacin, such as Niaspan, Niacor, Simcor and others. Other medications that a doctor should be informed of include gemfibrozil, fenofibric acid, fenofibrate, cimetidine, spironolactone and other ‘statins’.

Here are some drugs that can potentially interact with pravastatin:


  • Erythromycin (Ery-Tab)
  • Clarithromycin (Biaxin)
  • Flagyl (metronidazole)

Antilipemic drugs

  • cholestyramine (Questran)
  • colestipol (Cholestid)

Antiulcer drugs

  • cimetidine (Tagamet)

Immunosuppresive agents

  • cyclosporine (Gengraf, Neoral, Sandimmune)

Nutritional supplements

  • Niacin (nicotinic acid, Niacor, Nicolar, Niaspan)

Some antifungals

  • fluconazole (Diflucan)
  • itraconazole (Sporanox)
  • ketoconazole (Nizoral)
  • miconazole
  • posaconazole (Noxafil)
  • voriconazole (VFEND)

Other lipid-lowering agents

  • Fenofibrate (Antara, Lofibra, Tricor, Triglide)
  • Gemfibrozil (Lopid)

Patients taking antifungal drugs, erythromycin, fibrates and niacin along with pravastatin are at an increased risk for developing serious muscle problems such as rhabdomyolysis and myopathy. When taken along with pravastatin, these drugs can potentially increase pravastatin levels in the blood. Check with your healthcare provider before taking pravastatin along with these drugs. As much as possible, these drugs should not be taken concurrently with pravastatin. Usually, it should be given only if the perceived benefits outweigh the potential risks. Meanwhile, concurrent use of gemfibrozil and pravastatin is highly discouraged.

Patients taking cyclosporine may be given a lower initial and maintenance dose of pravastatin. Information about cyclosporine and pravastatin interactions is quite conflicting. It is said that this drug can increase the pravastatin levels in the blood thereby causing significant side effects, including serious muscle problems. Patients taking pravastatin and cyclosporine together may require close monitoring for possible dose adjustments.

Antilipemic agents or bile resins such as cholestyramine (Questran) and colestipol (Cholestid) can increase the elimination of pravastatin if taken subsequently. Hence, these two drugs should be taken hours between each other. It is recommended that you take pravastatin 1 hour before or 4 hours after taking antilipemics. Similarly, if you are taking antacids such as cimitedine (Tagamet), you should take pravastatin at least one hour after the antacid.

How to prevent pravastatin drug interactions?

Inform your physician if you are taking any of the drugs mentioned above as well as other drugs you are taking. Your healthcare provider may need to adjust your dose or monitor you closely for potential drug interactions.

Usually, taking these drugs along with pravastatin increases your risk for developing serious side effects especially muscle problems. If you develop unwanted symptoms such as fever, muscle tenderness, pain or weakness while on pravastatin, contact your physician right away. These symptoms may signal untoward drug interactions and may require dose adjustment or discontinuing the drug.

Finally, do not take any medication without consulting your healthcare provider. These medications may contain substances that can negatively interact with pravastatin.