Pravastatin dosage

PRAVASTATIN SODIUM Pravastatin can be administered as a single dose at any time of the day, with or without food. Because the maximal effect of a given dose is seen within 4 weeks, perform periodic lipid determinations at this time and adjust dosage according to the patient s response to therapy and established treatment guidelines. 

Elderly In patients older than 70 years of age, the AUC of lovastatin, pravastatin, and simvastatin is increased. Pravastatin does not need dosage adjustment. The safety and efficacy of atorvastatin, rosuvastatin, and lovastatin extended-release in patients 70 years of age and older were similar to those of patients younger than 70 years of age. Elderly patients (65 years of age and older) demonstrated a greater treatment response in respect to LDL-C, total-C and LDL/HDL ratio than patients younger than 65 years of age. 

In a comparison of atorvastatin with pravastatin, of 224 patients taking atorvastatin, two had clinically significant increases in alanine transaminase activity (32). They recovered during the next 4 months, one after withdrawal of atorvastatin and the other after a dosage reduction. Withdrawals due to adverse effects were similar in the two groups. One patient developed hepatitis while taking atorvastatin, but was able to tolerate simvastatin (33). The authors concluded that this adverse effect was not a class effect. Eosinophils in a liver-biopsy specimen pointed to an immunological mechanism. 

Healthy volunteers were given protease inhibitors and statins, and the authors concluded that simvastatin should be avoided and that atorvastatin could be used with caution in people taking ritonavir and saquinavir (111). Dosage adjustment of pravastatin may be necessary with co-administration of ritonavir and saquinavir. Pravastatin does not alter the pharmacokinetics of nelfinavir, and thus appears to be safe for co-administration. 

The AUC of a single 40-mg dose of pravastatin was increased by 71% in 10 healthy subjects who took itraconazole 200 mg daily for 4 days, although this did not reach statistical significance. In a similar study, the same dosage of itraconazole caused a modest 51% increase in the AUC of pravastatin. In contrast, one study in 104 subjects found that itraconazole had no effect on pravastatin pharmacokinetics. ... 

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