-
Profiles of Drug Substances,... 2014Pravastatin sodium is an [HMG-CoA] reductase inhibitor and is a lipid-regulating drug. This monograph includes the description of the drug: nomenclature, formulae,... (Review)
Review
Pravastatin sodium is an [HMG-CoA] reductase inhibitor and is a lipid-regulating drug. This monograph includes the description of the drug: nomenclature, formulae, elemental composition, solubility, appearance, and partition coefficient. The uses and the methods that have been reported for the synthesis of this drug are described. The physical methods that were used to characterize the drug are the X-ray powder diffraction pattern, thermal methods, melting point, and differential scanning calorimetry. This chapter also contains the following spectra of the drug: the ultraviolet spectrum, the vibrational spectrum, the nuclear magnetic resonance spectra, and the mass spectrum. The compendial methods of analysis include the British Pharmacopoeia and the United States Pharmacopoeia methods. Other methods of analysis that are included in this profile are spectrophotometric, electrochemical, polarographic, voltammetric and chromatographic, and immunoassay methods. The chapter also contains the pharmacokinetics, metabolism, stability, and articles that reviewed pravastatin sodium manufacturing, characterization, and analysis. One hundred and sixty-two references are listed at the end of this comprehensive profile.
Topics: Animals; Biotransformation; Chemistry, Pharmaceutical; Drug Stability; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors; Molecular Structure; Pravastatin
PubMed: 24794911
DOI: 10.1016/B978-0-12-800173-8.00008-8 -
Journal of Reproductive Immunology Nov 2017Pre-eclampsia is a disease of pregnancy affecting 5%-8% of all pregnancies and a leading cause of maternal and fetal mortality. Despite improvements in the diagnosis,... (Review)
Review
Pre-eclampsia is a disease of pregnancy affecting 5%-8% of all pregnancies and a leading cause of maternal and fetal mortality. Despite improvements in the diagnosis, there is no effective method for prevention and treatment. While studies in women are of critical importance, investigation of pathological mechanisms in pregnant women is necessarily limited, and the ability to establish cause and effect relationships, difficult. Mouse models have been instrumental in defining pathogenic mechanisms in preeclampsia and in the identification of pravastatin as a potential treatment to prevent pregnancy complications associated with placental dysfunction. Numerous epidemiological studies provided robust evidence demonstrating that pravastatin exposure during pregnancy does not affect fetal development. In addition, pravastatin is hydrophilic and has a limited passage through the placenta, diminishing any safety concerns. Several pilot studies suggest that pravastatin may be a good option to prevent and treat preeclampsia in women. While these studies are promising, the effectiveness of pravastatin to treat preeclampsia needs to be confirmed by randomized clinical trials.
Topics: Animals; Anticholesteremic Agents; Clinical Trials as Topic; Disease Models, Animal; Drug Evaluation, Preclinical; Female; Fetal Development; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors; Mice; Placenta; Pravastatin; Pre-Eclampsia; Pregnancy
PubMed: 29028516
DOI: 10.1016/j.jri.2017.09.009 -
Obstetrics and Gynecology Clinics of... Mar 2023Preeclampsia is a hypertensive disorder of pregnancy affecting up to 8% of pregnancies. It is associated with significant neonatal and maternal morbidities and... (Review)
Review
Preeclampsia is a hypertensive disorder of pregnancy affecting up to 8% of pregnancies. It is associated with significant neonatal and maternal morbidities and mortality. Although its pathogenesis is not completely understood, abnormal placentation resulting in imbalance in angiogenic factors, increased inflammation, and endothelial dysfunction are thought to be key pathways in the development of the disease. Administration of low-dose aspirin is recommended by professional societies for the prevention of preeclampsia in high-risk individuals. In this review, we summarize the evidence behind the use of low-dose aspirin and pravastatin in pregnant individuals at high risk of preeclampsia.
Topics: Pregnancy; Infant, Newborn; Female; Humans; Aspirin; Pre-Eclampsia; Pravastatin; Pregnancy, High-Risk; Hypertension
PubMed: 36822711
DOI: 10.1016/j.ogc.2022.10.005 -
Expert Opinion on Drug Metabolism &... Jun 2008It is well known that statins lead to a markable reduction in cardiovascular morbidity and mortality. One of the first and best studied statins is pravastatin, which has... (Review)
Review
BACKGROUND
It is well known that statins lead to a markable reduction in cardiovascular morbidity and mortality. One of the first and best studied statins is pravastatin, which has been studied in both primary and secondary prevention trials. With 40 mg pravastatin daily, total cholesterol can be reduced by 25-34% with a very consistent risk reduction of 24% of death from cardiovascular diseases. Side effects are rare and usually consist of myopathy. Following the Adult Treatment Panel III (ATPIII) guidelines on cholesterol management, apart from therapeutic lifestyle changes, in high-risk patients (including patients with diabetes mellitus), cholesterol-lowering therapy should be targeted at a treatment goal of LDL cholesterol<2.5 mmol/l. Statin-lowering therapy should be commenced to adequately lower cardiovascular risk. Therefore, when the expected 25-34% LDL cholesterol lowering would be enough to reach an LDL<2.5 mmol/l, treatment should be started with pravastatin.
METHOD
Trials have shown that treatment with pravastatin is safe in older patients as well as in children with familial hypercholesterolemia.
RESULTS/CONCLUSION
Since obesity seems to become a worldwide problem and given the low costs of generic pravastatin, it may even be cost-effectively used in developing countries.
Topics: Atherosclerosis; Cardiovascular Diseases; Evidence-Based Medicine; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors; Hypercholesterolemia; Practice Guidelines as Topic; Pravastatin; Treatment Outcome
PubMed: 18611121
DOI: 10.1517/17425255.4.6.821 -
Journal of Investigative Medicine High... 2021Pancreatitis is inflammation of pancreas associated most commonly with chronic alcoholism and gallstones. Other less common causes of pancreatitis are hyperlipidemia,... (Review)
Review
Pancreatitis is inflammation of pancreas associated most commonly with chronic alcoholism and gallstones. Other less common causes of pancreatitis are hyperlipidemia, infections, surgery, trauma, post endoscopic retrograde cholangiopancreatography, and drugs. Drugs are now increasingly recognized as a cause of pancreatitis, and high suspicion and exclusion of other most common causes is required before considering drug-induced pancreatitis. There are few case reports of acute pancreatitis in the literature after statin use, but out of these, only 3 are after starting pravastatin. We are reporting a case of 49-year-old male who presented with nausea, vomiting, and abdominal pain. His laboratory findings were significant for lipase more than 10 000 on admission, and computed tomography scan of abdomen was showing peripancreatic fat stranding and inflammation. After exclusion of most common causes of pancreatitis, pravastatin was found probable culprit for his symptoms, which he started taking 2 weeks ago. We also reviewed the literature on statins-induced acute pancreatitis. With increased uses of statins, physician need to be vigilant to suspect statins as a culprit in cases of pancreatitis with unknown etiology. Prompt discontinuation of statins is required in these cases.
Topics: Abdominal Pain; Acute Disease; Humans; Male; Middle Aged; Pancreatitis; Pravastatin; Tomography, X-Ray Computed
PubMed: 34180257
DOI: 10.1177/23247096211028386 -
Obstetrical & Gynecological Survey Jan 2018We have performed a systematic search to summarize the role of statins for preventing and treating severe preeclampsia. (Review)
Review
IMPORTANCE
We have performed a systematic search to summarize the role of statins for preventing and treating severe preeclampsia.
OBJECTIVE
The aim of this study was to examine whether pravastatin is a useful and safe alternative for treating preeclampsia during pregnancy.
EVIDENCE ACQUISITION
A systematic MEDLINE (PubMed) search was performed (1979 to June 2017), which was restricted to articles published in English, using the relevant key words of "statins," "pregnancy," "preeclampsia," "obstetrical antiphospholipid syndrome," and "teratogenicity."
RESULTS
The initial search provided 296 articles. Finally, 146 articles were related to the use of statins during pregnancy, regarding their effect on the fetus and the treatment of preeclampsia. Ten studies were related to in vitro studies, 25 in animals, and 24 in humans (13 case report series and 11 cohort studies). We found 84 studies on reviews of such guidelines on cardiovascular disease (35 studies), use of statins in the antiphospholipid syndrome (25 studies), statin's specific use during pregnancy (13 studies), or preeclampsia treatment (11 studies).
CONCLUSIONS
Although the studies are of poor quality, the rate of major congenital abnormalities in the newborn exposed to statins during pregnancy is no higher than the expected when compared with overall risk population. The review shows a potential beneficial role of statins in preventing and treating severe preeclampsia that needs to be evaluated through well-designed clinical trials.
RELEVANCE
This update could influence positively the clinical practice, giving an alternative therapy for clinicians who treat preeclampsia, particularly in severe cases.
Topics: Animals; Disease Models, Animal; Female; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors; Placenta; Placentation; Pravastatin; Pre-Eclampsia; Pregnancy; Randomized Controlled Trials as Topic; Severity of Illness Index
PubMed: 29368790
DOI: 10.1097/OGX.0000000000000522 -
Journal of Perinatal Medicine Oct 2018
Review
Topics: Female; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors; Infant, Newborn; Models, Biological; Pravastatin; Pre-Eclampsia; Pregnancy; Pregnancy Complications, Cardiovascular; Safety
PubMed: 29570452
DOI: 10.1515/jpm-2017-0109 -
Drugs Jul 1991Pravastatin is an HMG-CoA reductase inhibitor which reduces plasma cholesterol levels by inhibiting de novo cholesterol synthesis and increasing the receptor-mediated... (Review)
Review
Pravastatin is an HMG-CoA reductase inhibitor which reduces plasma cholesterol levels by inhibiting de novo cholesterol synthesis and increasing the receptor-mediated catabolism of low density lipoprotein (LDL). Several large multicentre placebo-controlled trials have shown that pravastatin reduces total and LDL-cholesterol levels in a dose-proportional manner in patients with familial or nonfamilial hypercholesterolaemia. Reductions in LDL-cholesterol levels reported in the largest study were 18% (10 mg/day), 23% (20 mg/day) and 31% (40 mg/day) after 12 weeks. Once-daily administration appears to be as effective as two daily doses. Pravastatin consistently increases HDL-cholesterol levels and decreases levels of total triglycerides but these changes are not dose dependent. At the study dosages used, the antihypercholesterolaemic effects of pravastatin were superior to those of bezafibrate and clinofibrate, and were similar to those of simvastatin, lovastatin, gemfibrozil and cholestyramine although in some studies a trend towards a superior effect with pravastatin was seen. Pravastatin did not reduce HDL-cholesterol like probucol, or increase triglyceride levels like cholestyramine. Combined treatment with pravastatin and cholestyramine or colestipol enhances the cholesterol-lowering effects of either drug administered alone and offsets the increase in total triglyceride levels seen with cholestyramine or colestipol therapy. Pravastatin is well tolerated during treatment of up to 24 months but longer term tolerability has not yet been established. The effect of provastatin on cardiovascular events related to elevated plasma cholesterol levels is under investation in several large scale regression and primary and secondary prevention trials.(ABSTRACT TRUNCATED AT 250 WORDS)
Topics: Animals; Anticholesteremic Agents; Humans; Hypercholesterolemia; Pravastatin
PubMed: 1718686
DOI: 10.2165/00003495-199142010-00005 -
DICP : the Annals of Pharmacotherapy Apr 1991The rate-limiting step in cholesterol biosynthesis is controlled by the enzyme 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase. Inhibitors of this enzyme lower... (Review)
Review
The rate-limiting step in cholesterol biosynthesis is controlled by the enzyme 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase. Inhibitors of this enzyme lower serum cholesterol very efficiently by increasing cellular uptake of cholesterol-rich, low-density lipoproteins. Pravastatin, a derivative of mevastatin and in the same class as lovastatin, lowers total cholesterol concentrations by 20-30 percent in patients with hypercholesterolemia. In patients who also have hypertriglyceridemia, serum triglyceride levels are decreased. Detailed pharmacokinetic data and long-term adverse-effect experience with pravastatin are extremely limited. The issue of tissue-selectivity for pravastatin has given rise to the marketing terminology "second-generation" HMG-CoA reductase inhibitor, but any clinical advantage of pravastatin over other HMG-CoA reductase inhibitors remains to be demonstrated.
Topics: Animals; Anticholesteremic Agents; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors; Hypercholesterolemia; Pravastatin
PubMed: 1926908
DOI: 10.1177/106002809102500410 -
The Australasian Journal of Dermatology Feb 2006SUMMARY A 64-year-old woman presented with diffuse and numerous pigmented macules on her face and upper back. Histopathological examination of a skin punch biopsy of the... (Review)
Review
SUMMARY A 64-year-old woman presented with diffuse and numerous pigmented macules on her face and upper back. Histopathological examination of a skin punch biopsy of the rash showed a lichenoid dermatitis. The most likely offending drug was pravastatin. Cessation of pravastatin resulted in gradual fading of the pigmentation. 3-Hydroxy-3-methylglutaryl coenzyme A reductase inhibitors have previously been reported to cause lichenoid drug eruptions.
Topics: Biopsy, Needle; Coronary Disease; Drug Eruptions; Female; Follow-Up Studies; Humans; Immunohistochemistry; Lichenoid Eruptions; Middle Aged; Pravastatin; Severity of Illness Index
PubMed: 16405486
DOI: 10.1111/j.1440-0960.2006.00225.x