Description: Pravastatin is commonly marketed under its trade names, Pravachol and Selektine. It is a member of the drug class called “statins,” and is primarily used for lowering cholesterol levels in order to prevent cardiovascular diseases. Pravachol works to lower cholesterol by blocking one of the steps in its synthesis, and also by lowering production of the precursor to LDL (low-density lipoprotein).
Serious Side Effects of Pravastatin
According to the Pravachol drug label as reported by the FDA (2012), serious side effects, which tend to occur in individuals who are genetically predisposed, include myocardial infarction (heart attack), rhabdomyolysis (a serious syndrome due to a direct or indirect muscle injury, dyspnea (difficult breathing), and statin myopathy, which is a muscular condition in which the muscle fibers do not function. Kidney damage also can occur as a result of pravastatin treatment.
Common Side Effects of Pravastatin
Pravastatin is associated with a number of side effects. According to the Pravachol drug label, frequently reported adverse reactions include:
- Musculoskeletal pain (24%)
- Arthralgia (joint pain)
- Dyspepsia (indigestion)
- Cognitive side effects (e.g., memory issues)
- Chest pain
- Edema (swelling)
- Weight gain
- ALT/AST/GGT increase (these are liver function tests – increased results are usually associated with liver damage)
- Paresthesia (pins and needles)
- Upper respiratory tract infections (nose, throat infections)
- Dermatitis (redness of skin)
- Blurred vision and diplopia (double vision)
- Sleep disturbance
- Sexual dysfunction
- Urinary tract infection
How Does Pharmacogenetic Testing Work?
Pharmacogenetics is a burgeoning field which examines inter-individual genetic variation in drug metabolism. Some patients suffer no side effects when taking pravastatin while others may experience multiple severe adverse effects. This interpatient variability in response is thought to be partially due to the genetic variability between patients. There are 18 key genes involved in medication metabolism, and their variants (alleles) are analyzed to determine which variant you have – in a process called “SNP genotyping.”
According to an article in Pharmacogenetics and Genomics “The effect of SLCO1B1*15 on the disposition of pravastatin and pitavastatin” (May 2008), patients with specific polymorphisms (variations) in a particular gene, called “SLCO1B1”, can experience decreased uptake (absorption) of Pravachol and related statins into cells. This may result in higher blood concentrations of the drug, and could lead to increased probabilities of developing the adverse drug reactions.
Armed with the results of pharmacogenetic testing, your prescriber can adjust your dose based on your genetically modulated liver enzyme activity targeting a particular drug or drug class – preferably before treatment begins – instead of simply relying on trial and error.
Understand Your Risks with the Rxight® Genetic Test
Your risk for side effects from drugs like pravastatin is partly determined by your genetics. Rxight® – the most comprehensive CLIA-certified pharmacogenetic testing service available – is based on the sequencing of 18 genes (including those involved in the metabolism of statins) to establish how you are likely to respond to more than 200 over-the-counter and prescription medications across dozens of clinically significant pharmacological classes.
Genetic testing with Rxight® is specifically designed to aid prescribers in clinical decision-making specifically when prescribing drugs like pravastatin. All that is required is a simple cheeks swab of your DNA by a participating pharmacist, after which your sample will be sent to our lab for processing, followed by a detailed medication review designed to guide your prescriber in finding a dose that is both safe and effective.
Contributors to this Article:
Michael Sapko, MD, PhD; Deborah Kallick, PhD, Medicinal Chemistry
Read more about Rxight® pharmacogenetics