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Pravastatin

Pravastatin (trade name Pravachol) is a statin drug developed in Japan by scientists at pharmaceutical company Sankyo in 1979. Pravastatin is produced by chemical modification of lovastatin in a two-step fermentation reaction performed by the bacterium Nocardia autotrophica.

Pravastatin was first launched by Sankyo in Japan. In 1991, following FDA approval, pravastatin was introduced to the US market by Bristol-Myers Squibb who had acquired the rights to sell it outside of Japan. Pravastatin is classified as a first-generation statin. When second generation statins simvastatin and atorvastatin came along, use of pravastatin declined.

Myopathic patients, who cannot tolerate other stains, may be administered pravastatin.

Pravastatin is available in 10, 20, 40, and 80 mg tablets and is taken orally. Typical starting doses are between 20-40 mgs. Since the patent expired in 2006, several generic drug makers have received FDA approval to produce pravastatin.

Pravastatin is rarely prescribed in the United States anymore, unless there is a particular reason to do so. Simvastatin and atorvastatin are available as cheap generics. These are considered superior drugs that can lower serum cholesterol levels more with similar or fewer adverse effects. In the history of statins pravastatin is important as a pioneer, but its time is passed. The company funded a study called the PROVE-IT study, which Forbes magazine called "a huge, self-inflicted disaster".

A Polish study recent found pravastatin increased the body’s sensitivity to insulin, (http://www.ncbi.nlm.nih.gov/pubmed/21889144) which is the opposite effect that atorvastatin has.

There is some interest in using pravastatin for liver diseases.
*http://www.ncbi.nlm.nih.gov/pubmed/21749370?dopt=Abstract)

It is also being investigated as a protective agent for kidneys in chemotherapy patients.
(http://www.ncbi.nlm.nih.gov/pubmed/20650967?dopt=Abstract) And for cardiovascular issues in people with Marfan syndrome. http://www.ncbi.nlm.nih.gov/pubmed/21911808?dopt=Abstract

ALso: Low-dose pravastatin reduced atherothrombotic infarction in certain patients with stroke

 

Facts

Formula: C23H36O7
Category: synthetic, Type I
Manufacture: synthetic, Type I
Solubility: water
Introduction: 1991
Brands: Pravastatina; Pravastatine; Pravastatinum; Pravachol

One scientific paper claims pravastatin is the only statin that improves insulin resistance and glucose homeostasis. http://content.onlinejacc.org/article.aspx?articleid=1665662

Pravastatin has fewer negative metabolic effects than rosuvastatin http://www.internationaljournalofcardiology.com/article/S0167-5273(11)02085-7/abstract

A small percentage of pregnant women develop the complication preeclampsia, which drives their blood pressure up and possibly threatens kidney health. Patients often have protein in the urine and injury to the blood vessels. It is a leading cause of death for pregnant women and their fetuses. Preeclampsia has many similarities to cardiovascular disease, including Endothelial dysfunction so scientists thought about statin therapy to try to forestall it.

Many medications, including aspirin, have been tried in attempts to prevent preeclampsia, but they generally do not work. Animal studies found pravastatin could help with the condition, and a clinical trial to see if it could aid humans is underway.

A study suggested combining pravastatin with the blood medicine Valsartan (trade name Diovan) could work better than pravastatin alone http://content.onlinejacc.org/article.aspx?articleid=1665662 Scientists found the combination lowered fasting insulin, and improved insulin sensitivity.

Japanese researchers have found pravastatin therapy lower blood serum levels of hs-CRP in patients who had strokes. High-sensitivity C-reactive protein is considered a marker of inflammation in the circulatory system.

http://stroke.ahajournals.org/content/47/Suppl_1/ATMP94.short Some people have the ABCA1 R219K variant in their genome and there is some evidence these people get less benefit than pravastatin than other people do. http://www.atherosclerosis-journal.com/article/S0021-9150(14)00230-5/abstract

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