Why is Pravachol prescribed?
Pravachol is a cholesterol-lowering drug. Your doctor may prescribe it along with a cholesterol-lowering diet if your blood cholesterol level is dangerously high and you have not been able to lower it by diet alone.
High cholesterol can lead to heart problems. By lowering your cholesterol, Pravachol improves your chances of avoiding a heart attack, heart surgery, and death from heart disease. In people who already have hardening of the arteries, it slows progression of the disease and cuts the risk of acute attacks.
The drug works by helping to clear harmful low-density lipoprotein (LDL) cholesterol out of the blood and by limiting the body's ability to form new LDL cholesterol. For people at high risk of heart disease, current guidelines call for considering drug therapy when LDL levels reach 130. For people at lower risk, the cut-off is 160. For those at little or no risk, it's 190.
Pravachol can also be prescribed for children ages 8 and older when diet alone fails to lower their cholesterol levels.
Most important fact about Pravachol
Pravachol is usually prescribed only if diet, exercise, and weight-loss fail to bring your cholesterol levels under control. It's important to remember that Pravachol is a supplement--not a substitute--for those other measures. To get the full benefit of the medication, you need to stick to the diet and exercise program prescribed by your doctor. All these efforts to keep your cholesterol levels normal are important because together they may lower your risk of heart disease.
How should you take Pravachol?
For an even greater cholesterol-lowering effect, your doctor may prescribe Pravachol along with a different kind of lipid-lowering drug such as Questran or Colestid. However, you must not take Pravachol at the same time of day as the other cholesterol-lowering drug. Take Pravachol at least 1 hour before or 4 hours after taking the other drug.
Pravachol should be taken once daily. You may take it anytime, with or without food.
Your doctor will probably do blood tests for cholesterol levels every 4 weeks to determine the effectiveness of the dose.
--If you miss a dose...
Take the forgotten dose as soon as you remember. If it is almost time for your next dose, skip the one you missed and go back to your regular schedule. Do not take a double dose.
--Storage instructions...
Store at room temperature, in a tightly closed container, away from moisture and light.
What side effects may occur?
Side effects from Pravachol cannot be anticipated. If any develop or change in intensity, inform your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking Pravachol.
• More common side effects may include:
Abdominal pain, chest pain, constipation, cough, diarrhea, dizziness, fatigue, gas, headache, heartburn, inflammation of nasal passages, muscle aching or weakness, nausea, rash, stomach or intestinal discomfort, urinary problems, vomiting
Why should Pravachol not be prescribed?
Do not take Pravachol if you are sensitive or have ever had an allergic reaction to it.
Do not take Pravachol if you have liver disease.
Special warnings about Pravachol
Pravachol should not be used to try to lower high cholesterol that stems from a medical condition such as alcoholism, poorly controlled diabetes, an underactive thyroid gland, or a kidney or liver problem.
Because Pravachol may cause damage to the liver, your doctor will probably do blood tests before you start taking the drug and whenever he plans a dosage increase. The doctor should monitor you especially carefully if you've recently had liver disease, if you have any symptoms that might mean liver disease, or if you're a heavy drinker.
Since Pravachol may cause damage to muscle tissue, promptly report to your doctor any unexplained muscle pain, tenderness, or weakness, especially if you also have a fever or you just generally do not feel well.
Possible food and drug interactions when taking Pravachol
If Pravachol is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining Pravachol with the following:

Cholestyramine (Questran)
Cimetidine (Tagamet)
Colestipol (Colestid)
Diltiazem (Cardizem, Dilacor, Tiazac)
Drugs that suppress the immune system, such as Sandimmune and Neoral
Erythromycin (E.E.S., Erythrocin, others)
Gemfibrozil (Lopid)
Itraconazole (Sporanox)
Niacin (Niacor, Niaspan)
Warfarin (Coumadin)
Special information if you are pregnant or breastfeeding
You must not become pregnant while taking Pravachol. Because Pravachol lowers cholesterol, and cholesterol is necessary for the proper development of an unborn baby, there is some suspicion that Pravachol might cause birth defects. Your doctor will prescribe Pravachol only if you are highly unlikely to become pregnant while taking the drug. If you do become pregnant while taking Pravachol, inform your doctor immediately.
Because Pravachol appears in breast milk, and because its cholesterol-lowering effects might prove harmful to a nursing baby, you should not take Pravachol while you are breastfeeding.
Recommended dosage
ADULTS
The usual starting dose is 40 milligrams once a day. If this doesn't reduce LDL levels sufficiently, your doctor may increase the dose to 80 milligrams once daily.
CHILDREN 8 TO 13 YEARS OLD
The recommended starting dose is 20 milligrams once a day. Doses greater than 20 milligrams have not been studied in this age-group.
CHILDREN 14 TO 18 YEARS OLD
The recommended starting dose is 40 milligrams once a day. Doses greater than 40 milligrams have not been studied in this age-group.
For people with kidney or liver problems and those taking a medication that suppresses the immune system, the starting dose is 10 milligrams. People on immunosuppressive drugs generally take no more than 20 milligrams of Pravachol daily.
Overdosage
Although no specific information is available, any medication taken in excess can have serious consequences. If you suspect an overdose of Pravachol, seek medical attention immediately.