Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
Suggest An Alternative Medication For Pravastatin
Question: I have high ldl. 180 that has been controlled and dropped to 80 with statins. Over the last few months I developed bad muscle pains in my arms and legs. Doctor took me off 40 mg simvastatin and switched me to 40mg pravastatin. Same problem. Now on 10 mg pravastatin and starting to ache again. Is there anything else I can take besides statins to help me. I'm scared
Brief Answer:
I would recommend as follows:
Detailed Answer:
Hello!
Welcome and thank you for asking on HCM!
I understand your concern and would explain that this is a common adverse effect of statins.
They are usually the main treatment option for reducing cholesterol levels.
I would recommend stopping pravastatin for a couple of weeks and then restart it gradually ( starting in 5mg and increasing slowly).
Different studies have shown that temporary interruption can lead to improve of the adverse effects and better tolerance.
Nevertheless, IDL levels are not a true indicator of your cardiovascular risk related to dyslipidemia.
It is important checking Total Cholesterol/HDL ratio. If this ratio is above 4.5, it would indicate a high cardio- vascular risk and thus the need for antilipemiant treatment.
If this ratio is below these levels the trewoth statins may not be so necessary.
Other treatment options to consider would be:
- fish oil or omega 3 supplements. They are not as potent as statins, but are helpful in reducing cholesterol levels.
- diet modifications( reduce saturated fat intake and hypercalcemic food and increase food reach in omega 3 fatty acids like nuts, fish, fish oil, olive oil, walnuts, etc.)
- performing a lot of aerobics would also be helpful in reducing cholesterol levels
- try to lose some pounds if you are overweight.
Hope you will find this answer helpful!
Feel free to ask me again, whenever you need!
Best wishes,
Dr. Iliri
I would recommend as follows:
Detailed Answer:
Hello!
Welcome and thank you for asking on HCM!
I understand your concern and would explain that this is a common adverse effect of statins.
They are usually the main treatment option for reducing cholesterol levels.
I would recommend stopping pravastatin for a couple of weeks and then restart it gradually ( starting in 5mg and increasing slowly).
Different studies have shown that temporary interruption can lead to improve of the adverse effects and better tolerance.
Nevertheless, IDL levels are not a true indicator of your cardiovascular risk related to dyslipidemia.
It is important checking Total Cholesterol/HDL ratio. If this ratio is above 4.5, it would indicate a high cardio- vascular risk and thus the need for antilipemiant treatment.
If this ratio is below these levels the trewoth statins may not be so necessary.
Other treatment options to consider would be:
- fish oil or omega 3 supplements. They are not as potent as statins, but are helpful in reducing cholesterol levels.
- diet modifications( reduce saturated fat intake and hypercalcemic food and increase food reach in omega 3 fatty acids like nuts, fish, fish oil, olive oil, walnuts, etc.)
- performing a lot of aerobics would also be helpful in reducing cholesterol levels
- try to lose some pounds if you are overweight.
Hope you will find this answer helpful!
Feel free to ask me again, whenever you need!
Best wishes,
Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
What about fibrates or other medications other than statins?
Brief Answer:
My answer as follows:
Detailed Answer:
Hello again!
Regarding your concern, I would explain that fibrates have quite the same adverse effects like statins.
Besides, their main effect is on triglycerides and not in cholesterol levels. They are more indicated when there are very high levels of triglycerides with relatively high values of cholesterol.
Other treatment options to consider for the reduction of cholesterol levels would be:
1-Ezetimibe: it is the first lipid-lowering drug that inhibits intestinal uptake
of dietary and biliary cholesterol without affecting the absorption of fat-soluble nutrients.
2-Bile acid sequestrants (colesevelam, colestipol or cholestyramine).
3-The combination of ezetimebe and acid sequestrans hasresulted in an additional reduction of LDL-C levels without any additional adverse effects when compared with the stable bile acid sequestrant regimen alone.
One or a combination of these drugs, in combination with the above mentioned lifestyle modifications can help you reduce your cholesterol levels.
Anyway, before deciding what treatment option to chose, it would be better calculate your cardio-vascular risk related to cholesterol levels. As I explained before the total cholesterol/HDL ratio would be a more confident indicator if you really need to be treated with medications for your dyslipidemia.
Hope to have been helpful!
If you have any other uncertainties please do not hesitate to ask me again!
Best wishes,
Dr. Iliri
My answer as follows:
Detailed Answer:
Hello again!
Regarding your concern, I would explain that fibrates have quite the same adverse effects like statins.
Besides, their main effect is on triglycerides and not in cholesterol levels. They are more indicated when there are very high levels of triglycerides with relatively high values of cholesterol.
Other treatment options to consider for the reduction of cholesterol levels would be:
1-Ezetimibe: it is the first lipid-lowering drug that inhibits intestinal uptake
of dietary and biliary cholesterol without affecting the absorption of fat-soluble nutrients.
2-Bile acid sequestrants (colesevelam, colestipol or cholestyramine).
3-The combination of ezetimebe and acid sequestrans hasresulted in an additional reduction of LDL-C levels without any additional adverse effects when compared with the stable bile acid sequestrant regimen alone.
One or a combination of these drugs, in combination with the above mentioned lifestyle modifications can help you reduce your cholesterol levels.
Anyway, before deciding what treatment option to chose, it would be better calculate your cardio-vascular risk related to cholesterol levels. As I explained before the total cholesterol/HDL ratio would be a more confident indicator if you really need to be treated with medications for your dyslipidemia.
Hope to have been helpful!
If you have any other uncertainties please do not hesitate to ask me again!
Best wishes,
Dr. Iliri
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
