MAJOR — Use With Caution
CAUTION — pravastatin may be the best statin choice during rifampin but still monitor
Evidence level: MODERATE
Rifampin reduces pravastatin levels but less severely than other statins.
Rifampin induces OATP1B1 hepatic uptake transporter. Pravastatin levels may be reduced though less affected than CYP3A4-dependent statins.
Pravastatin is often the preferred statin during rifampin therapy. Monitor lipids closely.
Some antibiotics (erythromycin, clarithromycin) strongly inhibit CYP3A4 and can dramatically increase statin levels, raising rhabdomyolysis risk. Take Pravastatin in the evening as usual. Your prescriber may temporarily pause or reduce the statin during short antibiotic courses.
Cardiovascular disease
Reduced cholesterol control
Pravastatin may be the best option but needs monitoring.
Statin interactions often involve liver enzyme competition. Ask your doctor about alternative statins (rosuvastatin and pravastatin have fewer CYP interactions) or spacing doses 12 hours apart. CoQ10 supplementation may help with statin-related muscle discomfort.
Rifampin reduces pravastatin levels but less severely than other statins.
Some antibiotics (erythromycin, clarithromycin) strongly inhibit CYP3A4 and can dramatically increase statin levels, raising rhabdomyolysis risk. Take Pravastatin in the evening as usual. Your prescriber may temporarily pause or reduce the statin during short antibiotic courses.
Reduced cholesterol control
Statin interactions often involve liver enzyme competition. Ask your doctor about alternative statins (rosuvastatin and pravastatin have fewer CYP interactions) or spacing doses 12 hours apart. CoQ10 supplementation may help with statin-related muscle discomfort.
Pravastatin may be the best option but needs monitoring.
Or browse the full interaction database (121,000+ pairs).