Vogdia Drug Interactions

Pravastatin sodium is not significantly metabolised by the cytochrome P450 enzyme system, although caution has been advised when such combinations are used.
Anticoagulants: No change in warfarin activity has been seen in patients given both warfarin and Pravastatin sodium. An epidemiological study in patients stabilised on warfarin found that risk of hospitalisation from gastrointestinal bleeding was not raised when Pravastatin sodium was added to therapy.
Antidepressants: Increased creatine kinase concentrations occurred in a patient given Pravastatin sodium with nefazodone. A study in healthy subjects found that St. John's wort had no effect on Pravastatin sodium.
Antifungals: Pravastatin sodium is not significantly metabolised by the cytochrome P450 enzyme system. Effect of itraconazole and ketoconazole, which are inhibitors of CYP3A4, on Pravastatin sodium appears to be minimal.
Antivirals: HIV-protease inhibitors are inhibitors of the cytochrome P450 isoenzyme CYP3A4 and may affect the metabolism of statins. The plasma concentration of Pravastatin sodium was reduced with ritonavir-boosted saquinavir. Efavirenz is an inducer of CYP3A4 and a study in healthy subjects found that it could reduce plasma concentrations of Pravastatin sodium, although it is not metabolised by CYP3A4.
Colchicine: Use with caution. Colchicine increases the risk of rhabdomyolysis when given with Pravastatin sodium.
Fruit juices: Grapefruit juice inhibits the cytochrome P450 isoenzyme CYP3A4. Pravastatin sodium, which is not significantly metabolised by CYP3A4, does not appear to be affected.
Fusidic acid: Concurrent use of fusidic acid and Pravastatin sodium may result in increased exposure of fusidic acid and/or Pravastatin sodium. The risk of myopathy including rhabdomyolysis may be increased. If the treatment with systemic fusidic acid is necessary, Pravastatin sodium should be discontinued.
Immunosuppressants: The mechanism of the interaction may be additive toxicity, since both Pravastatin sodium and cyclosporine are known to cause myopathy, but effects on plasma concentrations may also be involved. Pharmacokinetic studies have shown that cyclosporine increases the plasma concentrations of Pravastatin sodium. Clinical and biochemical monitoring of patients receiving this combination is recommended.
Lipid regulating drugs: Myopathy and myositis are recognised adverse effects of both statins and fibric acid derivatives, including fibrates and gemfibrozil, and the risk is increased if they are given together. Studies have shown increased plasma concentrations of Pravastatin sodium when given with gemfibrozil.
Concurrent use of cholestyramine or colestipol and Pravastatin sodium may result in reduced effectiveness of Pravastatin sodium. There was no clinically significant decrease in bioavailability or therapeutic effect when Pravastatin sodium was administered one hour before or four hours after cholestyramine or one hour before colestipol.