Discussions that mention pravachol

High Cholesterol board


I had an initial negative reaction when my doctor put me on 40mg of Pravachol. I got really tired, and achey. However instead of quiting I had him back me off to 20mg.

I adjusted immediately to the lower dose, and then a month or two later I went back on 40 with no problems at all. Finally I went on to 80mg and I STILL had no side effects.

I'm no expert, but I think some people with symptoms may need a low dosage and move slowly up as needed.

Of course Crestor is known as the "Superstatin". Its about the most powerful one out there. Lipitor is amost as powerful at 40mg, and probably slightly more powerful at 80 since there is no 80mg dosage of Crestor right now.

I think in some cases of Homozygous FH docs will still prescribe higher doses though.

Believe me, I'm not keen to take meds, but I'm damn glad the statins came along, and wish I'd gotten on the bandwagon earlier.

I think is also worth pointing out, that many people who seek out boards like this are the ones having issues ...in this case with statins...those with no issues are watching TV.

mark
rahod, "I would try 10mg+Zetia first.... 20Mg Crestor +Zetia will almost certainly get you there."

Rahod, I hope your right, but so far, although I respond to statins, I have not responded to them as well as baseline reduction statistics would predict.

In fact, if I had responded to Pravachol as well as the CRESTOR people say I should, I'd already be at good levels. I'm not.

Here is what Elena Citkowitz, the Director of Cholesterol Management Center at Yale University School of Medicine says about people with FH:

"Because 50% of the LDL receptors are normal, these patients have an excellent response to the usual cholesterol-lowering drugs. However, LDLc elevations are so severe that treatment still remains difficult.

Maximum doses of one of the stronger HMG-CoA reductase inhibitors (ie, statins) such as atorvastatin or rosuvastatin and one or more other medications, including bile acid sequestrants or niacin, are required to approach the recommended LDLc goals"

Get that last bit..."to approach the recommended LDLc goals"

You're telling me I'll run faster if I use CRESTOR running shoes...maybe, but the real problem is, I only have one leg...LOL.

mark
mhtyler:


10mg Crestor is equivalent in LDL lowering to: 20mg Lipitor (actually exceeds)...80Mg Zocor...far exceeds 80 mg Pravachol.

20mg Crestor is equvalent to: 80mg Lipitor :)
"...far exceeds 80 mg Pravachol."

Where are you getting your figures? I'm looking right at the Crestor study, and it doesn't even measure Pravachol at 80mg, because that wasn't a recommended dose at the time.

What I do see on the report is that 40mg of Lipitor is slightly more powerful than 10mg of Crestor.

Crestor does appear to be slightly more powerful at 40 than Lipitor at 80.

55% reduction from baseline LDL vs 51% with Lipitor

The max dose of Crestor might be just the thing for me.

55% off of my baseline would be and LDL score of about 85 ...about 10-15 points off what I'd like to see. The trouble is, as I said, I respond to statins, but not in line with the mean baseline changes seen in the study.

I've a feeling they don't include FH's in such manuf. sponsored studies since FH's aren't likely to respond as well as people with normal cholesterol receptors.

Still...there is hope that the max dose of Lipitor or Crestor along with Zetia might...just might get me into a safe area.
"Where are you getting your figures? I'm looking right at the Crestor study, and it doesn't even measure Pravachol at 80mg, because that wasn't a recommended dose at the time."

My logic deduced that since 20mg exceeded 80mg Zocor, it would certainly exceed 80 mg Pravachol :D . Go to the Crestor site and click on "Efficacy" link..then click on "LDL Efficacy" and SCROLL DOWN TO THE SECOND CHART. You can also access the entire study...go to "Scientific Evidence" link. That will lead you to the link for the download(PDF) of the "STELLAR STUDY". Read that! You will see the "head to head" data. The charts at the end will also allow you to extrapolate the data on 40 mg Pravachol..80 mg wouldn't come close to 20mg Crestor. BTW, if you look at the data you'll see 20mg Crestor is very close to 80mg Lipitor as well.
Quote from mhtyler:
rahod, "I would try 10mg+Zetia first.... 20Mg Crestor +Zetia will almost certainly get you there."

Rahod, I hope your right, but so far, although I respond to statins, I have not responded to them as well as baseline reduction statistics would predict.

In fact, if I had responded to Pravachol as well as the CRESTOR people say I should, I'd already be at good levels. I'm not.

Here is what Elena Citkowitz, the Director of Cholesterol Management Center at Yale University School of Medicine says about people with FH:

"Because 50% of the LDL receptors are normal, these patients have an excellent response to the usual cholesterol-lowering drugs. However, LDLc elevations are so severe that treatment still remains difficult.

Maximum doses of one of the stronger HMG-CoA reductase inhibitors (ie, statins) such as atorvastatin or rosuvastatin and one or more other medications, including bile acid sequestrants or niacin, are required to approach the recommended LDLc goals"

Get that last bit..."to approach the recommended LDLc goals"

You're telling me I'll run faster if I use CRESTOR running shoes...maybe, but the real problem is, I only have one leg...LOL.

mark


From a study:
Each doubling of the statin dose produces an incremental LDL-C reduction of approximately 5–6% of the baseline LDL-C value, resulting in a further LDL-C reduction of 15–18% with a three step doubling of the statin, compared with the LDL-C reduction achieved with the statin starting dose. The addition of 6 tablets of colesevelam or the addition of 10 mg of ezetimibe to 10 mg of a statin results in about the same level of LDL-C lowering as 80 mg of the statin. The highest doses of statins are most associated with adverse side effects.

Do a search for 'Lipids on line" web site..then do a search for "Ezetimibe" on that home page and go to slide 21..sorry I wish I could post the link. That graph says it all.
Rahod, FH = Familia Cholesterolemia. Reread my post: People with FH do not respond to statins the same as people with normal liver functions.

The figures you are quoting are mean baseline reductions for people without FH. It is likely that Crestor and Lipitor will both have stronger reactions than Pravachol, but not in-line with what you've been reading...not on me anyway.

mark