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Pravachol

[Pravastatin]

CNS Toxicity

CNS vascular lesions, characterized by perivascular hemorrhage and edema and mononu-clear cell infiltration of perivascular spaces, were seen in dogs treated with pravastatin at a dose of 25 mg/ kg/ day. These effects in dogs were observed at approximately 59 times the human dose of 80 mg/ day, based on AUC. Similar CNS vascular lesions have been observed with several other drugs in this class. A chemically similar drug in this class produced optic nerve degeneration (Wallerian degeneration of retinogeniculate fibers) in clinically normal dogs in a dose-dependent fashion starting at 60 mg/ kg/ day, a dose that produced mean plasma drug levels about 30 times higher than the mean drug level in humans taking the highest recommended dose (as mea-sured by total enzyme inhibitory activity). This same drug also produced vestibulocochlear Wallerian-like degeneration and retinal ganglion cell chromatolysis in dogs treated for 14 weeks at 180 mg/ kg/ day, a dose which resulted in a mean plasma drug level similar to that seen with the 60 mg/ kg/ day dose.

Carcinogenesis, Mutagenesis, Impairment of Fertility

Text Continues Below



In a 2-year study in rats fed pravastatin at doses of 10, 30, or 100 mg/ kg body weight, there was an increased incidence of hepatocellular carcinomas in males at the highest dose (p 0.01). These effects in rats were observed at approximately 12 times the human dose (HD) of 80 mg, based on body surface area mg/ m 2 and at approximately 4 times the human dose, based on AUC. In a 2-year study in mice fed pravastatin at doses of 250 and 500 mg/ kg/ day, there was an increased incidence of hepatocellular carcinomas in males and females at both 250 and 500 mg/ kg/ day (p 0.0001). At these doses, lung adenomas in females were increased (p= 0.013). These effects in mice were observed at approximately 15 times (250 mg/ kg/ day) and 23 times (500 mg/ kg/ day) the human dose of 80 mg, based on AUC.

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