Primary hypercholesterolemia
Second line
Statin (HMG-CoA reductase inhibitor)
ATC code: C10AA08 (Pitavastatin)
Brand names
Livazo, Livalo
A competitive HMG-CoA reductase inhibitor. Mainly UGT-glucuronidation metabolism, minor CYP2C9 – no significant CYP3A4 interactions (differs from atorvastatin and simvastatin). reduction 35–45% at 2–4 mg – moderate-to-high intensity at low doses. Lower glycemia rise than rosuvastatin and atorvastatin (J-PREDICT data).
Second line
Second-line for hypercholesterolemia per 2019. Advantage over atorvastatin in patients on polytherapy with CYP3A4-metabolized drugs (cyclosporine post-transplant, antiretrovirals, azole antifungals) – fewer interactions. Dose 2–4 mg once daily. In pre-diabetes or T2D, preferred over atorvastatin due to less glycemic impact.
The drug is promoted for these uses outside international guidelines. Each entry below is analyzed against AEMPS, FDA, EMA, Cochrane and major RCTs.
Not recommended
Pitavastatin is a new-generation statin with minimal CYP3A4 interaction. It is prescribed for hyperlipidemia and for primary/secondary CV prevention in high-risk patients ( 2019). In anti-aging and longevity communities, pitavastatin is promoted as a means for life extension and vessel protection in healthy adults. In people with normal lipid profile and low CV risk, no clinical studies of prophylactic use exist, and meta-analyses do not confirm benefit. The drug causes myalgia, elevated liver enzymes, risk of rhabdomyolysis (rare but dangerous), elevated glucose, and new-onset diabetes risk. If pitavastatin was prescribed at a normal lipid profile, consider seeking a second opinion.
1 pair found. Sorted from critical to minor.
Mechanism
Cyclosporine inhibits OATP1B1 – pitavastatin rises 5-7 fold. Livalo contraindication.
Symptoms
Myalgia, weakness, dark urine, rising CK within 5-10 days.
Management
Combination contraindicated.
Opens the checker prefilled with this drug. Pick the second one from your regimen.
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Contraindicated. Stop 1–3 months before planned conception.
Contraindicated during lactation.
Reference information, not a clinical decision. Discuss feeding pauses or changes with your physician or an IBCLC.
Pitavastatin is evaluated for the following indications with varying evidence strength: Primary hypercholesterolemia (evidence tier A), Anti-aging and longevity (evidence tier F). See the full indication matrix with dosing and citations above on this page.
Common side effects of Pitavastatin (≥ 1 in 100): Myalgia, Headache, Back pain, Constipation, Elevated ALT. See the Safety section for uncommon and serious reactions.
FDA category X. Contraindicated. Stop 1–3 months before planned conception.
Contraindicated during lactation.
Pitavastatin is contraindicated in: Hypersensitivity to pitavastatin or other statins; Active hepatic disease or transaminase elevation over 3× upper limit; Pregnancy and lactation; Concomitant cyclosporine; Age under 18. Full list in the Safety section.