Does pravastatin cause weight gain?

In this article:

• Pravastatin weight gain
• Weight loss on pravastatin
• Tips for weight management
• Alternatives

In this article

• Pravastatin weight gain
• Weight loss on pravastatin
• Tips for weight management
• Alternatives

If you’re one of the 47 million Americans who take a medication to treat high cholesterol, you may have heard of pravastatin, a statin drug that is approved by the Food and Drug Administration (FDA) to lower bad cholesterol levels and help prevent heart disease.

While pravastatin, also sold under the brand name Pravachol, does not directly cause weight gain, some people may notice slight changes in their weight after starting the medication. These changes are often due to indirect factors rather than the drug itself. 

Can pravastatin cause weight gain?

Weight gain is not a side effect of pravastatin. It’s a common myth that statin medications make you pack on the pounds. However, research shows it’s not true for most people with no preexisting health conditions.

Previously, it was thought that taking statins decreased leptin production (a hormone that suppresses hunger and promotes satiety), increasing appetite. Clinical trials have proven these medications don’t slow your metabolism or change leptin levels. Yet, pravastatin can indirectly influence weight gain in a few ways. 

Muscle weakness 

Statins “can sometimes lead to muscle fatigue or weakness, making staying active more challenging,” explains Pamela Tambini, MD, a board-certified internist and Medical Director at Engage Wellness. Muscle pain or fatigue is one of the most common side effects associated with statin use. However, it is often alleviated by reducing the dose of the medication or switching to a different statin medication. 

HMG-CoA reductase inhibitors, the class of medication to which pravastatin belongs, can cause muscle weakness or fatigue, which can reduce how much you exercise. The age-old rule applies here: If you become less active, you will likely burn fewer calories, which can lead to weight gain. 

Fatigue

Even though statins don’t inhibit metabolism function, studies indicate that they reduce coenzyme Q10 (CoQ10), an energy metabolism component. This can lead to minor fatigue and reduced energy usage, indirectly contributing to weight gain.

Insulin resistance

For people with Type 2 diabetes, statins can potentially increase blood sugar and insulin resistance. Insulin resistance is linked to excess belly fat and difficulty losing weight. However, the benefits of statin use often outweigh the risks of these side effects. 

Dietary changes

Before starting statin therapy, people may try to reduce cholesterol naturally by losing weight or eating a balanced diet. It’s possible after starting pravastatin, some might unconsciously relax their diet, assuming that the medication will counterbalance their eating habits, Dr. Tambini says. In other words, people feel like taking medication for cholesterol means they don’t have to watch what they eat and may consume high-fat, high-calorie foods. For that reason, it’s important to focus on eating a healthy diet and prioritizing exercise.

Age

It’s relatively normal to experience weight redistribution as you get older. Additionally, statin use tends to increase with age, from 17.4% in adults aged 40–59 to 43.3% in adults aged 60–74 and 47.6% in adults aged 75 and older. “If belly fat increases after starting pravastatin, it is more likely due to lifestyle changes, diet, or natural aging rather than the medication itself,” Dr. Tambini says.

While the impact of statins can vary from person to person, the general medical consensus is that weight gain while taking pravastatin is likely related to the medication but not caused by it. In fact, many individuals taking pravastatin do not notice any changes in their weight or activity levels. 

Does pravastatin make it hard to lose weight?

Reduced ability to lose weight is not a side effect of pravastatin. The most common side effects of statins are muscle pain, nausea, vomiting, or diarrhea. However, some who take statins report difficulty losing weight. In many cases, this is due to decreased activity, insulin resistance, dietary changes, or natural aging. Luckily, many of these causes are easily managed with traditional lifestyle interventions and weight management techniques.

RELATED: Pravastatin side effects and how to avoid them

Tips for managing your weight on pravastatin

According to Dr. Horsham, the first rule is, “Do not overeat with a false sense of security due to being on a statin. This is what usually causes weight gain.” While providers cite this overconfidence as the most common reason for weight gain on pravastatin, the good news is that the recommendations for maintaining a healthy weight while taking this medication don’t differ substantially from the recommendations you might already be familiar with.

• Prioritize strength training to counteract potential muscle fatigue and preserve lean body mass.
• Increase dietary CoQ10 (found in organ meat, nuts, and fatty fish) or supplement to counteract statin-induced fatigue.
• Eat a balanced, heart-healthy diet that includes lean proteins, fruits, vegetables, healthy fats, and whole grains. Avoid consuming foods that can make insulin resistance or LDL cholesterol worse, such as high-sugar foods, processed carbohydrates, or fried foods.
• Stay active with low-impact exercise (walking, swimming) if statins cause muscle pain. Simple activities like walking workouts can make a meaningful difference without stressing your muscles and joints. 
• Prioritize hydration, getting enough quality sleep, and managing stress. All of these habits contribute to maintaining a stable weight. 
• Avoid alcohol. Excessive alcohol consumption can increase liver stress, especially when used with cholesterol medications, which can cause liver problems in some individuals.

While many statins interact with grapefruit and grapefruit juice, you can safely consume it in moderation while taking pravastatin.

Following these guidelines should help mitigate possible side effects or weight gain, but if you experience fatigue or muscle weakness, you should consult your healthcare provider about possible adjustments to your medication, says Dr. Tambini. There are many other prescription drugs available to manage high cholesterol levels and reduce your risk of heart attack or stroke.

Alternatives to pravastatin

“Pravastatin is often regarded as one of the more well-tolerated statins, as it is less likely to cause muscle aches than more potent statins like atorvastatin or rosuvastatin,” says Dr. Tambini. After pravastatin, Lipitor (atorvastatin) in low doses is said to be one of the most tolerated cholesterol medications among statin users, says Dr. Horsham. 

“If statins lead to too many side effects, alternatives such as Zetia (ezetimibe) or PCSK9 inhibitors may be considered. The most suitable medication depends on the person’s overall health, cholesterol levels, and body response to the treatment,” says Dr. Tambini. 

The following options are available:

Pravastatin alternatives
Drug name	Medication type	Coupons
Lipitor (atorvastatin)	Statin	Atorvastatin coupons
Lescol (fluvastatin)	Statin	Lescol coupons
Mevacor (lovastatin)	Statin	Lovastatin coupons
Livalo (pitavastatin)	Statin	Livalo coupons
Zocor (simvastatin)	Statin	Simvastatin coupons
Crestor (rosuvastatin)	Statin	Rosuvastatin coupons
Zetia (ezetimibe)	Cholesterol absorption inhibitor	Ezetimibe coupons
Repatha (evolocumab)	PCSK9 inhibitor	Repatha coupons
Praluent (alirocumab)	PCSK9 inhibitor	Praluent coupons
Lopid (gemfibrozil)	Fibrate	Gemfibrozil coupons

However, it’s important to note that responses to medication can vary significantly, and what works for one person might not work as well for you. 

If you are experiencing side effects from pravastatin, seek medical advice from a healthcare professional before making any changes to your medication. Alternative options or adjustments may be available that can help you lower cholesterol levels and reduce risk factors for heart problems without facing adverse effects.