Drug
Pitavastatin
Pronounced
"pit-A-va-STAT-in"
Drug Interactions
See also How to Use section.
Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.
Some products that may interact with this drug include: colchicine, daptomycin, gemfibrozil.
Other medications can affect the removal of pitavastatin from your body, which may affect how pitavastatin works. Examples include cyclosporine, letermovir, sofosbuvir/velpatasvir/voxilaprevir, among others.
Do not take any red yeast rice products while you are taking pitavastatin because some red yeast rice products may also contain a statin called lovastatin. Taking pitavastatin and red yeast rice products together can increase your risk of serious muscle and liver problems.
Negative Interactions
1- Reduces Effectiveness
Pitavastatin
Magnesium
This interaction is based on this drug belonging to a drug class. While this drug may differ from the text and references below, drugs within this class work in a similar way and this interaction is applicable to drugs within the same class.
A magnesium- and aluminum-containing antacid was reported to interfere with atorvastatin absorption. People can avoid this interaction by taking atorvastatin two hours before or after any aluminum/magnesium-containing antacids. Some magnesium supplements such as magnesium hydroxide are also antacids.
MagnesiumPitavastatin- Threlkeld DS, ed. Diuretics and Cardiovasculars, Antihyperlipidemic Agents, HMG-CoA Reductase Inhibitors. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, Sep 1998, 172a.
Supportive Interactions
5- Replenish Depleted Nutrients
Pitavastatin
Coenzyme Q10
In a group of patients beginning treatment with atorvastatin, the average concentration of coenzyme Q10 in blood plasma decreased within 14 days, and had fallen by approximately 50% after 30 days of treatment. Many doctors recommend CoQ10 supplementation to prevent the drug-induced decline in CoQ10 levels.
Coenzyme Q10Pitavastatin- Rundek T, Naini A, Sacco R, et al. Atorvastatin decreases the coenzyme Q10 level in the blood of patients at risk for cardiovascular disease and stroke. Arch Neurol 2004;61:889-92.
- Reduce Side Effects
Pitavastatin
Coenzyme Q10
In a preliminary study, supplementation with 100 mg of CoQ10 per day reduced the severity of muscle pain by 40% in people with muscle pain caused by a statin drug. A double-blind trial also found that CoQ10 (200 mg per day) significantly decreased drug-induced muscle symptoms in people taking statin drugs.
However, in another double-blind trial, CoQ10 in the amount of 60 mg twice a day for one month was not more effective than a placebo for relieving muscle pain. Although the evidence is conflicting regarding whether supplementing with CoQ10 relieves statin-induced muscle symptoms, many doctors recommend CoQ10 supplementation to prevent the drug-induced decline in CoQ10 levels.
Coenzyme Q10Pitavastatin- Caso G, Kelly P, McNurlan MA, Lawson WE. Effect of coenzyme Q10 on myopathic symptoms in patients treated with statins. Am J Cardiol 2007;99:1409-12.
- Fedacko J, Pella D, Fedackova P, et al. Coenzyme Q10 and selenium in statin-associated myopathy treatment. Can J Physiol Pharmacol 2013;91:165–70.
- Bookstaver DA, Burkhalter NA, Hatzigeorgiou C. Effect of coenzyme Q10 supplementation on statin-induced myalgias. Am J Cardiol 2012;110:526-9.
- Reduce Side Effects
Pitavastatin
Creatine
In a preliminary study, ten patients who had to discontinue statin drugs because of muscle-related side effects were given creatine (as creatine monohydrate) in the amount of 5 grams twice a day for five days, then 5 grams per day. Eight of the ten patients experienced no muscle symptoms upon resuming the statin drug.CreatinePitavastatin- Shewmon DA, Craig JM. Creatine supplementation prevents statin-induced muscle toxicity. Ann Intern Med 2010;153:690-2.
- Reduce Side Effects
Pitavastatin
Vitamin D
In a preliminary trial, supplementation with vitamin D appeared to prevent muscle-related side effects in patients taking statin drugs. The amount of vitamin D used in this study was very large (up to 50,000 IU twice a week) and potentially toxic. People taking statin drugs should consult with their doctor regarding how much vitamin D can be taken.Vitamin DPitavastatin- Glueck CJ, Budhani SB, Masineni SS, et al. Vitamin D deficiency, myositis-myalgia, and reversible statin intolerance. Curr Med Res Opin 2011;27:1683-90.
- Reduce Side Effects
Pitavastatin
Vitamin E
This interaction is based on this drug belonging to a drug class. While this drug may differ from the text and references below, drugs within this class work in a similar way and this interaction is applicable to drugs within the same class.
Oxidative damage to LDL (“bad”) cholesterol is widely believed to contribute to heart disease. In a double-blind trial, lovastatin was found to increase oxidative damage to LDL cholesterol and vitamin E was reported to protect against such damage, though not to completely overcome the negative effect of lovastatin. This study suggests that people taking lovastatin might benefit from supplemental vitamin E.
Vitamin EPitavastatin- Palomäki A, Malminiemi K, Malminiemi O, Solakivi T. Effects of lovastatin therapy on susceptibility of LDL to oxidation durgy alpha-tocopherol supplementation. Arterioscler Thromb Vasc Biol 1999;19:1541-8.