Aspirin Pravastatin

Aspirin Pravastatin Brand Name– Pravigard PAC

What is Aspirin Pravastatin

NOTE: This drug is discontinued in the US.

Aspirin Pravastatin combination has been approved to reduce the risk of death, non-fatal myocardial infarction, myocardial revascularization procedures and ischemic stroke in patients with cardiovascular and/or cerebrovascular disease.

Aspirin has antithrombotic and antiplatelet effects, while pravastatin is an oral HMG-CoA reductase inhibitor.

By itself, pravastatin is indicated to treat primary hypercholesterolemia, and is also used for primary or secondary prevention of myocardial infarction.

The original secondary prevention approval for pravastatin monotherapy was based on the Cholesterol and Recurrent Events (CARE) trial; 84% of patients in this trial also received aspirin.

The subsequent LIPID study also documented the secondary prevention benefit of pravastatin in patients who had a prior myocardial infarction or were hospitalized for unstable angina.

Pravigard™ PAC was FDA-approved on June 25, 2003. This FDA approval was based on combined data from five secondary prevention trials including CARE, LIPID, REGRESS, PLAC I, and PLAC II. Pravigard™ PAC includes six combinations of daily doses of buffered aspirin 81 mg or 325 mg, co-packaged with pravastatin 20 mg, 40 mg, or 80 mg tablets.

Marketing of this drug was discontinued by the manufacturer in May, 2005.

Indications

  1. atherosclerosis
  2. hypercholesterolemia
  3. hyperlipoproteinemia
  4. myocardial infarction prophylaxis
  5. stroke prophylaxis

Side Effects

  1. abdominal pain
  2. agranulocytosis
  3. alopecia
  4. anaphylactoid reactions
  5. angioedema
  6. aplastic anemia
  7. arthralgia
  8. azotemia
  9. bronchospasm
  10. chills
  11. cirrhosis
  12. Co-Enzyme Q-10 deficiency
  13. constipation
  14. diabetes mellitus
  15. diarrhea
  16. dizziness
  17. dyspepsia
  18. dyspnea
  19. elevated hepatic enzymes
  20. eosinophilia
  21. erythema nodosum
  22. esophageal stricture
  23. esophageal ulceration
  24. esophagitis
  25. fatigue
  26. fever
  27. flushing
  28. gastritis
  29. GI bleeding
  30. GI perforation
  31. headache
  32. hemolytic anemia
  33. hemorrhoids
  34. hepatic failure
  35. hepatic necrosis
  36. hepatitis
  37. hyperbilirubinemia
  38. hyperuricemia
  39. hyperventilation
  40. hypoglycemia
  41. hypoprothrombinemia
  42. impaired cognition
  43. insomnia
  44. interstitial nephritis
  45. intracranial bleeding
  46. laryngeal edema
  47. leukocytosis
  48. leukopenia
  49. lupus-like symptoms
  50. maculopapular rash
  51. malaise
  52. melena
  53. myalgia
  54. myasthenia
  55. myoglobinuria
  56. myopathy
  57. nausea
  58. pancreatitis
  59. pancytopenia
  60. peptic ulcer
  61. peripheral neuropathy
  62. photosensitivity
  63. platelet dysfunction
  64. prolonged bleeding time
  65. pruritus
  66. purpura
  67. pyrosis (heartburn)
  68. rash
  69. renal failure (unspecified)
  70. renal papillary necrosis
  71. renal tubular necrosis
  72. renal tubular obstruction
  73. Reye’s syndrome
  74. rhabdomyolysis
  75. Stevens-Johnson syndrome
  76. thrombocytopenia
  77. tinnitus
  78. toxic epidermal necrolysis
  79. urticaria
  80. vasculitis
  81. vomiting
  82. weakness
  83. wheezing

Monitoring Parameters

  • creatine phosphokinase (CPK)
  • LFTs
  • serum cholesterol profile

Contraindications

  • abrupt discontinuation
  • acid/base imbalance
  • acute bronchospasm
  • agranulocytosis
  • alcoholism
  • anticoagulant therapy
  • ascites
  • asthma
  • bone marrow suppression
  • breast-feeding
  • children
  • cholestasis
  • coagulopathy
  • dehydration
  • diabetes mellitus
  • electrolyte imbalance
  • endocrine disease
  • G6PD deficiency
  • geriatric
  • GI bleeding
  • GI disease
  • gout
  • head trauma
  • heart failure
  • hemophilia
  • hepatic disease
  • hepatic encephalopathy
  • hepatitis
  • hypertension
  • hypoprothrombinemia
  • hypotension
  • hypovolemia
  • immunosuppression
  • increased intracranial pressure
  • infants
  • intramuscular injections
  • iron-deficiency anemia
  • jaundice
  • labor
  • metabolic acidosis
  • metabolic alkalosis
  • myopathy
  • nasal polyps
  • neutropenia
  • NSAID hypersensitivity
  • obstetric delivery
  • organ transplant
  • peptic ulcer disease
  • pregnancy
  • renal disease
  • renal failure
  • renal impairment
  • respiratory acidosis
  • respiratory alkalosis
  • Reye’s syndrome
  • rhabdomyolysis
  • salicylate hypersensitivity
  • seizure disorder
  • sepsis
  • surgery
  • systemic lupus erythematosus (SLE)
  • tartrazine dye hypersensitivity
  • thrombocytopenia
  • thrombolytic therapy
  • thrombotic thrombocytopenic purpura (TTP)
  • tobacco smoking
  • urticaria
  • viral infection
  • vitamin K deficiency

Interactions

  • Abciximab
  • Acetaminophen
  • Acetaminophen; Aspirin, ASA; Caffeine
  • Acetaminophen; Butalbital
  • Acetaminophen; Butalbital; Caffeine
  • Acetaminophen; Butalbital; Caffeine; Codeine
  • Acetaminophen; Caffeine
  • Acetaminophen; Caffeine; Dihydrocodeine
  • Acetaminophen; Caffeine; Magnesium Salicylate; Phenyltoloxamine
  • Acetaminophen; Caffeine; Phenyltoloxamine; Salicylamide
  • Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine
  • Acetaminophen; Chlorpheniramine; Dextromethorphan; Pseudoephedrine
  • Acetaminophen; Chlorpheniramine; Phenylephrine; Phenyltoloxamine
  • Acetaminophen; Codeine
  • Acetaminophen; Dextromethorphan
  • Acetaminophen; Dextromethorphan; Doxylamine
  • Acetaminophen; Dextromethorphan; Guaifenesin; Phenylephrine
  • Acetaminophen; Dextromethorphan; Phenylephrine
  • Acetaminophen; Dextromethorphan; Pseudoephedrine
  • Acetaminophen; Dichloralphenazone; Isometheptene
  • Acetaminophen; Diphenhydramine
  • Acetaminophen; Guaifenesin; Phenylephrine
  • Acetaminophen; Hydrocodone
  • Acetaminophen; Oxycodone
  • Acetaminophen; Pentazocine
  • Acetaminophen; Propoxyphene
  • Acetaminophen; Pseudoephedrine
  • Acetaminophen; Tramadol
  • Acetazolamide
  • Acetohexamide
  • Acidifying Agents
  • Ado-Trastuzumab emtansine
  • Aliskiren; Amlodipine; Hydrochlorothiazide, HCTZ
  • Aliskiren; Hydrochlorothiazide, HCTZ
  • Alkalinizing Agents
  • Alogliptin
  • Alogliptin; Metformin
  • Alogliptin; Pioglitazone
  • Alpha-glucosidase Inhibitors
  • Amiloride
  • Amiloride; Hydrochlorothiazide, HCTZ
  • Aminoglycosides
  • Amlodipine; Benazepril
  • Amlodipine; Celecoxib
  • Amlodipine; Hydrochlorothiazide, HCTZ; Olmesartan
  • Amlodipine; Hydrochlorothiazide, HCTZ; Valsartan
  • Amoxicillin
  • Amoxicillin; Clarithromycin; Lansoprazole
  • Amoxicillin; Clarithromycin; Omeprazole
  • Amoxicillin; Clavulanic Acid
  • Amphotericin B
  • Amphotericin B cholesteryl sulfate complex (ABCD)
  • Amphotericin B lipid complex (ABLC)
  • Amphotericin B liposomal (LAmB)
  • Ampicillin
  • Ampicillin; Sulbactam
  • Anagrelide
  • Angiotensin-converting enzyme inhibitors
  • Antithrombin III
  • Antithymocyte Globulin
  • Apixaban
  • Ardeparin
  • Ascorbic Acid, Vitamin C
  • Aspirin, ASA; Citric Acid; Sodium Bicarbonate
  • Aspirin, ASA; Dipyridamole
  • Atazanavir
  • Atazanavir; Cobicistat
  • Atenolol; Chlorthalidone
  • Azilsartan; Chlorthalidone
  • Azithromycin
  • Bacitracin
  • Barbiturates
  • Bempedoic Acid
  • Benazepril
  • Benazepril; Hydrochlorothiazide, HCTZ
  • Bendroflumethiazide; Nadolol
  • Benzhydrocodone; Acetaminophen
  • Beta-blockers
  • Betrixaban
  • Bismuth Subsalicylate
  • Bismuth Subsalicylate; Metronidazole; Tetracycline
  • Bisoprolol; Hydrochlorothiazide, HCTZ
  • Bisphosphonates
  • Boceprevir
  • Bortezomib
  • Bromocriptine
  • Bumetanide
  • Buspirone
  • Calcium Carbonate
  • Calcium Carbonate; Magnesium Hydroxide
  • Calcium Carbonate; Risedronate
  • Calcium Carbonate; Simethicone
  • Canagliflozin
  • Canagliflozin; Metformin
  • Candesartan; Hydrochlorothiazide, HCTZ
  • Capreomycin
  • Captopril
  • Captopril; Hydrochlorothiazide, HCTZ
  • Carbenicillin
  • Cefixime
  • Cefotetan
  • Celecoxib
  • Chlorothiazide
  • Chlorpropamide
  • Chlorthalidone
  • Chlorthalidone; Clonidine
  • Cholestyramine
  • Cidofovir
  • Cilostazol
  • Cimetidine
  • Citalopram
  • Citric Acid; Potassium Citrate
  • Citric Acid; Potassium Citrate; Sodium Citrate
  • Citric Acid; Sodium Citrate
  • Clarithromycin
  • Clofarabine
  • Clomipramine
  • Clopidogrel
  • Cobicistat
  • Colchicine
  • Colchicine; Probenecid
  • Colestipol
  • Colistimethate, Colistin, Polymyxin E
  • Collagenase
  • Corticosteroids
  • Cyclosporine
  • Dabigatran
  • Daclatasvir
  • Dalteparin
  • Danazol
  • Dapagliflozin
  • Dapagliflozin; Metformin
  • Dapagliflozin; Saxagliptin
  • Daptomycin
  • Darunavir
  • Darunavir; Cobicistat
  • Darunavir; Cobicistat; Emtricitabine; Tenofovir alafenamide
  • Dasabuvir; Ombitasvir; Paritaprevir; Ritonavir
  • Deferasirox
  • Defibrotide
  • Dichlorphenamide
  • Diclofenac
  • Diclofenac; Misoprostol
  • Dicloxacillin
  • Diflunisal
  • Diphenhydramine; Ibuprofen
  • Diphenhydramine; Naproxen
  • Dipyridamole
  • Doravirine; Lamivudine; Tenofovir disoproxil fumarate
  • Drotrecogin Alfa
  • Edoxaban
  • Efalizumab
  • Efavirenz; Emtricitabine; Tenofovir
  • Efavirenz; Lamivudine; Tenofovir Disoproxil Fumarate
  • Elexacaftor; tezacaftor; ivacaftor
  • Eltrombopag
  • Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Alafenamide
  • Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Disoproxil Fumarate
  • Empagliflozin
  • Empagliflozin; Linagliptin
  • Empagliflozin; Linagliptin; Metformin
  • Empagliflozin; Metformin
  • Emtricitabine; Rilpivirine; Tenofovir disoproxil fumarate
  • Emtricitabine; Tenofovir disoproxil fumarate
  • Enalapril, Enalaprilat
  • Enalapril; Felodipine
  • Enalapril; Hydrochlorothiazide, HCTZ
  • Enoxaparin
  • Epoprostenol
  • Eprosartan; Hydrochlorothiazide, HCTZ
  • Eptifibatide
  • Ertugliflozin; Metformin
  • Ertugliflozin; Sitagliptin
  • Erythromycin
  • Erythromycin; Sulfisoxazole
  • Escitalopram
  • Esomeprazole; Naproxen
  • Ethacrynic Acid
  • Ethanol
  • Ethotoin
  • Etodolac
  • Etravirine
  • Everolimus
  • Famotidine; Ibuprofen
  • Fenofibrate
  • Fenofibric Acid
  • Fenoprofen
  • Fibric acid derivatives
  • Fish Oil, Omega-3 Fatty Acids (Dietary Supplements)
  • Flavocoxid, Flavocoxid; Citrated Zinc Bisglycinate
  • Fluoxetine
  • Fluoxetine; Olanzapine
  • Flurbiprofen
  • Fluvoxamine
  • Fondaparinux
  • Foscarnet
  • Fosinopril
  • Fosinopril; Hydrochlorothiazide, HCTZ
  • Fosphenytoin
  • Furosemide
  • Gallium Ga 68 Dotatate
  • Garlic, Allium sativum
  • Gemfibrozil
  • Ginger, Zingiber officinale
  • Ginkgo, Ginkgo biloba
  • Glecaprevir; Pibrentasvir
  • Glimepiride
  • Glimepiride; Pioglitazone
  • Glimepiride; Rosiglitazone
  • Glipizide
  • Glipizide; Metformin
  • Glyburide
  • Glyburide; Metformin
  • Green Tea
  • Griseofulvin
  • Heparin
  • Hyaluronidase
  • Hyaluronidase, Recombinant; Immune Globulin
  • Hydralazine; Hydrochlorothiazide, HCTZ
  • Hydrochlorothiazide, HCTZ
  • Hydrochlorothiazide, HCTZ; Irbesartan
  • Hydrochlorothiazide, HCTZ; Lisinopril
  • Hydrochlorothiazide, HCTZ; Losartan
  • Hydrochlorothiazide, HCTZ; Methyldopa
  • Hydrochlorothiazide, HCTZ; Metoprolol
  • Hydrochlorothiazide, HCTZ; Moexipril
  • Hydrochlorothiazide, HCTZ; Olmesartan
  • Hydrochlorothiazide, HCTZ; Propranolol
  • Hydrochlorothiazide, HCTZ; Quinapril
  • Hydrochlorothiazide, HCTZ; Spironolactone
  • Hydrochlorothiazide, HCTZ; Telmisartan
  • Hydrochlorothiazide, HCTZ; Triamterene
  • Hydrochlorothiazide, HCTZ; Valsartan
  • Hydrocodone; Ibuprofen
  • Ibritumomab Tiuxetan
  • Ibrutinib
  • Ibuprofen
  • Ibuprofen; Oxycodone
  • Ibuprofen; Pseudoephedrine
  • Idelalisib
  • Iloprost
  • Immune Globulin IV, IVIG, IGIV
  • Incretin Mimetics
  • Indapamide
  • Indomethacin
  • Inotersen
  • Insulins
  • Intravenous Lipid Emulsions
  • Iron Sucrose, Sucroferric Oxyhydroxide
  • Isoniazid, INH; Pyrazinamide, PZA; Rifampin
  • Isoniazid, INH; Rifampin
  • Ketoprofen
  • Ketorolac
  • Lamivudine; Tenofovir Disoproxil Fumarate
  • Lansoprazole; Naproxen
  • Lanthanum Carbonate
  • Leflunomide
  • Lesinurad
  • Lesinurad; Allopurinol
  • Letermovir
  • Linagliptin
  • Linagliptin; Metformin
  • Lisinopril
  • Loop diuretics
  • Lovastatin; Niacin
  • Low Molecular Weight Heparins
  • Macimorelin
  • Mannitol
  • Measles Virus; Mumps Virus; Rubella Virus; Varicella Virus Vaccine, Live
  • Meclofenamate Sodium
  • Mefenamic Acid
  • Meglitinides
  • Meloxicam
  • Metformin
  • Metformin; Pioglitazone
  • Metformin; Repaglinide
  • Metformin; Rosiglitazone
  • Metformin; Saxagliptin
  • Metformin; Sitagliptin
  • Methazolamide
  • Methotrexate
  • Methyclothiazide
  • Methylsulfonylmethane, MSM
  • Metoclopramide
  • Metolazone
  • Moexipril
  • Muromonab-CD3
  • Mycophenolate
  • Nabumetone
  • Nafcillin
  • Naproxen
  • Naproxen; Pseudoephedrine
  • Naproxen; Sumatriptan
  • Nateglinide
  • Niacin, Niacinamide
  • Niacin; Simvastatin
  • Nitazoxanide
  • Nitisinone
  • Nitroglycerin
  • Omacetaxine
  • Ombitasvir; Paritaprevir; Ritonavir
  • Omeprazole; Amoxicillin; Rifabutin
  • Omeprazole; Sodium Bicarbonate
  • Orlistat
  • Oxacillin
  • Oxaprozin
  • Paroxetine
  • Penicillin G
  • Penicillin G Benzathine
  • Penicillin G Benzathine; Penicillin G Procaine
  • Penicillin G Procaine
  • Penicillin V
  • Penicillins
  • Pentosan
  • Pentoxifylline
  • Perindopril
  • Perindopril; Amlodipine
  • Phentermine; Topiramate
  • Phenytoin
  • Phosphorated Carbohydrate Solution
  • Phosphorus
  • Photosensitizing agents (topical)
  • Pioglitazone
  • Piperacillin
  • Piperacillin; Tazobactam
  • Piroxicam
  • Pneumococcal Vaccine, Polyvalent
  • Polymyxins
  • Potassium Bicarbonate
  • Potassium Chloride
  • Potassium Citrate
  • Potassium Phosphate
  • Potassium Phosphate; Sodium Phosphate
  • Pramlintide
  • Prasterone, Dehydroepiandrosterone, DHEA (Dietary Supplements)
  • Prasterone, Dehydroepiandrosterone, DHEA (FDA-approved)
  • Prasugrel
  • Probenecid
  • Psyllium
  • Quinapril
  • Raltegravir
  • Ramipril
  • Red Yeast Rice
  • Repaglinide
  • Rifabutin
  • Rifampin
  • Rifapentine
  • Rituximab; Hyaluronidase
  • Rivaroxaban
  • Rosiglitazone
  • Salicylic Acid
  • Saxagliptin
  • Selective serotonin reuptake inhibitors
  • Serotonin norepinephrine reuptake inhibitors
  • Sertraline
  • Sibutramine
  • Simeprevir
  • Simvastatin; Sitagliptin
  • Sirolimus
  • Sitagliptin
  • Sodium Bicarbonate
  • Sodium Hyaluronate, Hyaluronic Acid
  • Sodium Lactate
  • Sodium Thiosulfate; Salicylic Acid
  • Sofosbuvir; Velpatasvir; Voxilaprevir
  • Spironolactone
  • Sulfinpyrazone
  • Sulfonamides
  • Sulfonylureas
  • Sulindac
  • Tacrolimus
  • Telavancin
  • Telbivudine
  • Telithromycin
  • Tenofovir Alafenamide
  • Tenofovir, PMPA
  • Teriflunomide
  • Thiazide diuretics
  • Thiazolidinediones
  • Thrombin Inhibitors
  • Thrombolytic Agents
  • Ticagrelor
  • Ticarcillin
  • Ticarcillin; Clavulanic Acid
  • Ticlopidine
  • Tinzaparin
  • Tipranavir
  • Tirofiban
  • Tolazamide
  • Tolbutamide
  • Tolmetin
  • Tolvaptan
  • Topiramate
  • Torsemide
  • Trandolapril
  • Trandolapril; Verapamil
  • Trastuzumab; Hyaluronidase
  • Trazodone
  • Treprostinil
  • Triamterene
  • Tromethamine
  • Valproic Acid, Divalproex Sodium
  • Vancomycin
  • Varicella-Zoster Virus Vaccine, Live
  • Verapamil
  • Verteporfin
  • Vilazodone
  • Vorapaxar
  • Vortioxetine
  • Warfarin
  • Zafirlukast
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