Posted by CCF Cardio MD-SGM on March 29, 1998 at 16:24:31:

In Reply to: Adverse reaction to Pravachol posted by Sandi on March 17, 1998 at 18:28:26:

: After some routine blood work, my doctor told me I had high cholesterol and suggested I try taking Pravachol to lower it. He left some samples at the front desk, with instructions to take one at night before going to bed.

I read over the literature provided with the sample. I guess I saw "thrombocytopenia" but I really didn't know what it meant.

After taking the medicine for several days, I noticed that I had some bruises, but couldn't remember injuring myself. However, since I work in a machine shop and am somewhat of a klutz, I thought I had just whacked myself and didn't remember.

However, it really got my attention when I scratched a mosquito bite and the next morning had a large bruise on the site. Upon closer inspection I found about a dozen bruises as large or larger than a silver dollar. Then I noticed that my legs were covered in little red dots. That was a Saturday morning. I didn't think a visit to the emergency room was warrented, since I was experiencing no pain or discomfort. I decided to call my Dr. on Mon. AM for an appointment.

He had me come in right away. My thrombocytes were only 6,000. It has taken 6 months, numerous CBC's, and what seems like a ton of prednisone but it seems I'm finally back to normal.

Except, regardless of trying to improve my diet, I still have high cholesterol. Needless to say, after this experience, I have a new respect for prescription meds.

Are there any cholesterol-lowering drugs that are less likely to cause adverse reactions? I also take Accupril for hypertension.

I sure wish that darned bottle had said in large red letters. "IF YOU START TO GET A LOT OF BRUISES, STOP TAKING THIS MEDICATION IMMEDIATELY AND CALL YOU DOCTOR." "May cause thrombocytopenia" doesn't mean much to the average patient.

Thrombocytopenia, a medical term that describes low platelet counts, has been reported as a rare complication of therapy with the "statin" class of cholesterol-lowering medications, including Pravachol, or pravastatin. This is quite rare, and a cursory review of the medical literature only revealed one case report describing this problem over the past seven years. It seems likely that your experience is related to the medication, but is not impossible that you were experiencing a condition known as ITP, or an auto-immune disease resulting in low platelet counts, and only incidentally began the Pravachol at the same time. In any case, I agree with you that the labelling is unclear and not helpful to the average patient. I'm glad that you have recovered from this situation.

Regarding the still-elevated cholesterol, there are many other classes of medications that might be used for therapy. I'd recommend that you avoid any drug in the "statin" class. Other possibilities include Niacin, which works quite well despite not-infrequent complaints of gastrointestinal upset and flushing, and the fibric acid derivatives which are well tolerated. A good diet low in total and saturated fats is always a prudent step.

Best of luck. Information in the Heart Forum is for general purposes only. Specific diagnoses and therapies can only be provided by your physician.