THE PHARMACOKINETICS OF PRAVASTATIN IN PATIENTS ON CHRONIC-HEMODIALYSIS

Objective: The single-dose and steady-state pharmacokinetics of the HM G CoA reductase inhibitor pravastatin and its two metabolites, SQ 31 9 06 and SQ 31 945, were evaluated in 12 hemodialysis patients. A single 20-mg i.v. dose was employed, followed by daily oral dosing of 20 mg over four hemodialysis intervals. Results: No statistical differences in the pharmacokinetics of pravastatin or-SQ 31 906 were evident when comparing the first and last days of oral dosing with pravastatin. The pharmacokinetic parameters of pravastatin and SQ 31 906 were similar to those of healthy volunteers. SQ 31 945, the inactive polar metaboli te, did accumulate in dialysis patients, as evidenced by an accumulati on index of 1.7 +/- 1.0. Although metabolic clearance is the predomina nt mode of elimination of pravastatin, hemodialysis clearances of prav astatin, SQ 31 906 and SQ 31 945 will contribute to total body clearan ce since dialytic clearance ranged from 40 to 80 ml . min(-1). Conclus ion: Pravastatin can be safely administered in the usual dosages to su bjects with renal failure on hemodialysis and no change in dosing is n ecessary.