Is Pravastatin Safe to Take with Myrbetriq?
Yes, pravastatin can be safely taken with Myrbetriq (mirabegron) as there are no known clinically significant drug-drug interactions between these medications.
Why This Combination Is Safe
Pravastatin has a favorable drug interaction profile compared to other statins because:
- Pravastatin is not primarily metabolized by CYP3A4 enzymes, which are responsible for most statin drug interactions 1
- Pravastatin is a hydrophilic (water-soluble) statin with minimal metabolism through cytochrome P450 pathways 2
- Non-CYP metabolized statins like pravastatin generally have fewer drug interactions compared to lipophilic statins such as simvastatin, lovastatin, or atorvastatin 2
Mirabegron's Interaction Profile
Mirabegron (Myrbetriq) is a beta-3 adrenergic agonist used for overactive bladder. While mirabegron is a moderate CYP2D6 inhibitor and has some effects on CYP3A4, pravastatin's metabolism does not rely on these pathways, making this combination low-risk.
Pravastatin's Safety Record with Multiple Medications
The evidence demonstrates pravastatin's compatibility with various cardiovascular medications:
- Pravastatin can be safely combined with amiodarone without dose restrictions, unlike simvastatin which requires dose limitation 1
- Pravastatin is reasonable to use with ranolazine, digoxin, and warfarin 1
- Pravastatin is well-tolerated in elderly patients and those with diabetes 3, 4
Important Monitoring Considerations
While the combination is safe, standard statin monitoring applies:
- Evaluate muscle symptoms at baseline, 6-12 weeks after starting, and at each follow-up visit 2
- Obtain creatine kinase (CK) only if muscle pain, tenderness, weakness, or dark urine develops 2
- Monitor liver function tests (ALT/AST) at 12 weeks, then annually 2
- Instruct patients to immediately report muscle symptoms 2
Clinical Bottom Line
Pravastatin and Myrbetriq can be prescribed together without dose adjustments or special precautions beyond routine statin monitoring. This combination does not carry the elevated myopathy risk seen with CYP3A4-metabolized statins when combined with interacting medications 1, 2.