How do pravastatin and atorvastatin doses compare?
Pravastatin and atorvastatin are both statins but they are not directly interchangeable milligram-for-milligram because they differ in potency. In routine prescribing, many clinicians use guideline-style “equivalent intensity” (low, moderate, high) rather than a strict dose conversion.
What doses are typically used for “moderate-intensity” treatment?
Common moderate-intensity regimens include:
- Pravastatin: 40–80 mg once daily
- Atorvastatin: 10–20 mg once daily
What doses are typically used for “high-intensity” treatment?
Common high-intensity regimens include:
- Pravastatin: high-intensity regimens are generally not commonly used; pravastatin is usually considered lower potency than atorvastatin in practice
- Atorvastatin: 40–80 mg once daily
If you’re switching from pravastatin to atorvastatin, what should you do with the dose?
Because atorvastatin is typically more potent, switching from pravastatin often means moving to a lower milligram strength of atorvastatin for a similar lipid effect, based on the targeted intensity (moderate vs high) and the patient’s risk/LDL response. The safest approach is to select an atorvastatin starting dose consistent with the intended intensity and then recheck lipids after initiation or dose change.
How long until cholesterol levels change after changing the dose?
After starting or adjusting a statin dose, lipid effects are usually assessed after several weeks of steady therapy (commonly around 4 to 12 weeks) with repeat testing to confirm the expected LDL reduction.
What factors change the dose choice between the two drugs?
Clinicians often tailor statin dosing based on:
- LDL goal and cardiovascular risk
- Age
- Kidney function (more relevant to some statins than others)
- Drug interactions (important for atorvastatin)
- History of statin intolerance or muscle symptoms
Is there a “dose table” that’s exact?
There is no single universal, exact conversion table that is perfectly accurate for every patient because statin response varies and guideline recommendations are framed in intensity categories. If you share your current pravastatin dose and what you’re trying to achieve (moderate vs high intensity, or a specific LDL goal), I can help map it to a typical atorvastatin starting range to discuss with your clinician.