Meta Information
ID:pitavastatin
Name:
Schema Version:2.4_uniform_evidence_2026_06_18
Created
2026-05-25T18:50:05.062584+00:00
Model
claude-sonnet-4.6-wave15-stub-rebuild
Interactions
Target id:
/intervention/cyclosporine
Target name:
Cyclosporine
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Cyclosporine significantly increases pitavastatin exposure; combination is contraindicated.
Actionable advice:
This combination should be avoided; if unavoidable, it should be managed under specialist supervision with intensive monitoring.
Validation status:
validated_via_fda_label
Evidence tier:
tier_a
Evidence basis:
fda_label_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Pitavastatin Systemic Exposure Coadministered drug Dosage regimen Change in AUC* Change in C max * Cyclosporine
Label source:
FDA label: Pitavastatin (LIVALO)
Action type:
avoid
Target id:
/class/macrolide-antibiotics
Target name:
Erythromycin
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Erythromycin substantially increases pitavastatin AUC; combination is contraindicated.
Actionable advice:
This combination should be avoided; if unavoidable, it should be managed under specialist supervision with intensive monitoring.
Validation status:
validated_via_fda_label
Evidence tier:
tier_a
Evidence basis:
fda_label_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
There are pitavastatin dosage restrictions for patients taking erythromycin or rifampin [see Dosage and Administration (2.4) ] .
Label source:
FDA label: Pitavastatin (LIVALO)
Action type:
avoid
Target id:
/intervention/rifampin
Target name:
Rifampin
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Rifampin increases pitavastatin exposure via OATP1B1 inhibition; reduce pitavastatin dose.
Actionable advice:
This is best used with caution, and it is a good idea to monitor for clinical effect; dose adjustment or monitoring may be required.
Validation status:
validated_via_fda_label
Evidence tier:
tier_a
Evidence basis:
fda_label_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Intervention: In patients taking rifampin, do not exceed pitavastatin 2 mg once daily [see Dosage and Administration (2.4) ].
Label source:
FDA label: Pitavastatin (LIVALO)
Action type:
adjust_with_prescriber
Target id:
/intervention/gemfibrozil
Target name:
Gemfibrozil/Fibrates
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Risk of myopathy and rhabdomyolysis increases when statins are combined with fibrates.
Actionable advice:
This combination should be avoided; if unavoidable, it should be managed under specialist supervision with intensive monitoring.
Validation status:
validated_via_fda_label
Evidence tier:
tier_a
Evidence basis:
fda_label_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Gemfibrozil Clinical Impact: Gemfibrozil may cause myopathy when given alone.
Label source:
FDA label: Pitavastatin (LIVALO)
Action type:
avoid
Target id:
/intervention/niacin
Target name:
Niacin (Lipid-Modifying Doses)
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Risk of skeletal muscle effects may be increased with lipid-modifying doses of niacin.
Actionable advice:
This is best used with caution, and it is a good idea to monitor for clinical effect; dose adjustment or monitoring may be required.
Validation status:
validated_via_fda_label
Evidence tier:
tier_a
Evidence basis:
fda_label_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
thy and rhabdomyolysis may be increased with concomitant use of lipid-modifying doses (≥1 g/day) of niacin with pitavastatin.
Label source:
FDA label: Pitavastatin (LIVALO)
Action type:
adjust_with_prescriber
Target id:
/adverse/myopathy-rhabdomyolysis
Target name:
Myopathy / Rhabdomyolysis
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Statin-associated myopathy with possible progression to rhabdomyolysis; risk is dose-related.
Actionable advice:
Unexplained muscle pain, tenderness, weakness, or dark urine should be reported immediately; this may require CK measurement and drug discontinuation.
Validation status:
validated_via_fda_label
Evidence tier:
tier_a
Evidence basis:
fda_label_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Inform patients of the risk of myopathy and rhabdomyolysis when starting or increasing the pitavastatin dosage.
Label source:
FDA label: Pitavastatin (LIVALO)
Action type:
monitor
Target id:
/adverse/hepatotoxicity
Target name:
Hepatic Effects
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Increases in serum transaminases (3x ULN or greater) reported with pitavastatin therapy.
Actionable advice:
Liver enzymes should be monitored per label, and it is worth reporting jaundice, dark urine, or persistent fatigue.
Validation status:
validated_via_fda_label
Evidence tier:
tier_a
Evidence basis:
fda_label_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Rare reports of fatal and non-fatal hepatic failure have occurred.
Label source:
FDA label: Pitavastatin (LIVALO)
Action type:
monitor
Target id:
/condition/pregnancy
Target name:
Pregnancy
Severity:
major
Interaction type:
contraindication
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Statins should generally not be used in pregnancy; discontinue when pregnancy is recognized.
Actionable advice:
Use should be avoided during pregnancy unless the benefit clearly outweighs the risk, and it is worth discussing with a prescriber.
Validation status:
validated_via_fda_label
Evidence tier:
tier_a
Evidence basis:
fda_label_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
( 2.4 , 7 ) 8 USE IN SPECIFIC POPULATIONS • Pregnancy : May cause fetal harm.
Label source:
FDA label: Pitavastatin (LIVALO)
Action type:
avoid
Target id:
/condition/lactation
Target name:
Lactation
Severity:
major
Interaction type:
contraindication
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Use of statins during breastfeeding is not recommended.
Actionable advice:
Not recommended while breastfeeding. If you are nursing, do not start pitavastatin without your prescriber arranging an alternative or advising you to stop nursing.
Validation status:
validated_via_fda_label
Evidence tier:
tier_a
Evidence basis:
fda_label_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
( 8.1 ) • Lactation : Breastfeeding not recommended during treatment with pitavastatin.
Label source:
FDA label: Pitavastatin (LIVALO)
Action type:
avoid
Target id:
/dietary/grapefruit
Target name:
Grapefruit Juice
Severity:
minor
Interaction type:
pharmacokinetic
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Grapefruit juice has minimal effect on pitavastatin compared with other statins.
Actionable advice:
Grapefruit and grapefruit juice are best avoided while on this medication.
Validation status:
validated_via_fda_label
Evidence tier:
tier_a
Evidence basis:
fda_label_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Pitavastatin 4 mg QD on Days 1 to 5 and 11 to 15 and diltiazem LA 240 mg on Days 6 to 15 ↑10% ↑15% Grapefruit
Label source:
FDA label: Pitavastatin (LIVALO)
Action type:
avoid
Target id:
/class/cns-depressants
Target name:
CNS Depressants
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
General caution when combined with other active therapeutic agents.
Actionable advice:
It is important to talk to a physician before combining this with other medications.
Validation status:
unvalidatable
Evidence tier:
tier_e
Evidence basis:
unvalidatable
Evidence anchors:
Source url:
Scientific literature support not found
Exact phrase from label:
Label source:
Generic placeholder row: the text is non-specific ('general caution') and there is no established CNS-depressant interaction for this agent. No validatable interaction claim - marked unvalidatable (candidate for removal).
Action type:
informational_none