Livalo (Pitavastatin)

Livalo (pitavastatin) is a prescription medication that helps lower LDL cholesterol alongside a balanced diet. Livalo is a type of statin that works by reducing how much cholesterol the liver makes. As a result, it helps the liver remove more LDL cholesterol from the blood. Livalo is used in adults with high cholesterol and in adults and children age 8 and older with heterozygous familial hypercholesterolemia (HeFH), an inherited condition that causes high cholesterol.

Directions

Take Livalo by mouth once per day, with or without food, at about the same time each day.

The usual dose is 2 mg to 4 mg once daily, and the highest recommended dose is 4 mg once daily.

If you have moderate or severe kidney problems or are on hemodialysis, your dose may start at 1 mg once daily, with a maximum dose of 2 mg once daily.

Your healthcare provider may check your cholesterol with a blood test about 4 weeks after you start Livalo or after a dose change.

Swallow the tablet whole.

Take Livalo exactly as prescribed, and do not stop taking it without talking to your healthcare provider.

Healthy lifestyle habits, such as eating a heart-healthy diet, exercising, and managing weight, are also important.

Ingredients

The active ingredient in Livalo is pitavastatin. The inactive ingredients may include hypromellose, lactose monohydrate, low-substituted hydroxypropyl cellulose, magnesium aluminometasilicate, and magnesium stearate.

Cautions

Before using this medication, you may want to consult a healthcare provider about the following:

Contraindications

Avoid taking or using this medication if any of the following apply:

• The use of cyclosporine. Taking Livalo with cyclosporine can increase blood levels of pitavastatin and the risk of muscle damage.
• Active liver failure or decompensated cirrhosis.
• A known allergy or hypersensitivity to pitavastatin or to any of the inactive ingredients in Livalo.

• Any existing health conditions
• Any allergies
• A list of all medications currently being taken

Livalo may cause muscle problems, including myopathy and a more severe form called rhabdomyolysis, in which muscle tissue breaks down and damages the kidneys. The risk is higher in people aged 65 and older, those with untreated low thyroid (hypothyroidism), people with kidney problems, those taking certain other medicines, and at higher Livalo doses.

A rare autoimmune muscle problem called immune-mediated necrotizing myopathy (IMNM) has been reported with statins. It causes persistent muscle weakness and elevated creatine kinase that don’t improve when the statin is stopped.

Livalo can affect the liver. Mild increases in liver enzymes can happen, and rare cases of fatal or serious liver failure have been reported. Liver enzyme tests are often checked before starting Livalo and as needed after that.

Livalo has important drug interactions beyond cyclosporine. Erythromycin, rifampin, niacin, and fibrate medications such as gemfibrozil can change pitavastatin levels or increase the risk of muscle injury.

People with kidney problems often need a lower starting and maximum dose of Livalo. Tell your provider about any kidney disease, especially if you’re on dialysis.

Use during pregnancy may cause harm to an unborn baby and is generally avoided. Breastfeeding is not recommended while taking Livalo.

Heavy alcohol use can increase the risk of liver problems on a statin. Tell your provider about how much alcohol you drink so they can give appropriate guidance.

Statins, including Livalo, may increase blood sugar levels and the risk of being diagnosed with type 2 diabetes.

Side Effects

Common side effects of Livalo include:

• Muscle aches or pain
• Back pain
• Pain in the arms or legs
• Constipation
• Diarrhea
• Headache
• Mild rise in liver enzymes on blood tests

Get medical help for any signs of a serious allergic reaction such as swelling of the face, lips, tongue, or throat, trouble breathing, or a severe rash.

Stop Livalo and contact your healthcare provider if you notice unexplained muscle pain, tenderness, weakness (especially if you also have fever or unusual tiredness), dark or cola-colored urine, or a decrease in urine output.

Other serious problems include liver injury with yellowing of the skin or eyes, nausea, or upper-right abdominal pain.

References

• Livalo Highlights of Prescribing Information. Montgomery, AL: Kowa Pharmaceuticals America, Inc.; 2024.
• Livalo Drug Label Information. Montgomery, AL: Kowa Pharmaceuticals America, Inc.; 2026.