This page shows what was measured, who it was measured in, and what that does not settle.
What Pitavastatin does in the body
Pitavastatin blocks the liver enzyme that makes cholesterol, so the liver cell puts out more receptors and pulls LDL particles from the blood.
What makes it unusual is how the body disposes of it: instead of being burned by the cytochrome enzymes that handle almost every other statin, it is tagged with a sugar molecule and excreted. That single difference means it barely interacts with the antivirals, antifungals and antibiotics that constrain the rest of the class, which is why it ended up being the statin tested in people living with HIV.
Why people take it. High cholesterol
What happened in people
LDL cholesterol reduced 45% by pitavastatin 4 mg against 44% by atorvastatin 20 mg over 12 weeks (Study 301)
✎ Source-linked record
Where this came from
A person wrote this into the record with the study named beside it. No reviewer has signed it off.
The recorded finding that sits closest to something a person would notice. Written into the record, not signed off, and it carries no population or interval.
REPRIEVE registration record on ClinicalTrials.gov (NCT02344290) · a recorded source, not a stored snapshot
LIVALO (pitavastatin) United States prescribing information — Indications 1, Contraindications 4, Warnings and Precautions 5.1 to 5.3, Drug Interactions 7, C… · a recorded source, not a stored snapshot
The limit that matters most
That pitavastatin is glycaemically neutral — absent from the label and contradicted by the REPRIEVE diabetes counts
Where it acts
Hepatocyte cytoplasm — entered through OATP transporters and cleared by glucuronidation rather than by the cytochrome P450 system
Kind of result
A number that stands in for health
Supervision
RNAWiki has not recorded a supervision or regulatory status for this substance.
What the registries record it as
The substance registry classes this as chemical.
FDA substance registry · IYD54XEG3W · read 2026-08-29
Where each sentence above came from
A person wrote this explanation into the record, with the studies named in the path below.
The recorded use, written for a reader without medical training. Not signed off.
A limit recorded against this substance. Not signed off as a reviewed claim.
The four opening statements run to 113 words.
Words this page uses
Four words worth knowing first
Chosen from what this page shows, with each one explained before the word it depends on.
Stand-in result
A stand-in result is a number measured because the real result takes too long.
A picture of it, and where the picture fails
It is like judging a journey by the speedometer rather than by arriving.
Where that stops being true. Speed does predict arrival. Many stand-in results do not predict the real one.
What people get wrong. A stand-in result is often reported as the result itself.
A surrogate endpoint substituted for a clinical endpoint, valid only where the substitution has been shown to hold.
Randomisation
Randomisation means chance decides who gets which treatment.
A picture of it, and where the picture fails
It is like a coin toss deciding the groups.
Where that stops being true. A coin toss is fair once. Fairness here comes from doing it for everyone.
What people get wrong. It is thought to make groups identical. It makes them similar on average, including on things nobody measured.
Allocation of participants to arms by a chance process, so that unmeasured factors are balanced in expectation.
Confidence interval
A confidence interval is the range the true answer is likely to sit in.
A picture of it, and where the picture fails
It is like a weather forecast giving a range rather than one number.
Where that stops being true. A forecast range covers tomorrow. This one covers what the study could resolve.
What people get wrong. The middle number is read as the answer. A range crossing zero means no change is still possible.
An interval estimate that would contain the true parameter in a stated proportion of repeated studies.
Pathway
A pathway is a chain of steps inside a cell, each one setting off the next.
A picture of it, and where the picture fails
A pathway is like a row of dominoes.
Where that stops being true. Dominoes fall one way. Pathways loop back and can switch themselves off.
What people get wrong. Changing one step is read as changing the outcome. Other steps often absorb it.
An ordered series of molecular interactions producing a defined cellular change.
What happened in people◇Read from sources, not yet reviewed
What was measured, goal by goal
One row for each goal a registered study measured something for. One column for each kind of thing that could be measured.
Registered studies list 33 outcome measures that RNAWiki could read. A registered study says what someone planned to measure. It does not say what they found. 0 of the matched studies tested this substance, and 0 posted a result.
There is no single score. A strong test result and a weak life result are different facts.
Goals down the side, kinds of measurement across the top. Each cell says what kind of thing was registered, not what was found.
Goal
Life outcome
What a body can do
How a person feels
A test result
A step in the body
Harms
How long
Who was studied
Cholesterol
∅Nothing in the sources checkedNo registered study lists a life outcome for this goal.
∅Nothing in the sources checkedNo registered study lists a performance measure for this goal.
∅Nothing in the sources checkedNo registered study lists a symptom measure for this goal.
△Only a number moved11 registered test measure.
∅Nothing in the sources checkedNo registered study lists a body-step measure for this goal.
—Not recordedHarms were not a registered measure for this goal.
—Not recordedNo finished study window is recorded.
…Waiting for a reviewerWho was studied is listed further down the page.
Healthy ageing
…Waiting for a reviewer2 registered study measure of this kind. No reviewed result yet.
∅Nothing in the sources checkedNo registered study lists a performance measure for this goal.
∅Nothing in the sources checkedNo registered study lists a symptom measure for this goal.
∅Nothing in the sources checkedNo registered study lists a test result for this goal.
∅Nothing in the sources checkedNo registered study lists a body-step measure for this goal.
—Not recordedHarms were not a registered measure for this goal.
—Not recordedNo finished study window is recorded.
…Waiting for a reviewerWho was studied is listed further down the page.
Blood sugar
∅Nothing in the sources checkedNo registered study lists a life outcome for this goal.
∅Nothing in the sources checkedNo registered study lists a performance measure for this goal.
∅Nothing in the sources checkedNo registered study lists a symptom measure for this goal.
△Only a number moved1 registered test measure.
∅Nothing in the sources checkedNo registered study lists a body-step measure for this goal.
—Not recordedHarms were not a registered measure for this goal.
—Not recordedNo finished study window is recorded.
…Waiting for a reviewerWho was studied is listed further down the page.
Which registered measures put each goal on this table
Cholesterol
low density lipoprotein cholesterol at week 12; ldl c; low density lipoprotein cholesterol; low density lipoprotein cholesterol at 12 weeks; attaining ncep ldl c target at week 16; attaining ncep ldl c target at week 44; ncep ldl c target attainment; achieving ldl c 100mg
Healthy ageing
all cause mortality; all cause mortality non fatal mi repeat re vascularization
Blood sugar
insulin stimulated glucose uptake
Sorted by fixed word lists, version v1. A name the rules do not recognise stays unsorted rather than moving to the nearest column.
What each mark on this table means
∅ Nothing in the sources checked
No registered study lists a life outcome for this goal.
△ Only a number moved
11 registered test measure.
— Not recorded
Harms were not a registered measure for this goal.
… Waiting for a reviewer
Who was studied is listed further down the page.
What happened in people◇Read from sources, not yet reviewed
What happened in people
Each card is one study: the exact question it asked, who was in it, and whether it showed what it set out to show.
Composite of cardiovascular death, myocardial infarction, hospitalisation for unstable angina, stroke, transient ischaemic attack, peripheral arterial ischaemia, revascularisation or death from an undetermined cause, in people with HIV on antiretroviral therapy at low to moderate cardiovascular risk
✓ The study showed what it set out to show
Who was studied
REPRIEVE (N Engl J Med 2023;389:687-699; NCT02344290)
4.81 against 7.32 events per 1,000 person-years; hazard ratio 0.65 (95% CI 0.48 to 0.90), p=0.002, over a median 5.1 years, with the trial stopped early for efficacy
Repeated elsewhere
Unreplicated
What this does not prove. Meeting one endpoint in one population does not carry to other goals or other people.
The limits of this study, and where it came from
Main limit. Diabetes mellitus occurred in 206 participants (5.3%) on pitavastatin against 155 (4.0%) on placebo, and muscle-related symptoms in 91 (2.3%) against 53 (1.4%). Stopping early for efficacy tends to overstate effect size. The population was entirely people with HIV on antiretroviral therapy, so the result does not transfer automatically to HIV-negative people at the same conventional risk score.
How far it carries. This study is recorded from the curated record, not from the registry match.
Form and route. Oral tablet at 1, 2 and 4 mg once daily, as pitavastatin calcium (Livalo) or magnesium (Zypitamag)
Interval reported. 95% CI 0
Written into the record, not signed off as a reviewed claim.
REPRIEVE registration record on ClinicalTrials.gov (NCT02344290) · a recorded source, not a stored snapshot
LIVALO (pitavastatin) United States prescribing information — Indications 1, Contraindications 4, Warnings and Precautions 5.1 to 5.3, Drug Interactions 7, C… · a recorded source, not a stored snapshot
Mean percentage change in LDL cholesterol from baseline at week 12, pitavastatin against atorvastatin, with non-inferiority declared if the 95% CI lower bound exceeded −6%
✓ The study showed what it set out to show
Who was studied
LIVALO Study 301 — active-controlled comparison with atorvastatin (NDA 022363)
Pitavastatin 2 mg against atorvastatin 10 mg: mean treatment difference 0% (95% CI −3% to 3%). Pitavastatin 4 mg against atorvastatin 20 mg: 1% (−2% to 4%). LDL reductions −38% and −45% against −38% and −44%
Repeated elsewhere
Replicated
What this does not prove. Meeting one endpoint in one population does not carry to other goals or other people.
The limits of this study, and where it came from
Main limit. This is a 12-week lipid study and measured no clinical event of any kind. Non-inferiority on a surrogate against a comparator that costs a fortieth as much is a commercially useful result and a clinically neutral one.
How far it carries. This study is recorded from the curated record, not from the registry match.
Form and route. Oral tablet at 1, 2 and 4 mg once daily, as pitavastatin calcium (Livalo) or magnesium (Zypitamag)
Interval reported. 95% CI −3% to 3%)
Written into the record, not signed off as a reviewed claim.
REPRIEVE registration record on ClinicalTrials.gov (NCT02344290) · a recorded source, not a stored snapshot
LIVALO (pitavastatin) United States prescribing information — Indications 1, Contraindications 4, Warnings and Precautions 5.1 to 5.3, Drug Interactions 7, C… · a recorded source, not a stored snapshot
RNAWiki holds 2 written-up human studies for this substance, each with the question it asked.
How we know it
Each card names the study, the number of people and what the study set out to measure.
What this does not prove
These summaries were written by a person and have not been signed off as reviewed claims.
Why it matters
A study that failed is as informative as one that worked, and both are here.
What we still do not know
No reviewed claim exists, so no exact population, effect size or interval is published yet.
What happened in people◇Read from sources, not yet reviewed
How close this is to real life
The top step is something a person would feel or care about. The bottom is a guess from software. Filled steps are where evidence exists for this substance.
■Living longer, or avoiding a major eventEvidence recorded. Death, a heart attack, a stroke, a hospital stay.2 registered measures of this kind. No reviewed result.
□What a body can do day to dayNo evidence recorded. Walking, dressing, breathing, recovering.No registered study measures this.
□Measured performanceNo evidence recorded. How much was lifted, how far was run, how fast.No registered study measures this.
□Symptoms and quality of lifeNo evidence recorded. Pain, tiredness, mood, sleep, as the person rated it.No registered study measures this.
■A number that stands in for healthEvidence recorded. Cholesterol, blood sugar, bone density. A stand-in, not the thing itself.16 registered measures of this kind.
■A step measured inside a personEvidence recorded. Something measured in human tissue or human cells.A human record sits on the stored organism ladder.
■AnimalsEvidence recorded. Mice, rats, dogs. Useful for ideas, not proof about people.Stored records in Mouse, Rat. A result in animals says what to test next. It does not say what happens in people.
■Cells in a dishEvidence recorded. Cells or chemistry on a bench, far from a whole body.Stored mechanism abstracts describe steps measured in cells or tissue.
□A guess from softwareNo evidence recorded. Nobody measured it. RNAWiki never publishes one as a finding.RNAWiki stores no prediction for this record. Software can suggest a link. RNAWiki does not publish one as a finding.
Higher on these steps means closer to something a person would feel. It does not mean better done.
What it changes in the body◇Read from sources, not yet reviewed
The path through the body
From what a person takes to what changes. A solid line is a step measured in people. A dashed line is a step nobody has measured that way.
Start
Pitavastatin
What a person takes: Oral tablet at 1, 2 and 4 mg once daily, as pitavastatin calcium (Livalo) or magnesium (Zypitamag).
The measurement behind this step
Peak plasma concentration is reached about one hour after dosing and exposure rises approximately dose-proportionally from 1 mg to 24 mg. Absolute bioavailability of the oral solution is 51%. Absorption occurs in the small intestine and very little in the colon. A high-fat meal reduces peak concentration by 43%. Peak concentration and total exposure did not differ between evening and morning administration, although the LDL reduction after evening dosing was slightly greater in healthy volunteers on 4 mg. Metabolism is by glucuronidation through UGT1A3 and UGT2B7 with subsequent lactone formation; the lactone is the major plasma metabolite. About 79% of a dose is excreted in faeces and 15% in urine within seven days, with a mean plasma half-life of about 12 hours. Exposure is 10% higher in peak and 30% higher in area under the curve in people aged 65 and over.
Getting in
A synthetic quinoline, given already active
No mould was involved and no activation is needed. The molecule that blocks the enzyme is the one in the tablet, delivered as a calcium or magnesium salt.
──Measured in people. Written by a person from the study named beside the step. Not signed off as a reviewed claim.
The measurement behind this step
A 2-cyclopropyl-4-(4-fluorophenyl)quinoline linked by an E-vinyl bridge to a 3,5-dihydroxyheptenoic acid. Peak plasma concentration comes at about one hour; absolute bioavailability of the oral solution is 51%. A high-fat meal reduces peak concentration by 43%.
REPRIEVE registration record on ClinicalTrials.gov (NCT02344290) · a recorded source, not a stored snapshot
LIVALO (pitavastatin) United States prescribing information — Indications 1, Contraindications 4, Warnings and Precautions 5.1 to 5.3, Drug Interactions 7, C… · a recorded source, not a stored snapshot
Reaching the cell
Carried into the liver, not burned by cytochromes
It enters liver cells through a transporter and leaves the body tagged with a sugar molecule, bypassing the enzyme system that constrains every other statin.
╌╌Described, with no measurement named. No measurement is named for this step, so it is drawn as an unconfirmed link.
The measurement behind this step
Hepatic uptake is transporter-mediated. The label states the principal metabolic route is glucuronidation by UGT1A3 and UGT2B7 with subsequent lactone formation, with only minimal cytochrome P450 involvement — marginal CYP2C9 and lesser CYP2C8. About 79% of a dose leaves in faeces, 15% in urine; half-life is about 12 hours.
REPRIEVE registration record on ClinicalTrials.gov (NCT02344290) · a recorded source, not a stored snapshot
LIVALO (pitavastatin) United States prescribing information — Indications 1, Contraindications 4, Warnings and Precautions 5.1 to 5.3, Drug Interactions 7, C… · a recorded source, not a stored snapshot
What it acts on
It blocks the rate-limiting enzyme
Inside the cell it occupies the site the enzyme needs to build cholesterol, and the pathway stalls.
╌╌Described, with no measurement named. No measurement is named for this step, so it is drawn as an unconfirmed link.
The measurement behind this step
Inhibition of HMG-CoA reductase, the enzyme catalysing conversion of HMG-CoA to mevalonate, the rate-limiting step in cholesterol biosynthesis.
REPRIEVE registration record on ClinicalTrials.gov (NCT02344290) · a recorded source, not a stored snapshot
LIVALO (pitavastatin) United States prescribing information — Indications 1, Contraindications 4, Warnings and Precautions 5.1 to 5.3, Drug Interactions 7, C… · a recorded source, not a stored snapshot
The change it makes
LDL receptors rise and cholesterol falls
The liver responds by making more receptors and clearing LDL out of the blood. Four milligrams does what twenty milligrams of atorvastatin does.
╌╌Described, with no measurement named. No measurement is named for this step, so it is drawn as an unconfirmed link.
The measurement behind this step
The label states that expression of LDL receptors is accelerated, followed by uptake of LDL from blood to liver, and that sustained inhibition also decreases VLDL. Study 301: LDL −45% on pitavastatin 4 mg against −44% on atorvastatin 20 mg, mean treatment difference 1% (95% CI −2% to 4%).
REPRIEVE registration record on ClinicalTrials.gov (NCT02344290) · a recorded source, not a stored snapshot
LIVALO (pitavastatin) United States prescribing information — Indications 1, Contraindications 4, Warnings and Precautions 5.1 to 5.3, Drug Interactions 7, C… · a recorded source, not a stored snapshot
What that does for a person
In people living with HIV, a third fewer cardiovascular events
The one outcome trial ran in nearly eight thousand people with HIV and was stopped early because the benefit was clear.
──Measured in people. Written by a person from the study named beside the step. Not signed off as a reviewed claim.
The measurement behind this step
REPRIEVE: major adverse cardiovascular events 4.81 against 7.32 per 1,000 person-years, hazard ratio 0.65 (95% CI 0.48 to 0.90), p=0.002, over a median 5.1 years in 7,769 participants at low to moderate conventional risk.
REPRIEVE registration record on ClinicalTrials.gov (NCT02344290) · a recorded source, not a stored snapshot
LIVALO (pitavastatin) United States prescribing information — Indications 1, Contraindications 4, Warnings and Precautions 5.1 to 5.3, Drug Interactions 7, C… · a recorded source, not a stored snapshot
What that does for a person
And more diabetes, in the same trial
The drug is often described as the statin that spares blood sugar. In that trial, more people on it developed diabetes than on placebo.
╌╌Described, with no measurement named. No measurement is named for this step, so it is drawn as an unconfirmed link.
The measurement behind this step
REPRIEVE: diabetes mellitus in 206 (5.3%) against 155 (4.0%); muscle-related symptoms in 91 (2.3%) against 53 (1.4%). The label carries the class warning that increases in HbA1c and fasting serum glucose have been reported with statins including this one, and makes no neutrality claim.
REPRIEVE registration record on ClinicalTrials.gov (NCT02344290) · a recorded source, not a stored snapshot
LIVALO (pitavastatin) United States prescribing information — Indications 1, Contraindications 4, Warnings and Precautions 5.1 to 5.3, Drug Interactions 7, C… · a recorded source, not a stored snapshot
No suggested links are held for this record, so nothing is hidden from this path.
What we know
The record describes 6 steps from taking it to an effect in a person.
How we know it
Each step names the study behind it in the technical detail beside it.
What this does not prove
A change inside the body is a reason to look. It is not a result in a person.
Why it matters
A reader can see exactly where the chain stops being measured in people.
What we still do not know
No reviewed claim binds any of these steps to a named population.
What it would be like to take◇Read from sources, not yet reviewed
Felt, measured, or meaningful
Three different things that get called the same word. Registered studies measured all three, and mixing them is how a blood test becomes a health claim.
Felt
Things a person could notice without a test.
No registered study measured anything of this kind.
Measured
Things only a test, a scale or a device shows.
low density lipoprotein cholesterol at week 12
ldl c
low density lipoprotein cholesterol
low density lipoprotein cholesterol at 12 weeks
attaining ncep ldl c target at week 16
attaining ncep ldl c target at week 44
ncep ldl c target attainment
achieving ldl c 100mg
low density lipoprotein cholesterol from baseline to week 12
changes in plasma coq10 levels
and 6 more.
Meaningful
Things that change how a life goes, not only a number.
all cause mortality
all cause mortality non fatal mi repeat re vascularization
A registered study says what someone planned to measure. It does not say what they found. A number moving is not the same as a life going better. The two are shown apart here.
Felt, but not shown to help. A person notices a change. No study showed it leads anywhere good.
Measured, but not felt. A number moves. The person notices nothing. Both can be true.
Measured, but not shown to matter. A number moves in the good direction. Nobody showed that lives went better.
Matters, but takes years. The result that counts may take longer than anyone would keep watching.
Names that fit none of the three (15)
plaque volume
pharmacokinetics of oral midazolam
area under the curve from time 0 to tau
whose alt levels were over ctcae grade ii after treatment
safety
assessment of platelet reaction
incidence of contrast induced nephropathy
liver fat
complete response rate
clinical response rate
statin use on secondary prevention
statin use on primary prevention
incidence and severity of adverse events
recommended phase ii dose
adverse events
These are harms, study-process measures, or names the rules did not recognise. They are shown rather than dropped.
What it would be like to take◇Read from sources, not yet reviewed
How long anything takes
Nine different lengths of time that get confused with each other. None of them is worked out from another.
Before anything is noticed.RNAWiki does not store this separately, and never works it out from another figure on this page.
Before a test result moves.RNAWiki does not store this separately, and never works it out from another figure on this page.
Before performance moves.RNAWiki does not store this separately, and never works it out from another figure on this page.
How long the result was watched.No finished study window is recorded for a study that tested this substance.
How long people took it.How long people actually took it is not stored. The study window is not the same thing.
How long people were followed.Follow-up length is not stored separately. It is never read off the study window, which would be a different thing.
How fast the body clears it. 12 hours hours
Read from the label, which states: “The mean plasma elimination half-life is approximately 12 hours.”
How long effects linger.RNAWiki does not store this separately, and never works it out from another figure on this page.
Beyond the studies. Nothing is recorded about the long term.
The longest finished study sets the edge of what anyone measured.
A study window is not how long people took it, and neither is how long they were followed. Where RNAWiki holds only one of the three, it shows one.
What is missing or unclear◇Read from sources, not yet reviewed
Were people like you studied?
RNAWiki cannot tell whether a study fits you. It can show who was in it, and where the result stops carrying.
Who was studied
People similar to this profile were included.
Adults with high cholesterol, children from age eight with familial hypercholesterolaemia, and — increasingly — people living with HIV, because it is the statin least likely to collide with antiretroviral therapy.
Who is missing from the studies
Which groups were under-represented in the studies has not been recorded for this substance. Pregnancy, breastfeeding, children, older adults, and people with liver or kidney conditions are commonly excluded from trials; nothing here says whether they were.
What the label states about particular groups
On pediatric, the label states: “The safety and effectiveness of pitavastatin have not been established in pediatric patients younger than 8 years of age with heterozygous familial hypercholesterolemia (HeFH) or in pediatric patients with other types of hyperlipidemia (other than HeFH).”
US prescribing information · a52401eb-a822-475b-a40d-7b8acde2ae1a · read 2026-08-30
On older people, the label states: “In controlled clinical studies, 1,209 (43%) patients were 65 years and older.”
US prescribing information · a52401eb-a822-475b-a40d-7b8acde2ae1a · read 2026-08-30
On people who are pregnant, the label states: “Risk Summary Discontinue pitavastatin when pregnancy is recognized.”
US prescribing information · a52401eb-a822-475b-a40d-7b8acde2ae1a · read 2026-08-30
On people who are breastfeeding, the label states: “Risk Summary There is no available information about the prescence of pitavastatin in human or animal milk, the effects of the drug on the breastfed infant, or the effects of the drug on milk production.”
US prescribing information · a52401eb-a822-475b-a40d-7b8acde2ae1a · read 2026-08-30
On people with reduced liver function, the label states: “Pitavastatin is contraindicated in patients with active liver failure or decompensated cirrhosis [see Contraindications (4) , Warnings and Precautions (5.3) ] .”
US prescribing information · a52401eb-a822-475b-a40d-7b8acde2ae1a · read 2026-08-30
On people with reduced kidney function, the label states: “is a risk factor for myopathy and rhabdomyolysis.”
US prescribing information · a52401eb-a822-475b-a40d-7b8acde2ae1a · read 2026-08-30
Where the result stopped carrying
The glycaemic-neutrality proposition, which the drug’s largest randomised trial did not support
The absence of any cardiovascular claim in the United States indication despite a positive outcome trial
Freedom from cytochrome metabolism did not buy freedom from interactions: ciclosporin remains an outright contraindication and erythromycin and rifampin impose hard dose caps
This is a scope explorer, not a diagnosis engine.
It shows who was studied so you can see whether people similar to you were included.
RNAWiki cannot tell whether a study fits you. It can show who was in it.
What it would be like to take◇Read from sources, not yet reviewed
Why it might seem to do nothing
A real effect and a noticed effect are different things. These are the recorded reasons the two come apart.
It was studied for a different goal
The studies measured something else entirely.
On this record: Some registered studies measured things that match no goal on this page.
It was studied in different people
The people in the studies were not much like the reader.
On this record: Which groups were under-represented in the studies has not been recorded for this substance. Pregnancy, breastfeeding, children, older adults, and people with liver or kidney conditions are commonly excluded from trials; nothing here says whether they were.
The evidence may simply be wrong
Small early studies often do not hold up.
On this record: RNAWiki has not yet published a reviewed conclusion for this use.
Other reasons RNAWiki checked and found nothing for (10)
A different form was studied
The studied form is not the form on the shelf. Nothing in this record points to this reason.
There was nothing to correct
Where a level is already normal, topping it up may change nothing. Nothing in this record points to this reason.
Something else had to happen too
In the studies it was paired with training, a diet or another treatment. Nothing in this record points to this reason.
The change is too small to feel
A real change can still sit below what a person notices. Nothing in this record points to this reason.
Day-to-day swing hides it
Sleep, food, stress and time of day move most numbers more than this would. Nothing in this record points to this reason.
Not enough time yet
The studies ran longer than the person has waited. Nothing in this record points to this reason.
It was not taken as studied
Missed days change the result, and studies count them. Nothing in this record points to this reason.
Something else changed at the same time
Two changes at once cannot be told apart afterwards. Nothing in this record points to this reason.
The product may not be what it says
Contents of a sold product are not always what the label states. Nothing in this record points to this reason.
No recorded reason
RNAWiki has nothing stored that would explain it. Nothing in this record points to this reason.
None of these is a reason to take more. Taking more is not a step this page ever suggests.
What it would be like to take◇Read from sources, not yet reviewed
What taking it involves
The recorded facts about getting hold of it and using it. Nothing here is a suggestion about what you should do.
How it is supplied
Prescription only
❝ Quoted from a source
Where this came from
Copied from a source RNAWiki stored, with the source named.
Read from the recorded approval status.
No source is stored against this line.
Form and route
Oral tablet at 1, 2 and 4 mg once daily, as pitavastatin calcium (Livalo) or magnesium (Zypitamag)
✎ Source-linked record
Where this came from
A person wrote this into the record with the study named beside it. No reviewer has signed it off.
The form and route recorded on this substance.
No source is stored against this line.
Who oversees it
RNAWiki has not recorded a supervision or regulatory status for this substance.
❝ Quoted from a source
Where this came from
Copied from a source RNAWiki stored, with the source named.
No register row and no identity class settled the question.
No source is stored against this line.
What is in the pack
Peak plasma concentration is reached about one hour after dosing and exposure rises approximately dose-proportionally from 1 mg to 24 mg. Absolute bioavailability of the oral solution is 51%. Absorption occurs in the small intestine and very little in the colon. A high-fat meal reduces peak concentration by 43%. Peak concentration and total exposure did not differ between evening and morning administration, although the LDL reduction after evening dosing was slightly greater in healthy volunteers on 4 mg. Metabolism is by glucuronidation through UGT1A3 and UGT2B7 with subsequent lactone formation; the lactone is the major plasma metabolite. About 79% of a dose is excreted in faeces and 15% in urine within seven days, with a mean plasma half-life of about 12 hours. Exposure is 10% higher in peak and 30% higher in area under the curve in people aged 65 and over.
✎ Source-linked record
Where this came from
A person wrote this into the record with the study named beside it. No reviewer has signed it off.
Recorded notes on how this is sold and what that means for what is in the pack.
No source is stored against this line.
Where it is registered
Regulatory records are listed in the technical disclosure at the foot of this page.
# Counted from records
Where this came from
A count of rows RNAWiki holds. It describes our records, not your body.
Register entries are stored per jurisdiction and shown with their dates.
No source is stored against this line.
Why people stop
Not recorded.
∅ Nothing recorded
Where this came from
RNAWiki holds nothing here and says so rather than guessing.
No record of why people stopped taking it is stored for this substance.
No source is stored against this line.
What it would be like to take◇Read from sources, not yet reviewed
What can go wrong
Sorted by where each line came from. A regulator's label and a report somebody sent in are not the same kind of fact.
·Worth asking a clinician aboutWritten into the record from the studies named on this page
Contraindicated with ciclosporin, in acute liver failure or decompensated cirrhosis, and in hypersensitivity — angioedema, rash, pruritus and urticaria have been reported. Myopathy and rhabdomyolysis occur, with acute kidney injury secondary to myoglobinuria and rare fatalities reported for statins including this one; risk factors are age 65 or over, uncontrolled hypothyroidism, renal impairment, interacting drugs and higher dosage. Immune-mediated necrotising myopathy has been reported rarely and persists after discontinuation. Transaminase increases occur, some persistent, with rare reports of fatal and non-fatal hepatic failure. Increases in HbA1c and fasting serum glucose have been reported. Erythromycin caps the dose at 1 mg daily and rifampin at 2 mg daily; gemfibrozil should be avoided and fibrates require a benefit-risk judgement with monitoring.
Nobody counted how many people took this and were fine, so this cannot be turned into a rate.
REPRIEVE registration record on ClinicalTrials.gov (NCT02344290) · a recorded source, not a stored snapshot
LIVALO (pitavastatin) United States prescribing information — Indications 1, Contraindications 4, Warnings and Precautions 5.1 to 5.3, Drug Interactions 7, C… · a recorded source, not a stored snapshot
Reports sent to a regulator
These are reports people sent to a regulator. They do not show the medicine caused the reaction.
Nobody counted how many people took the medicine and reported nothing.
The same event can be reported more than once, and many reports are incomplete.
News coverage, lawsuits and new warnings change how often people report.
A count is not a rate and not a risk.
Pitavastatin appears in spontaneous reports to regulators. Across the 10 most-reported reaction terms, 136 reaction mentions were counted. One report can name several reactions.
open-targets-adr · recorded 2026-06-24 · a recorded source, not a stored snapshot
Over a long time. No completed tested study window is recorded, so long-term effects are not established by the registry record.
Groups the studies covered thinly. Which groups were under-represented in the studies has not been recorded for this substance. Pregnancy, breastfeeding, children, older adults, and people with liver or kidney conditions are commonly excluded from trials; nothing here says whether they were.
What is missing or unclear◇Read from sources, not yet reviewed
Does the exact form matter?
Evidence belongs to the exact thing that was tested. A different salt, a different mixture or a different preparation is a different question.
The form that was studied
Oral tablet at 1, 2 and 4 mg once daily, as pitavastatin calcium (Livalo) or magnesium (Zypitamag)
✎ Source-linked record
Where this came from
A person wrote this into the record with the study named beside it. No reviewer has signed it off.
The form used in the studies cited on this page.
No source is stored against this line.
What is sold
Absolute bioavailability of the oral solution is 51%. Absorption occurs in the small intestine and very little in the colon. A high-fat meal reduces peak concentration by 43%. Peak concentration and total exposure did not differ between evening and morning administration, although the LDL reduction after evening dosing was slightly greater in healthy volunteers on 4 mg. Metabolism is by glucuronidation through UGT1A3 and UGT2B7 with subsequent lactone formation; the lactone is the major plasma metabolite. About 79% of a dose is excreted in faeces and 15% in urine within seven days, with a mean plasma half-life of about 12 hours. Exposure is 10% higher in peak and 30% higher in area under the curve in people aged 65 and over.
✎ Source-linked record
Where this came from
A person wrote this into the record with the study named beside it. No reviewer has signed it off.
Recorded notes on which forms are sold and how they compare.
No source is stored against this line.
What is recorded as being sold
49 products list this as an active ingredient in the United States drug directory. 49 of them contain it and nothing else.
FDA National Drug Code directory · 0832-6050 · read 2026-08-29
They are sold as granule, powder, tablet and tablet, film coated, taken oral.
FDA National Drug Code directory · 0832-6050 · read 2026-08-29
The regulator's established pharmacologic class for it is hmg-coa reductase inhibitor [epc] and hydroxymethylglutaryl-coa reductase inhibitors [moa].
FDA National Drug Code directory · 0832-6050 · read 2026-08-29
15 published labels name it as an active ingredient. 15 of them describe this substance alone, which is where its own label text on this page comes from.
US prescribing information · a52401eb-a822-475b-a40d-7b8acde2ae1a · read 2026-08-29
Those labels are classed as human prescription drug.
US prescribing information · a52401eb-a822-475b-a40d-7b8acde2ae1a · read 2026-08-29
Pitavastatin is oral at 3 DOSAGE FORMS AND STRENGTHS 1 mg: White to off-white, round shaped film-coated tablets, debossed with ‘K’ on one side and ‘55’ on the other side. 2 mg: White to off-white, round shaped film-coated tablets, debossed wit…, recorded as fda label in effect 2024-04-12 in the United States.
US prescribing information · a52401eb-a822-475b-a40d-7b8acde2ae1a · read 2026-08-30
Recorded price in US: 0.98653–1.1362 USD per one unit as the pricing file counts it — a tablet, capsule, patch or single item, across 23 priced products whose strengths and pack forms differ, as of 2026-08-26, paid by retail pharmacies buying the product, as surveyed by the Centers for Medicare & Medicaid Services. It is not a list price, an insurance price, or what anyone pays at a counter..
Recorded source · 2026-08-26 · read 2026-08-28
Evidence carries across two names for one substance. It does not carry across a salt, a mirror form or a mixture.
What it would be like to take◇Read from sources, not yet reviewed
What you could measure
This one is decided with a clinician, so this section holds questions to ask rather than a plan to run.
RNAWiki could not confidently classify this substance, so no self-experiment plan is offered.
Questions worth asking
Which of the trials of Pitavastatin studied people like me?
What was measured, and for how long?
Was the result a laboratory value or a health outcome?
What would we watch for, and when would we stop?
Tracking can show whether something changed for you. It cannot show what caused it.
RNAWiki records evidence. It does not say whether this substance is right for you.
What is missing or unclear◇Read from sources, not yet reviewed
Claims that go past the evidence
Things said about this substance that sound reasonable, and the exact step that is missing between the evidence and the claim.
✗Goes past the evidence
That pitavastatin is glycaemically neutral — absent from the label and contradicted by the REPRIEVE diabetes counts
Why it sounds right. It follows from something real on this page: a body step, an animal result or a related finding.
The missing step. Nobody measured this in people for this use, or the study that did measure it did not show it.
What would change this
A study in people, for this exact use, measuring this exact thing, that a reviewer signs off.
RNAWiki has not yet published a reviewed conclusion for this use.
✗Goes past the evidence
That REPRIEVE extends to low-risk primary prevention generally, when every participant had HIV and was on antiretroviral therapy
Why it sounds right. It follows from something real on this page: a body step, an animal result or a related finding.
The missing step. Nobody measured this in people for this use, or the study that did measure it did not show it.
What would change this
A study in people, for this exact use, measuring this exact thing, that a reviewer signs off.
RNAWiki has not yet published a reviewed conclusion for this use.
✗Goes past the evidence
That the price premium buys a better lipid effect, when the label’s own comparison found it equivalent to atorvastatin milligram for milligram of effect
Why it sounds right. It follows from something real on this page: a body step, an animal result or a related finding.
The missing step. Nobody measured this in people for this use, or the study that did measure it did not show it.
What would change this
A study in people, for this exact use, measuring this exact thing, that a reviewer signs off.
RNAWiki has not yet published a reviewed conclusion for this use.
✗Goes past the evidence
That the licensed indication reflects the current evidence, when a positive outcome trial from 2023 appears nowhere in it
Why it sounds right. It follows from something real on this page: a body step, an animal result or a related finding.
The missing step. Nobody measured this in people for this use, or the study that did measure it did not show it.
What would change this
A study in people, for this exact use, measuring this exact thing, that a reviewer signs off.
RNAWiki has not yet published a reviewed conclusion for this use.
What is missing or unclear◇Read from sources, not yet reviewed
What nobody knows yet
Open questions, each with why it is open and what would close it.
Missing populations
Which groups were under-represented in the studies has not been recorded.
Why it matters. Recorded by the evidence model as a gap on this record.
What would answer it
A study that measures it, and a reviewer to sign it off.
Last checked 2026-09-04. Searched: The sources listed in the receipts at the foot of this page.
Missing long-term data
No completed tested study window is recorded.
Why it matters. Recorded by the evidence model as a gap on this record.
What would answer it
A study that measures it, and a reviewer to sign it off.
Last checked 2026-09-04. Searched: The sources listed in the receipts at the foot of this page.
No reviewed conclusion
RNAWiki has not yet published a reviewed conclusion for this use.
Why it matters. Recorded by the evidence model as a gap on this record.
What would answer it
A study that measures it, and a reviewer to sign it off.
Last checked 2026-09-04. Searched: The sources listed in the receipts at the foot of this page.
Missing interaction studies
No interaction was found in the registers checked. Not finding one is not the same as showing there is none.
Why it matters. Recorded by the evidence model as a gap on this record.
What would answer it
A study that measures it, and a reviewer to sign it off.
Last checked 2026-09-04. Searched: The sources listed in the receipts at the foot of this page.
Formulation uncertainty
Several salts, forms or products of Pitavastatin are recorded. Results from one form may not transfer to another.
Why it matters. Recorded by the evidence model as a gap on this record.
What would answer it
A study that measures it, and a reviewer to sign it off.
Last checked 2026-09-04. Searched: The sources listed in the receipts at the foot of this page.
Mechanism not reviewed
No reviewed mechanism story exists for this substance.
Why it matters. Recorded by the evidence model as a gap on this record.
What would answer it
A study that measures it, and a reviewer to sign it off.
Last checked 2026-09-04. Searched: The sources listed in the receipts at the foot of this page.
What happened in people◇Read from sources, not yet reviewed
Check any of this yourself
Every line above traced back to the study it came from. This is the technical layer, and the vocabulary changes here.
Every line above can be traced to the study named beside it. Follow the link and read it.
REPRIEVE: a third fewer cardiovascular events, and the trial stopped early
In plain words
Nearly eight thousand people living with HIV, none of them at high cardiovascular risk, took pitavastatin or placebo. Major cardiovascular events fell by about a third and the trial was halted ahead of schedule because the answer was clear.
What was measured
Major adverse cardiovascular events per 1,000 person-years over a median 5.1 years in 7,769 people with HIV
Effect estimate
No reviewed effect estimate exists for this record.
Limits
See the technical detail.
From the source
REPRIEVE randomised 7,769 participants with HIV infection at low to moderate cardiovascular risk, receiving antiretroviral therapy, to pitavastatin calcium 4 mg daily or placebo. Median age was 50; median CD4 count 621 cells/mm³; HIV RNA was below quantification in 5,250 of 5,997 participants with data (87.5%). The primary outcome was a composite of cardiovascular death, myocardial infarction, hospitalisation for unstable angina, stroke, transient ischaemic attack, peripheral arterial ischaemia, revascularisation, or death from an undetermined cause. The trial was stopped early for efficacy after a median 5.1 years. Incidence was 4.81 per 1,000 person-years on pitavastatin against 7.32 on placebo: hazard ratio 0.65 (95% CI 0.48 to 0.90), p=0.002. This is a genuine primary-prevention outcome result in a population that had never had one, and it is the strongest piece of evidence any statin holds specifically for people living with HIV.
Written into the record, not signed off as a reviewed claim
That outcome trial is not in the licensed indication
In plain words
REPRIEVE reported in 2023 and was positive. The United States indication for pitavastatin still says only that it lowers LDL cholesterol in high cholesterol and familial hypercholesterolaemia. There is no cardiovascular claim on the label at all.
What was measured
That the licensed indication reflects the current evidence — here it does not, and the drug has an outcome trial its label does not mention
Effect estimate
No reviewed effect estimate exists for this record.
Limits
See the technical detail.
From the source
The LIVALO indication reads in full: as an adjunct to diet to reduce low-density lipoprotein cholesterol in adults with primary hyperlipidaemia, and in adults and paediatric patients aged 8 years and older with heterozygous familial hypercholesterolaemia. Nothing about events, nothing about mortality, nothing about HIV. Compare simvastatin, licensed to reduce total mortality; pravastatin, licensed to reduce total mortality by reducing coronary death; lovastatin, licensed to reduce infarction and revascularisation. A licence changes only when a sponsor applies to change it, and the gap between what a drug has been shown to do and what its label says it does is a gap in the regulatory record rather than in the science. A reader should know that in this case the evidence is stronger than the label, which is the opposite of the usual direction and worth naming for that reason.
Written into the record, not signed off as a reviewed claim
The glycaemic-neutrality claim did not survive its own outcome trial
In plain words
Pitavastatin has a reputation for being the statin that does not raise blood sugar. In its own largest trial, more people on pitavastatin developed diabetes than on placebo, and its label carries the same sugar warning as every other statin.
What was measured
That pitavastatin is glycaemically neutral — a claim absent from its label and contradicted by the diabetes counts in its own outcome trial
Effect estimate
No reviewed effect estimate exists for this record.
Limits
This entry records a failure.
From the source
A body of narrative review and short-term metabolic literature describes pitavastatin as having favourable or neutral effects on glucose tolerance relative to other statins, and it is a recurring reason given for choosing it. Two harder measurements point the other way. First, the LIVALO label carries the class warning verbatim: increases in HbA1c and fasting serum glucose levels have been reported with statins, including LIVALO. It makes no neutrality claim. Second, REPRIEVE recorded diabetes mellitus in 206 pitavastatin participants (5.3%) against 155 on placebo (4.0%) over a median 5.1 years — a difference in the same direction as the class, in the largest randomised comparison the drug has. Muscle-related symptoms in the same trial were 91 (2.3%) against 53 (1.4%). None of this makes the drug a poor choice; the cardiovascular benefit in REPRIEVE was clear. It does mean the distinguishing property most often cited for it is not one its own evidence supports.
Written into the record, not signed off as a reviewed claim
Its own label shows it is no better than atorvastatin, at forty times the price
In plain words
The comparison study in the package insert found pitavastatin 4 mg lowered LDL by the same amount as atorvastatin 20 mg. A pitavastatin tablet costs a pharmacy about a dollar fourteen; an atorvastatin tablet costs under three cents.
What was measured
Mean percentage change in LDL cholesterol at 12 weeks, pitavastatin against atorvastatin, with pharmacy acquisition cost from the same survey date
Effect estimate
No reviewed effect estimate exists for this record.
Limits
See the technical detail.
From the source
LIVALO Study 301 randomised 817 adults with primary hyperlipidaemia or mixed dyslipidaemia to 12 weeks of pitavastatin or atorvastatin, with non-inferiority defined as a 95% CI lower bound above −6% for mean percentage change in LDL cholesterol. Pitavastatin 2 mg against atorvastatin 10 mg gave a mean treatment difference of 0% (95% CI −3% to 3%); pitavastatin 4 mg against atorvastatin 20 mg gave 1% (−2% to 4%). Mean LDL reductions were −38% and −45% for pitavastatin 2 mg and 4 mg, and −38% and −44% for atorvastatin 10 mg and 20 mg. The two drugs are, on the label’s own measurement, interchangeable on LDL. From the same CMS survey effective 19 August 2026, pitavastatin costs US$1.14 per unit across 30 listed products and atorvastatin US$0.0281 across 278. That is roughly a fortyfold difference for an identical measured effect, and the only defensible reason to pay it is the metabolic profile rather than the lipid result.
Source
LIVALO United States prescribing information, section 14, Study 301 (NDA 022363); CMS NADAC survey effective 19 August 2026
Role in the trial
Not matched to a registered study
Identity check
no open identity hold
Audit mark
verified
Review state
Written into the record, not signed off as a reviewed claim
Almost no cytochrome metabolism, which is the whole point of the molecule
In plain words
Nearly every other statin is burned up by cytochrome enzymes that dozens of common drugs block. This one is tagged with a sugar and excreted instead, so those collisions mostly do not happen.
What was measured
Metabolic route and the resulting contraindication and dose-cap list, from the label
Effect estimate
No reviewed effect estimate exists for this record.
Limits
See the technical detail.
From the source
The label states that the principal route of pitavastatin metabolism is glucuronidation by hepatic UGT1A3 and UGT2B7 with subsequent formation of pitavastatin lactone, that there is only minimal metabolism by the cytochrome P450 system, and that it is marginally metabolised by CYP2C9 and to a lesser extent CYP2C8. The interaction table is correspondingly short and, revealingly, has nothing to do with cytochromes: ciclosporin is contraindicated because it significantly increases exposure; erythromycin caps the dose at 1 mg daily and rifampin at 2 mg daily for the same reason; gemfibrozil is avoided. Those three drugs are transporter inhibitors, not primarily CYP3A4 inhibitors of this molecule, which is why the constraint survives despite the absence of cytochrome metabolism. This is the property that made pitavastatin the statin chosen for a trial in people on antiretroviral therapy, where CYP3A4 is already crowded.
Source
LIVALO United States prescribing information, sections 4, 7 and 12.3 (NDA 022363)
Role in the trial
Not matched to a registered study
Identity check
no open identity hold
Audit mark
verified
Review state
Written into the record, not signed off as a reviewed claim
A trial in one population is not a trial in every population
In plain words
REPRIEVE studied people living with HIV on antiretroviral treatment. Whether the same benefit appears in people without HIV at the same estimated risk was not tested, and cannot be read off this trial.
What was measured
That REPRIEVE demonstrates statin benefit in low-risk primary prevention generally, when it was conducted entirely in people with HIV on antiretroviral therapy
Effect estimate
No reviewed effect estimate exists for this record.
Limits
See the technical detail.
From the source
REPRIEVE enrolled 7,769 participants with HIV infection receiving antiretroviral therapy, at low to moderate cardiovascular risk by conventional scoring, with a median CD4 count of 621 and viral suppression in 87.5% of those with data. The rationale for the trial was that cardiovascular risk is increased in HIV beyond what conventional risk scores capture — chronic immune activation and inflammation being the usual explanation. If that is why the absolute event rate was high enough to detect a benefit in a nominally low-risk group, then the result belongs to that population and does not automatically transfer to an HIV-negative person with the same risk score. Nothing in REPRIEVE settles whether a statin is worthwhile in genuinely low-risk primary prevention generally, and the trial does not claim to.
This order is fixed in code and does not count clicks or time on the page.
What is not here
3 questions this page could not answer
These sections were prepared and left out because there was nothing to put in them. They are listed rather than hidden, so the gaps in this record are visible.
What it may clash with — found nothing in the sources checked.
Other ways to the same goal — found nothing in the sources checked.
What changed on this page — found nothing in the sources checked.
The record as stored
The full record, for auditing
Everything above is built from what is below. This layer keeps the technical vocabulary, record identifiers and every stored row, so a reader who wants to check the page can.
The older medicine-wide conclusion held in this record
Written for a clinical reader, and about the medicine as a whole rather than about one indication, population and set of trials. RNAWiki does not treat it as a programme conclusion and no reviewer has signed it off in that form. It is here word for word because it is what the record holds.
The only statin with a modern placebo-controlled outcome trial that is not reflected in its licence: REPRIEVE cut major cardiovascular events from 7.32 to 4.81 per 1,000 person-years in 7,769 people with HIV (HR 0.65, 95% CI 0.48 to 0.90, p=0.002) and was stopped early, while the United States indication still reads only "to reduce LDL-C" — and the same trial recorded diabetes in 5.3% against 4.0%, which is awkward for the drug’s reputation as the glycaemically neutral statin.
Recorded evidence blocks (15)
Q1
What did Pitavastatin's largest trial (2133900 people) and its longest (8.4 years) measure?
2133900 people in Pitavastatin's largest registered study, 8.4 years in its longest registered window, measuring all cause mortality. ClinicalTrials.gov · 2026-09-01
30 phase4, 18 phase3, 14 phase1, 7 na, 3 na or unstated, 2 phase2, 1 early phase1; NCT02344290; 2023-08-21; no ageing endpoint recorded. Last human test completed 2026, NCT07567781.
Interpretation These counts include studies where Pitavastatin was a comparison treatment, a background treatment or an exposure in an observational study, and the longest window may be a planned end date. Trial roles have not yet been classified for this record.
Show the evidence
phase4
30
phase3
18
phase1
14
na
7
na or unstated
3
phase2
2
2 more recorded rows
early phase1
1
Last recorded human testNCT07567781
2026-07-21
recorded 2026-09-01 · last checked 2026-09-04
Q2
From mouse to human: where has Pitavastatin shown lifespan?
10 recorded entries; human; also "Pitavastatin 4mg", "Pitavastatin calcium 4mg", "Pitavastatin calcium(LIVALO) 4mg"
Show the evidence
human
NCT01042730
Pitavastatin 1 mg daily or 4 mg daily
NCT01043094
Pitavastatin 4mg
NCT02056847
Pitavastatin calcium 4mg
NCT02056847
Pitavastatin calcium(LIVALO) 4mg
NCT02056847
Pitavastatin calcium 2mg
NCT02056847
LIVALO 2mg
4 more recorded rows
humanNCT02545231
Pitavastatin 1mg
humanNCT02545231
Livalo 1mg
humanNCT02545231
Livalo 4mg
humanNCT06317051
Pitavastatin 4 Mg Oral Tablet
recorded 2026-09-01 · last checked 2026-09-04
Q4
Did Pitavastatin move DunedinPACE, and by how much?
DunedinPACE: "However, the median pace of aging by the DunedinPACE increased in the placebo arm (0.036, Q1, Q3 [-0.018, 0.10], P = .021) but not in the pitavastatin arm (0.001, Q1, Q3 [-0.031, 0.036], [P = .77]), treatment group difference (P = .049)." Europe PMC · epigenetic clock search · 2026-05-29
2 recorded sentences; 2026; biomarker
Show the evidence
DunedinPACEPMID 40576558
2026; "However, the median pace of aging by the DunedinPACE increased in the placebo arm (0.036, Q1, Q3 [-0.018, 0.10], P = .021) but not in the pitavastatin arm (0.001, Q1, Q3 [-0.031, 0.036], [P = .77]), treatment group difference (P = .049)."
epigenetic agePMID 42294499
2026; "Our data suggest that a diverse range of pharmaceutical, lifestyle, supplementation, non-pharmaceutical clinical, and psychosocial interventions can decrease epigenetic age, including exercise, a plant-rich diet, the GLP-1 receptor agonist semaglutide, caloric restriction, ketamine, omega-3 fatty acids, a multivitamin-multimineral supplement, umbilical cord plasma, and the cholesterol-lowering…"
recorded 2026-05-29 · last checked 2026-09-04
Q5
Pitavastatin's half-life is 12 hours — which schedules were studied?
12 hours, the half-life Pitavastatin's label states. openfda-label · 2d5a1b78-4aa6-537b-e063-6394a90a522f · 2026-08-30
bioavailability 51% %.
Show the evidence
half life
12 hours hours; The mean plasma elimination half-life is approximately 12 hours.
bioavailability
51% %; The absolute bioavailability of pitavastatin oral solution is 51%.
metabolism
Distribution Pitavastatin is more than 99% protein bound in human plasma, mainly to albumin and alpha 1-acid glycoprotein, and the mean volume of distribution is approximately 148 L. Elimination Metabolism The principal route of pitavastatin metabolism is glucuronidation via liver uridine 5'-diphosphate glucuronosyltransferase (UGT) with subsequent formation of pitavastatin lactone.
recorded 2026-08-30 · last checked 2026-09-04
Q6
Could one person measure Pitavastatin's effect on plaque volume?
Plaque volume: measured in Pitavastatin's trials.
Interpretation plaque volume is the recorded endpoint.
Show the evidence
biomarkers
plaque volume; 2026-09-01
low density lipoprotein cholesterol at week 12; 2026-09-01
ldl c; 2026-09-01
low density lipoprotein cholesterol; 2026-09-01
low density lipoprotein cholesterol at 12 weeks; 2026-09-01
attaining ncep ldl c target at week 16; 2026-09-01
14 more recorded rows
biomarkers
attaining ncep ldl c target at week 44; 2026-09-01
biomarkers
ncep ldl c target attainment; 2026-09-01
biomarkers
pharmacokinetics of oral midazolam; 2026-09-01
biomarkers
all cause mortality; 2026-09-01
biomarkers
achieving ldl c 100mg; 2026-09-01
biomarkers
area under the curve from time 0 to tau; 2026-09-01
biomarkers
whose alt levels were over ctcae grade ii after treatment; 2026-09-01
biomarkers
safety; 2026-09-01
biomarkers
low density lipoprotein cholesterol from baseline to week 12; 2026-09-01
biomarkers
assessment of platelet reaction; 2026-09-01
biomarkers
changes in plasma coq10 levels; 2026-09-01
biomarkers
ldl c level at week 12; 2026-09-01
biomarkers
incidence of contrast induced nephropathy; 2026-09-01
biomarkers
insulin stimulated glucose uptake; 2026-09-01
half life
2026-09-04; halfLife; hours; 12 hours; 2026-08-30
human trials at or under30
19
smallest human trial
0; NCT00786734; PHASE4; the smallest recorded human enrolment at or below 30; the registry states no direction of its result; WITHDRAWN
Q7
Which of achieving ldl c 100mg, adverse events and all cause mortality did Pitavastatin's trials measure?
achieving ldl c 100mg, adverse events and all cause mortality lead 33 outcome terms across Pitavastatin's trials. ClinicalTrials.gov · 2026-09-01
low density lipoprotein cholesterol, low density lipoprotein cholesterol at 12 weeks, attaining ncep ldl c target at week 16, attaining ncep ldl c target at week 44, ncep ldl c target attainment and pharmacokinetics of oral midazolam follow.
Show the evidence
plaque volume
1
low density lipoprotein cholesterol at week 12
1
ldl c
1
low density lipoprotein cholesterol
1
low density lipoprotein cholesterol at 12 weeks
1
attaining ncep ldl c target at week 16
1
14 more recorded rows
attaining ncep ldl c target at week 44
1
ncep ldl c target attainment
1
pharmacokinetics of oral midazolam
1
all cause mortality
1
achieving ldl c 100mg
1
area under the curve from time 0 to tau
1
whose alt levels were over ctcae grade ii after treatment
1
safety
1
low density lipoprotein cholesterol from baseline to week 12
1
assessment of platelet reaction
1
changes in plasma coq10 levels
1
ldl c level at week 12
1
incidence of contrast induced nephropathy
1
insulin stimulated glucose uptake
1
recorded 2026-09-01 · last checked 2026-09-04
Q8
Which of Pitavastatin's 7 ongoing trials reports first?
absolute change in LDL-C from baseline by months 1 and 3 of study therapy; Change form baseline homeostatic model assessment for insulin resistance (HOMA-IR) at 24 weeks; latest 2028-03-31
Show the evidence
Trial
NCT05537948
"Efficacy and Safety of Pitavastatin and PCSK9 Inhibitors in Liver Transplant Patients"; n 59; "absolute change in LDL-C from baseline by months 1 and 3 of study therapy"; 2025-01-31
NCT05705804
"Effects of Pitavastatin or Combination of Pitavastatin and Ezetimibe on Glucose Metabolism Compared to AtoRvastatin in atheroscLerotic Cardiovascular Disease Patients With Metabolic Syndrome: The EZ-PEARL Randomized Trial"; n 250; "Change form baseline homeostatic model assessment for insulin resistance (HOMA-IR) at 24 weeks"; 2027-06-01
NCT06317051
"Optimising Metabolic Management for People With Human Immunodeficiency Virus (HIV) on Integrase Based Antiretroviral Therapy (ART)"; n 300; "To assess the impact of dapagliflozin vs. placebo on weight reduction"; 2027-12
NCT06982131
"A Study Investigating the Safety of RO7795081 and the Effect of RO7795081 on How the Body Processes Pitavastatin and Rosuvastatin in Otherwise Healthy Overweight or Obese Adult Participants"; n 40; "Incidence and Severity of Adverse Events"; 2026-12-04
NCT07442630
"Long-term Comparison of Pitavastatin/Ezetimibe and Pitavastatin in Patients With Hypercholesterolemia and Elevated Triglycerides"; n 88; "Percentage change from baseline in LDL Cholesterol at Week 8 after the first dose of study treatment"; 2026-11-30
NCT07549958
"PhIbRandomGemcitabine(G)w/or w/Out Pitavastatin(P)MainTx UnresecPancreaticAdenocarcinoma(uPDAC)"; n 18; "Recommended Phase II Dose"; 2028-03-31
1 further recorded trialNCT07726368
"Study of ECC4703 With Sulfasalazine and Pitavastatin"; n 40; "Maximum plasma concentration of sulfasalazine in the blood of participants who have taken ECC4703 (as part of called pharmacokinetic or 'PK' testing)"; 2026-12
recorded 2026-09-01 · last checked 2026-09-04
Q9
Which running trial of Pitavastatin could settle insulin sensitivity?
NCT05705804 measures Change form baseline homeostatic model assessment for insulin resistance (HOMA-IR) at 24 weeks, reading out 2027-06-01.
1 open trial; n 250; "Effects of Pitavastatin or Combination of Pitavastatin and Ezetimibe on Glucose Metabolism Compared to AtoRvastatin in atheroscLerotic Cardiovascular Disease Patients With Metabolic Syndrome: The…"
Show the evidence
TrialNCT05705804
"Effects of Pitavastatin or Combination of Pitavastatin and Ezetimibe on Glucose Metabolism Compared to AtoRvastatin in atheroscLerotic Cardiovascular Disease Patients With Metabolic Syndrome: The EZ-PEARL Randomized Trial"; n 250; "Change form baseline homeostatic model assessment for insulin resistance (HOMA-IR) at 24 weeks"; 2027-06-01
Q10
Which 24 trials of Pitavastatin posted no result?
Posted no result
24 of 24 completed trials
Registrations
NCT00653913, NCT00242944, NCT00716846, NCT00444717, NCT00549926 and NCT01166633, and 18 more
Completion dates
oldest 2004-09; newest 2024-07-19
Show the evidence
Trial
NCT00653913
2004-09
NCT00242944
2008-03
NCT00716846
2008-08
NCT00444717
2008-09
NCT00549926
2010-02
NCT01166633
2011-02
14 further recorded trials
NCT00640276
2011-06
NCT01595828
2012-06
NCT00861861
2013-10
NCT00701285
2014-05
NCT02595268
2016-01
NCT02144922
2016-10
NCT02056847
2017-05
NCT02888327
2017-05-30
NCT04402112
2017-08-01
NCT01042730
2017-11
NCT02743260
2017-12
NCT02545231
2020-08
NCT02863185
2020-12-31
NCT04643093
2021-10-05
Q11
At the median, Pitavastatin's trials enrolled 131.5 people — anything larger?
Median enrolment
131.5
Largest enrolment
2133900
Registered trials counted
74
Q12
What do 136 spontaneous reports say about Pitavastatin — and not say?
These are reports people sent to a regulator. They do not show the medicine caused the reaction. Nobody counted how many people took the medicine and reported nothing. The same event can be reported more than once, and many reports are incomplete. News coverage, lawsuits and new warnings change how often people report. A count is not a rate and not a risk.
Pitavastatin appears in spontaneous reports to regulators. Across the 10 most-reported reaction terms, 136 reaction mentions were counted: myalgia 31; alanine aminotransferase increased 14; oedema peripheral 14; hepatic function abnormal 13. open-targets-adr · CHEMBL1201753 · 2026-06-24
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myalgia
31
alanine aminotransferase increased
14
oedema peripheral
14
hepatic function abnormal
13
rhabdomyolysis
13
blood creatine phosphokinase increased
11
4 more recorded rows
pruritus
11
aspartate aminotransferase increased
10
liver disorder
10
angioedema
9
recorded 2026-06-24 · last checked 2026-09-04
Q13
Pitavastatin and CYP2C8 and CYP2C9: shared by which compounds?
CYP2C8 and CYP2C9 appear in Pitavastatin's recorded interaction sentences, 2 in all. openfda-label+europepmc · 2026-08-30
Interpretation pharmacokinetics
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CYP2C8pharmacokinetics
Pitavastatin is marginally metabolized by CYP2C9 and to a lesser extent by CYP2C8.
CYP2C9pharmacokinetics
Pitavastatin is marginally metabolized by CYP2C9 and to a lesser extent by CYP2C8.
recorded 2026-08-30 · last checked 2026-09-04
Q14
Was Pitavastatin studied with fasting and exercise?
fasting and exercise are named in Pitavastatin's label sentences: "We analyzed fasting plasma I-FABP at entry and month 24 among participants randomized to pitavastatin 4 mg daily or placebo." openfda-label+europepmc · 2026-08-30
2 recorded statements; fasting, exercise
Show the evidence
fasting
We analyzed fasting plasma I-FABP at entry and month 24 among participants randomized to pitavastatin 4 mg daily or placebo.
exercise
Patients with diabetes who were prescribed pitavastatin therapy were enrolled and randomized to either treatment with 2 mg of pitavastatin once daily (n = 44) (PITA group) or diet and exercise only, except their antidiabetic medications (n = 49), for 24 weeks.
recorded 2026-08-30 · last checked 2026-09-04
Q15
What is recorded about Pitavastatin and IGF-1?
"In vitro, pitavastatin concentration-dependently inhibited the activation of CCD-18Co cells, significantly reduced the expression levels of the intestinal fibrosis-related proteins Col1A1, IGF-1, IGF-1R, MMP-3, and TIMP-1, and significantly inhibited cell proliferation and migration while markedly increasing MMP-9 protein expression." — where Pitavastatin and IGF-1 appear together. Europe PMC · pathway abstract search · 2025-08-22
"In vitro, pitavastatin concentration-dependently inhibited the activation of CCD-18Co cells, significantly reduced the expression levels of the intestinal fibrosis-related proteins Col1A1, IGF-1, IGF-1R, MMP-3, and TIMP-1, and significantly inhibited cell proliferation and migration while markedly increasing MMP-9 protein expression."
PMID 40862456
"Additionally, after silencing the IGF-1 and IGF-1R genes in CCD-18Co cells, the promotion of MMP-9 expression by pitavastatin was significantly inhibited."
autophagy
PMID 40050889
"Mechanistically, pitavastatin and atorvastatin can induce apoptosis and synergistically promote the 5-FU-mediated cytotoxic effect by activating autophagy, as well as the PERK/ATF4/CHOP signaling pathway while decreasing YAP expression."
PMID 38444467
"In conclusion, we found pitavastatin could induce autophagy-dependent ferroptosis in TNBC cells via the mevalonate pathway which may become a potential adjuvant treatment option for TNBC patients."
mTOR
PMID 38319449
"At the molecular level, we found that CD36 inhibition, either with pitavastatin or plasmid, reduced proliferation- and migration-related protein expression through the AKT/mTOR pathway."
PMID 33886150
"Moreover, cotreating the cells with metformin (30 mM) and pitavastatin (10 μM) could preserve mitochondrial function, activate AMPK, and inhibit PI3K/mTOR than treatment with metformin or pitavastatin alone."
AMPKPMID 33886150
"Moreover, cotreating the cells with metformin (30 mM) and pitavastatin (10 μM) could preserve mitochondrial function, activate AMPK, and inhibit PI3K/mTOR than treatment with metformin or pitavastatin alone."
mTORPMID 33886150
"These findings clearly indicated that metformin plus pitavastatin had a synergistic anticancer effect on pancreatic cancer cells, potentially caused due to the activation of AMPK and inhibition of PI3K/mTOR signaling."
AMPKPMID 33886150
"These findings clearly indicated that metformin plus pitavastatin had a synergistic anticancer effect on pancreatic cancer cells, potentially caused due to the activation of AMPK and inhibition of PI3K/mTOR signaling."
autophagyPMID 35387352
"In the present study, we showed that pitavastatin could increase apoptosis in a FOXO3a-dependent manner in the oral cancer cell line, SCC15, and the colon cancer cell line, SW480, along with the blockade of autophagy flux."
AMPKPMID 32406610
"Notably, treatment with pitavastatin in SCC15 cells induced the nuclear translocation of FOXO3a via dual regulation of two upstream kinases, AMPK and Akt, resulting in the up-regulation of PUMA, a transcriptional target gene of FOXO3a."
NAD+
PMID 19039310
"Increased expression of NAD(P)H oxidase subunits and activated p65 nuclear factor (NF)-kappaB, p44/p42 extracellular signal-regulated kinases and its downstream effector p90 ribosomal S6 kinase phosphorylation in failing rat hearts was inhibited by pitavastatin."
PMID 15502390
"The activated vascular NAD(P)H oxidase contributes to endothelial dysfunction in CHF, which was partly improved by pitavastatin via its inhibition of NAD(P)H oxidase."
PMID 16043016
"This increase was completely blocked by the treatment with pitavastatin (5 x 10(-7)M) as well as a NAD(P)H oxidase inhibitor (diphenylene iodonium) or a PKC inhibitor (calphostin C) in parallel with the change of small GTPase Rac-1 activity, a cytosolic regulatory component of NAD(P)H oxidase."
recorded 2025-08-22 · last checked 2026-09-04
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