Livalo (Pitavastatin) Oral: Uses, Side Effects, Dosages

What Is Livalo?

Livalo (pitavastatin) is an oral HMG-CoA reductase inhibitor, also known as a statin drug. It is most commonly used to treat high cholesterol (hyperlipidemia) and a condition called heterozygous familial hypercholesterolemia.

Livalo lowers levels of low-density lipoprotein (LDL) cholesterol, also known as “bad cholesterol.” Livalo slows cholesterol production to reduce buildup in the arteries. Elevated LDL levels are known to increase the risk of heart disease and its complications, such as heart attack and stroke.

Livalo is available in tablet form. It is a prescription drug, so your healthcare provider must prescribe it for you.

Drug Facts

Generic Name: Pitavastatin

Brand Name(s): Livalo (pitavastatin calcium), Zypitamag (pitavastatin magnesium)

Drug Availability: Prescription

Administration Route: Oral

Therapeutic Classification: Antihyperlipidemic

Available Generically: No

Controlled Substance: N/A

Active Ingredient: Pitavastatin

Dosage Form(s): Tablet

What Is Livalo Used For?

The Food and Drug Administration (FDA) approved Livalo for use in:

  • Adults with mixed hyperlipidemia (familial combined hyperlipidemia), which causes elevated fat levels in the blood and can be genetic.
  • Adults with primary hyperlipidemia
  • Primary heterozygous familial hypercholesterolemia in adults and children 8 years and older

Livalo helps to lower total cholesterol, LDL cholesterol, apolipoprotein B, and triglycerides. It also increases high-density lipoprotein cholesterol, also known as “good cholesterol.”

How to Take Livalo

Take Livalo at any time, with or without food, but at the same time each day. Follow your healthcare provider’s instructions on how to take this medication. Your dose might be individualized based on various factors, such as response to treatment, the goal of therapy, and other health conditions or medications you are taking.


Keep Livalo tablets at temperatures between 59 degrees and 86 degrees Fahrenheit. Protect the tablets from light and moisture.

Off-Label Uses

Healthcare providers may prescribe Livalo for off-label uses, meaning for conditions not specifically indicated by the FDA.

Off-label uses may include:

What Are the Side Effects of Livalo?

This is not a complete list of side effects and others may occur. A healthcare provider can advise you on side effects. If you experience other effects, contact your healthcare provider. You may report side effects to the FDA at or 1-800-FDA-1088.

Common Side Effects

Common side effects can include:

  • Constipation
  • Diarrhea
  • Backache
  • Muscle pain (myalgia)
  • Pain in limb

Severe Side Effects

Call your healthcare provider right away if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:

Report Side Effects

Livalo may cause other side effects. Call your healthcare provider if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your healthcare provider may send a report to the FDA’s MedWatch Adverse Event Reporting Program or by phone (800-332-1088).

Dosage: How Much Livalo Should I Take?

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The dose of this medicine will be different for different patients. Follow your doctor’s orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For oral dosage form (tablets):

    • For high cholesterol:

      • Livalo®:

        • Adults and children 8 years of age and older—At first, 2 milligrams (mg) once a day. Your doctor may adjust your dose as needed. However, the dose is usually not more than 4 mg per day.
        • Children younger than 8 years of age—Use and dose must be determined by your doctor.
      • Zypitamag™:

        • Adults—At first, 2 milligrams (mg) once a day. Your doctor may adjust your dose as needed. However, the dose is usually not more than 4 mg per day.
        • Children—Use and dose must be determined by your doctor.


In some instances, your healthcare provider may adjust the dosage of your medication. For example, people who have moderate and severe kidney impairment may need a lower starting dosage. Additionally, your healthcare provider may adjust your dosage if you take certain other medications, such as erythromycin and rifampin.

Livalo should not be used in people with active liver disease.

Missed Dose

If you miss a dose of Livalo, take it as soon as you remember. If it is almost time for the next dose, skip the missed dose and take the next dose at the regularly scheduled time. Do not take an extra dose to make up for the missed dose.

Overdose: What Happens If I Take Too Much Livalo?

Symptoms of overdosage with Livalo are expected to be similar to the side effects of normal doses, including:

  • Nausea
  • Diarrhea
  • Abdominal pain

Contact a healthcare provider if you think you’ve taken too much of this medication. If you do overdose, your healthcare provider may monitor you for abnormalities of blood electrolytes, liver enzymes, and blood counts.

What Happens If I Overdose on Livalo?

If you think you or someone else may have overdosed on Livalo, call a healthcare provider or the Poison Control Center (800-222-1222).

If someone collapses or isn’t breathing after taking Livalo, call 911 immediately.


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It is very important that your doctor check your progress at regular visits. This will allow your doctor to see if the medicine is working properly to lower your cholesterol and triglyceride levels and to decide if you should continue to take it. Blood and urine tests may be needed to check for unwanted effects.

Using this medicine while you are pregnant can harm your unborn baby. Use an effective form of birth control to keep from getting pregnant. If you think you have become pregnant while using the medicine, tell your doctor right away.

Do not use cyclosporine (Gengraf®, Neoral®, Sandimmune®) while you are using this medicine. Using these medicines together may cause serious side effects.

Call your doctor right away if you have unexplained muscle pain, tenderness, or weakness, especially if you also have unusual tiredness or a fever. These may be symptoms of serious muscle problems, such as myopathy or immune-mediated necrotizing myopathy (IMNM).

Call your doctor right away if you have dark urine, diarrhea, a fever, muscle cramps or spasms, muscle pain or stiffness, or feel very tired or weak. These could be symptoms of a serious muscle problem called rhabdomyolysis, which can cause kidney problems.

Call your doctor right away if you have stomach pain, bloating, nausea, vomiting, dark urine, light-colored stools, or yellow eyes or skin. These could be symptoms of liver damage.

Make sure any doctor or dentist who treats you knows that you use this medicine. You may need to stop using this medicine if you have major tests, major surgery, a major injury, or if you develop other serious health problems.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

What Are Reasons I Shouldn’t Take Livalo?

You should not take Livalo if you are pregnant or breastfeeding. The drug can cause harm to the fetus because it lowers cholesterol and possibly other biologically active substances made from cholesterol in the body. However, it does not appear to be linked to an increase in major birth malformations. There is also concern that Livalo may affect the lipid production of a breastfeeding infant. However, it is not known if pitavastatin is passed through human breast milk. Still, it is better to be safe.

You should also not use Livalo if you:

  • Have a known hypersensitivity (allergy) to Livalo or any of its inactive ingredients
  • If you are taking cyclosporine
  • Have active liver disease, including unexplained persistent elevations of liver transaminase levels
  • Consume red yeast rice

Tell your healthcare provider if you have had issues while using other statins before. You may need to use extra caution when taking Livalo.

What Other Medications Interact With Livalo?

The following drugs can increase the risk of myopathy and rhabdomyolysis when used in combination with Livalo:

  • Gengraf, Neoral, Sandimmune (cyclosporine): Do not use cyclosporine with Livalo.
  • Lopid (gemfibrozil): Do not use gemfibrozil with Livalo.
  • Erythromycin: Erythromycin increases blood levels of Livalo. Do not exceed 1 milligram daily of Livalo when taking erythromycin.
  • Rifadin, Rimactane (rifampin): Rifampin increases blood levels of Livalo. Do not exceed 2 milligrams daily of Livalo when taking rifampin. 
  • Fibrates (e.g., fenofibrate): You and your healthcare provider must weigh the risks of increased myopathy and rhabdomyolysis with the benefit of taking a fibrate with pitavastatin. 
  • Niacor (niacin): The risk of myopathy and rhabdomyolysis increases when Livalo is combined with niacin doses greater than or equal to 1 gram per day. Weigh the risks and benefits of this combination. 
  • Colcrys, Gloperba, Mitigare (colchicine): Weigh the risks and benefits of this combination with your healthcare provider.

Always tell your healthcare provider about your medications, including prescription and over-the-counter (OTC) products and supplements you take.

What Medications Are Similar?

Livalo belongs to a family of drugs known as statins or HMG-CoA reductase inhibitors. Other medications in this family include:

People should only take one statin medication at a time. If you experience side effects from one statin medication, your healthcare provider may try you on a different statin to see if you tolerate it with fewer side effects.

Frequently Asked Questions

  • What side effects can I expect while taking Livalo?

    The most common side effects of Livalo are backache, constipation, diarrhea, myalgia (muscle pain), and pain in the extremities.

  • How does Livalo work?

    Livalo blocks the enzyme HMG-CoA reductase in the liver, an important enzyme in the body’s formation of cholesterol. Blocking this enzyme reduces the amount of cholesterol the body makes, thus decreasing LDL levels.

  • What is Livalo used for?

    You may be prescribed Livalo if you have primary hyperlipidemia, mixed hyperlipidemia, or heterozygous familial hypercholesterolemia to help reduce elevated cholesterol levels.

How Can I Stay Healthy While Taking Livalo?

If you have been prescribed Livalo, you likely need to lower the levels of bad cholesterol in your body. Livalo should be used in addition to a cholesterol-lowering diet and regular physical activity. Talk to your healthcare provider about an appropriate diet and exercise plan.

Take some of these tips into consideration when working towards a heart-healthy diet:

  • Choose healthier fats: Healthy fats can be found in lean meat, nuts, and unsaturated oils (e.g., canola, olive, and safflower oils).
  • Limit bad fats such as total, saturated, and trans fats, as well as salt (sodium) and added sugars
  • Avoid cholesterol-rich foods: Aim for less than 200 milligrams of cholesterol per day. Foods with cholesterol include certain meats, egg yolks, shrimp, and whole milk dairy products.
  • Eat high-fiber foods: High-fiber foods include whole-grain cereal, fruits, and legumes
  • Eat more fruits and vegetables

Tell your healthcare provider immediately if you experience any of the signs and symptoms of muscle damage, such as pain or tenderness and weakness, especially if accompanied by tiredness or fever. The risk of myopathy and rhabdomyolysis increases when taken with certain prescription and OTC medications, so discuss your medications and any new additions with your healthcare provider.

Rarely, Livalo can cause liver damage, so be aware of any signs and symptoms that may indicate effects on the liver. These include:

  • Loss of appetite
  • Fatigue
  • Right upper abdominal pain discomfort
  • Dark urine
  • Jaundice

If you have diabetes, pay close attention to your blood sugar levels, as Livalo may cause an increase in blood sugar. Optimize lifestyle measures, including regular exercise and eating a healthy diet.

Medical Disclaimer

Verywell Health’s drug information is meant for educational purposes only and is not intended to replace medical advice, diagnosis, or treatment from a healthcare provider. Consult your healthcare provider before taking any new medication(s). IBM Watson Micromedex provides some of the drug content, as indicated on the page.