Niacin/ lovastatin

Generic Name: niacin/lovastatin (NYE-a-sin/LOE-va-STAT-in)
Brand Name: Advicor

Niacin/ lovastatin is used for:

Improving cholesterol levels and lowering very high serum triglyceride levels, in combination with diet and exercise. It may also be used for other conditions as determined by your doctor.

Niacin/lovastatin is an antihyperlipidemic and HMG-CoA reductase inhibitor ("statin") combination. The statin works by reducing the production of certain fatty substances in the body, including cholesterol. The antihyperlipidemic reduces low-density lipoprotein (LDL) ("bad") cholesterol and triglycerides. It also increases high-density lipoprotein (HDL) ("good") cholesterol.

Do NOT use niacin/ lovastatin if:

  • you are allergic to any ingredient in niacin/lovastatin
  • you have liver problems or unexplained abnormal liver function tests
  • you are pregnant, may become pregnant, or are breast-feeding
  • you have peptic ulcer disease or certain bleeding problems
  • you are taking boceprevir, clarithromycin, cobicistat, cyclosporine, erythromycin, gemfibrozil, HIV protease inhibitors (eg, ritonavir), itraconazole, ketoconazole, nefazodone, posaconazole, telaprevir, telithromycin, or voriconazole

Contact your doctor or health care provider right away if any of these apply to you.

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Before using niacin/ lovastatin:

Some medical conditions may interact with niacin/lovastatin. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

  • if you are pregnant, planning to become pregnant, or are breast-feeding
  • if you are able to become pregnant
  • if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
  • if you have allergies to medicines, foods, or other substances
  • if you drink alcohol or have a history of alcohol abuse, yellowing of the skin or eyes, liver problems, peptic ulcer disease, gout, or seizures
  • if you are scheduled to have surgery, you have a severe infection or serious injury, or you are very ill
  • if you have low blood pressure, kidney problems, diabetes, low thyroid function, muscle problems (eg, pain, weakness), metabolism problems, hormonal problems, electrolyte problems, heart disease, recurring chest pain, or a serious bleeding condition, or have had a recent heart attack
  • if you have had an organ transplant and you are taking medicine to suppress a rejection reaction
  • if you are taking vitamins or other nutritional supplements containing niacin or similar products (eg, nicotinamide)

Some MEDICINES MAY INTERACT with niacin/lovastatin. Tell your health care provider if you are taking any other medicines, especially any of the following:

  • Amiodarone, azole antifungals (eg, itraconazole, ketoconazole, posaconazole, fluconazole, voriconazole), boceprevir, cobicistat, colchicine, cyclosporine, danazol, diltiazem, dronedarone, fibrates (eg, gemfibrozil, fenofibrate), HIV protease inhibitors (eg, ritonavir), macrolide antibiotics (eg, clarithromycin, erythromycin), nefazodone, ranolazine, telaprevir, telithromycin, or verapamil because they may increase the risk of niacin/lovastatin's side effects, including serious muscle problems
  • Anticoagulants (eg, warfarin), cimetidine, or spironolactone because the risk of their side effects may be increased by niacin/lovastatin

This may not be a complete list of all interactions that may occur. Ask your health care provider if niacin/lovastatin may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use niacin/ lovastatin:

Use niacin/lovastatin as directed by your doctor. Check the label on the medicine for exact dosing instructions.

  • Take niacin/lovastatin by mouth at bedtime with a low-fat snack (eg, low-fat yogurt, banana, crackers with a glass of milk) to minimize flushing and upset stomach, unless directed otherwise by your doctor. Do not take niacin/lovastatin on an empty stomach. Do not take niacin/lovastatin with alcohol, a hot drink, or spicy foods.
  • If you also take cholestyramine or colestipol, do not take them within 4 to 6 hours of taking niacin/lovastatin. Check with your doctor if you have questions.
  • Swallow niacin/lovastatin whole. Do not break, crush, or chew before swallowing.
  • Do not eat grapefruit or drink grapefruit juice at the same time you take niacin/lovastatin.
  • Eating grapefruit or drinking grapefruit juice may increase the amount of niacin/lovastatin in your blood, which may increase your risk for serious side effects. The risk may be greater with large amounts of grapefruit or grapefruit juice. Avoid large amounts of grapefruit or grapefruit juice (eg, more than 1 quart daily) while you are using niacin/lovastatin. Talk with your doctor or pharmacist if you have questions about including grapefruit or grapefruit juice in your diet while you are taking niacin/lovastatin.
  • It may take several weeks for niacin/lovastatin to work. Do not stop using niacin/lovastatin without checking with your doctor.
  • If you miss a dose of niacin/lovastatin, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use niacin/lovastatin.

Important safety information:

  • Niacin/lovastatin may cause dizziness. These effects may be worse if you take it with alcohol or certain medicines. Use niacin/lovastatin with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.
  • Flushing occurs with niacin/lovastatin and may last for several hours. Flushing usually decreases after several weeks of use. Take niacin/lovastatin at bedtime so that flushing will occur during sleep, unless your doctor tells you otherwise. If flushing awakens you, get up slowly, especially if you feel dizzy or faint or if you are taking blood pressure medicine.
  • Taking aspirin 30 minutes before you take niacin/lovastatin may lessen flushing. Talk with your doctor to see if you should take aspirin before you take niacin/lovastatin. Talk to your doctor if flushing becomes bothersome.
  • Niacin/lovastatin may cause liver problems. Rarely, severe and sometimes fatal liver problems have been reported in patients taking "statin" medicines, including lovastatin. Your risk of developing liver problems may be greater if you drink alcohol daily or in large amounts with niacin/lovastatin or if you have a history of liver problems. Check with your doctor before drinking alcohol while you are taking niacin/lovastatin. Tell your doctor right away if you experience symptoms of liver problems (eg, dark urine; pale stools; severe or persistent nausea, loss of appetite, or stomach pain; unusual tiredness; yellowing of the skin or eyes).
  • For best results, niacin/lovastatin should be used alone with exercise, a low-cholesterol/low-fat diet, and a weight loss program if you are overweight. Follow the diet and exercise program given to you by your health care provider.
  • Niacin/lovastatin is only recommended if you have taken either lovastatin or long-acting niacin alone before and may need to further reduce your cholesterol and/or triglyceride levels. Tell your doctor if you have not taken either lovastatin or long-acting niacin before starting treatment with niacin/lovastatin. Also tell your doctor if you have been taking a short-acting form of niacin before you begin taking niacin/lovastatin. It is recommended that you take long-acting niacin for several weeks before using niacin/lovastatin so your body can adjust to its effects.
  • If you stop taking niacin/lovastatin for an extended period (more than 7 days), contact your doctor before you start taking it again. Your dose may need to be adjusted.
  • Tell your doctor or dentist that you take niacin/lovastatin before you receive any medical or dental care, emergency care, or surgery.
  • Women who may become pregnant should use effective birth control while taking niacin/lovastatin. Check with your doctor if you have questions about using birth control.
  • Muscle problems (myopathy) may occur with niacin/lovastatin. Report any unexplained muscle pain, tenderness, or weakness to your doctor right away, especially if you also have a fever or general body discomfort. Tell your doctor if you have muscle problems that persist even after your doctor has told you to stop taking niacin/lovastatin.
  • Diabetes patients - Niacin/lovastatin may affect your blood sugar. Check blood sugar levels closely. Ask your doctor before you change the dose of your diabetes medicine.
  • Niacin/lovastatin may interfere with certain lab tests, including urine glucose tests. Be sure your doctor and lab personnel know you are taking niacin/lovastatin.
  • Lab tests, including liver function tests, blood sugar, and blood cholesterol tests, may be performed while you use niacin/lovastatin. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.
  • Niacin/lovastatin should not be used in CHILDREN; safety and effectiveness in children have not been confirmed.
  • PREGNANCY and BREAST-FEEDING: Do not use niacin/lovastatin if you are pregnant. It may cause harm to the fetus. Avoid becoming pregnant while you are taking it. If you think you may be pregnant, contact your doctor right away. Niacin/lovastatin is found in breast milk. Do not breast-feed while taking niacin/lovastatin.

Possible side effects of niacin/ lovastatin:

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Back pain; diarrhea; headache; indigestion; nausea; stomach upset; temporary skin redness, itching, tingling, or feelings of warmth (flushing); vomiting; weakness.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue; unusual hoarseness); black, tarry, or bloody stools; burning, numbness, or tingling; chest pain; confusion; decreased urination; dizziness; fainting; fast or irregular heartbeat; fever, chills, or persistent sore throat; flu-like symptoms; increased sweating; joint pain; memory problems; mental or mood changes (eg, depression); muscle pain, tenderness, or weakness (especially if associated with fever and a general feeling of discomfort); red, swollen, blistered, or peeling skin; severe stomach or back pain (with or without nausea or vomiting); shortness of breath; swelling of the hands, legs, or feet; symptoms of high blood sugar (eg, increased thirst, hunger, or urination; confusion; drowsiness; rapid breathing; fruit-like breath odor); symptoms of liver problems (eg, dark urine; pale stools; severe or persistent nausea, loss of appetite, or stomach pain; unusual tiredness; yellowing of the skin or eyes); tremor; unusual bruising or bleeding; unusual tiredness or weakness; vision changes (eg, cloudy or blurred vision); vomit that looks like coffee grounds.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately.

Proper storage of niacin/lovastatin:

Store niacin/lovastatin at room temperature, between 68 and 77 degrees F (20 and 25 degrees C), in a tightly closed container. Store away from heat, moisture, and light. Do not store in the bathroom. Keep niacin/lovastatin out of the reach of children and away from pets.

General information:

  • If you have any questions about niacin/lovastatin, please talk with your doctor, pharmacist, or other health care provider.
  • Niacin/lovastatin is to be used only by the patient for whom it is prescribed. Do not share it with other people.
  • If your symptoms do not improve or if they become worse, check with your doctor.
  • Check with your pharmacist about how to dispose of unused medicine.

This information should not be used to decide whether or not to take niacin/lovastatin or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about niacin/lovastatin. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to niacin/lovastatin. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using niacin/lovastatin.

Issue Date: September 3, 2014
Database Edition 14.3.1.003
Copyright © 2014 Wolters Kluwer Health, Inc.

Disclaimer: This information should not be used to decide whether or not to take this medicine or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this medicine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using this medicine.

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