Drug interactions between ezetimibe/simvastatin and Niaspan
| Results for the following 2 drugs: |
|---|
| ezetimibe/simvastatin |
| Niaspan (niacin) |
Interactions between your selected drugs
niacin ↔ simvastatin
Applies to:Niaspan (niacin) and ezetimibe/simvastatin
GENERALLY AVOID: Severe myopathy and rhabdomyolysis have been reported with concomitant use of HMG-CoA reductase inhibitors (i.e., statins) and niacin. The mechanism of interaction is unknown, although both statins alone as well as lipid-modifying dosages of niacin (>=1 g/day) alone have been associated with the development of myopathy. Certain populations may be more susceptible to the interaction. In a double-blind, randomized cardiovascular outcomes trial for simvastatin, the incidence of myopathy was found to be higher in patients of Chinese descent (0.43%) compared to patients not of Chinese descent (0.03%) taking 40 mg simvastatin and lipid-modifying dosages of a niacin-containing product. The cause of the increased risk is unknown, and it is also unknown if the increased risk applies to other Asian populations or to other statins when given to Chinese patients.
MANAGEMENT: Concurrent use of statins and lipid-modifying dosages of niacin (>=1 g/day) should generally be avoided unless the benefit of further alterations in lipid levels is anticipated to outweigh the potential risks. Addition of niacin to statin therapy typically provides little additional reduction in LDL cholesterol, but further reductions of triglycerides and increases in HDL cholesterol may be attained. If the combination is prescribed, lower dosages of the statin should be considered. Lovastatin labeling recommends that the dosage not exceed 20 mg daily when prescribed with lipid-modifying dosages of niacin. Simvastatin labeling recommends that, due to an increased risk of myopathy, Chinese patients not be prescribed simvastatin 80 mg with lipid-modifying dosages of niacin. Caution should be used when treating Chinese patients with simvastatin dosages exceeding 20 mg/day in combination with lipid-modifying dosages of niacin. All patients should be advised to promptly report any unexplained muscle pain, tenderness or weakness, particularly if accompanied by fever, malaise and/or dark colored urine. Therapy should be discontinued if creatine kinase is markedly elevated in the absence of strenuous exercise or if myopathy is otherwise suspected or diagnosed.
See also...
Drug Interaction Classification
The classifications below are a guideline only. The relevance of a particular drug interaction to a specific patient is difficult to determine using this tool alone given the large number of variables that may apply.
| Major | Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. |
| Moderate | Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. |
| Minor | Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan. |
Do not stop taking any medications without consulting your healthcare provider.
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