lovastatin and niacin

Generic Name: lovastatin and niacin (LOE va sta tin and NYE a sin)
Brand Name: Advicor

What is lovastatin and niacin?

Niacin, also called nicotinic acid, is a B vitamin (vitamin B3). It occurs naturally in plants and animals, and is also added to many foods as a vitamin supplement. Niacin is also present in many multivitamins and nutritional supplements.

Lovastatin is in a group of drugs called HMG CoA reductase inhibitors, or "statins." Lovastatin reduces levels of "bad" cholesterol (low-density lipoprotein, or LDL) and triglycerides in the blood, while increasing levels of "good" cholesterol (high-density lipoprotein, or HDL).

The combination of lovastatin and niacin is used to lower cholesterol and triglycerides (types of fat) in the blood.

Lovastatin and niacin may also be used for other purposes not listed in this medication guide.

What is the most important information I should know about lovastatin and niacin?

You should not take this medication if you are allergic to niacin (Niaspan, Niacor, and others) or lovastatin (Altoprev, Mevacor), if you are pregnant or breast-feeding, or if you have liver disease, severe bleeding, or a stomach ulcer.

Stop taking this medication and tell your doctor right away if you become pregnant.

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Before taking lovastatin and niacin, tell your doctor if you have ever had liver or kidney disease, heart disease, diabetes, gout, or a thyroid disorder, if you have recently had a heart attack, or if you drink more than 2 alcoholic beverages daily.

In rare cases, lovastatin can cause a condition that results in the breakdown of skeletal muscle tissue, leading to kidney failure. Call your doctor right away if you have unexplained muscle pain, tenderness, or weakness especially if you also have fever, unusual tiredness, and dark colored urine.

There are many other drugs that can increase your risk of serious medical problems if you take them together with lovastatin and niacin. Tell your doctor about all medications you use. Keep a list of all your medicines and show it to any healthcare provider who treats you.

What should I discuss with my healthcare provider before taking lovastatin and niacin?

You should not take this medication if you are allergic to niacin (Niaspan, Niacor, and others) or lovastatin (Altoprev, Mevacor), if you are pregnant or breast-feeding, or if you have liver disease, severe bleeding, or a stomach ulcer.

To make sure you can safely take lovastatin and niacin, tell your doctor if you have any of these other conditions:

  • history of liver or kidney disease;

  • epilepsy or other seizure disorder;

  • diabetes;

  • gout;

  • a thyroid disorder;

  • if you drink more than 2 alcoholic beverages daily; or

  • if you are switched to this medication from regular niacin, nicotinic acid, or nicotinamide (or vitamin supplements that contain niacin).

In rare cases, lovastatin and niacin can cause a condition that results in the breakdown of skeletal muscle tissue, leading to kidney failure. This condition may be more likely to occur in older adults and in people who have kidney disease or poorly controlled hypothyroidism (underactive thyroid).

Many drugs should not be used at the same time. Tell your doctor about all other medications you use, especially:

  • danazol (Danocrine);

  • nefazodone (an antidepressant);

  • gemfibrozil (Lopid), fenofibric acid (Fibricor, Trilipix), or fenofibrate (Antara, Fenoglide, Lipofen, Lofibra, Tricor, Triglide);

  • an antibiotic such as clarithromycin (Biaxin), erythromycin (E.E.S., EryPed, Ery-Tab, Erythrocin, Pediazole), rifampin (Rifater, Rifadin, Rifamate), or telithromycin (Ketek);

  • antifungal medication such as itraconazole (Sporanox), ketoconazole (Nizoral), miconazole (Oravig), posaconazole (Noxafil), or voriconazole (Vfend);

  • heart or blood pressure medication such as nicardipine (Cardene) or quinidine (Quin-G);

  • the hepatitis C medications boceprevir (Victrelis) or telaprevir (Incivek);

  • HIV/AIDS medication such as atazanavir (Reyataz), delavirdine (Rescriptor), ritonavir (Norvir, Kaletra), and others;

  • other medicines that contain niacin (Advicor, Niaspan, Niacor, Slo-Niacin, and others); or

  • drugs that weaken your immune system, such as steroids, cancer medicine, or medicines used to prevent organ transplant rejection.

FDA pregnancy category X. This medication can harm an unborn baby or cause birth defects. Do not take lovastatin and niacin if you are pregnant. Stop taking this medication and tell your doctor right away if you become pregnant. Use effective birth control to avoid pregnancy while you are taking lovastatin and niacin.

Lovastatin and niacin may pass into breast milk and could harm a nursing baby. Do not breast-feed while you are taking lovastatin and niacin.

How should I take lovastatin and niacin?

Take exactly as prescribed by your doctor. Do not take in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label.

Lovastatin and niacin is usually taken at bedtime with a low-fat snack. Do not take lovastatin and niacin on an empty stomach.

Do not crush, chew, or break an extended-release tablet. Swallow it whole.

Niacin can cause dizziness, sweating, chills, redness or tingly feeling, fast or pounding heartbeats, shortness of breath, or feeling like you might pass out. These side effects can be made worse if you drink alcohol or hot beverages shortly after you take lovastatin and niacin.

You may need to stop using lovastatin and niacin for a short time if you have surgery or a medical emergency. If you stop taking the medicine for longer than 7 days in a row, talk with your doctor before restarting the medication.

To be sure this medicine is not causing harmful effects, your blood will need to be tested often. Visit your doctor regularly.

Niacin can raise your blood sugar, and may cause unusual results with certain medical tests. Tell any doctor who treats you that you are using lovastatin and niacin.

Lovastatin and niacin is only part of a complete program of treatment that also includes diet, exercise, and weight control. Follow your diet, medication, and exercise routines very closely.

Store at room temperature away from moisture and heat.

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. Overdose symptoms may include severe dizziness, severe redness or tingling, vomiting, or fainting.

What should I avoid while taking lovastatin and niacin?

If you also take cholestyramine (Prevalite, Questran) or colestipol (Colestid), avoid taking them within 4 to 6 hours before or after you take lovastatin and niacin.

Avoid eating foods that are high in fat or cholesterol. Lovastatin and niacin will not be as effective in lowering your cholesterol if you do not follow a cholesterol-lowering diet plan.

Avoid drinking alcohol. It can raise triglyceride levels and may increase your risk of liver damage.

Grapefruit and grapefruit juice may interact with lovastatin and niacin and lead to potentially dangerous effects. Discuss the use of grapefruit products with your doctor. Do not increase or decrease the amount of grapefruit products in your diet without first talking to your doctor.

Lovastatin and niacin side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Stop taking this medicine and call your doctor at once if you a serious side effect such as:

  • unexplained muscle pain, tenderness, or weakness;

  • confusion, memory problems;

  • fever, unusual tiredness, and dark colored urine;

  • chest pain, extreme dizziness, feeling like you might pass out;

  • swelling, weight gain, urinating less than usual or not at all;

  • high blood sugar (increased thirst, increased urination, hunger, dry mouth, fruity breath odor, drowsiness, dry skin, blurred vision, weight loss); or

  • nausea, upper stomach pain, itching, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes).

Less serious side effects may include:

  • headache, mild dizziness;

  • diarrhea, mild nausea, stomach pain or indigestion;

  • mild skin rash;

  • back pain;

  • flushing (warmth, redness, or tingly feeling); or

  • cold symptoms such as stuffy nose, sneezing, sore throat.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

Lovastatin and niacin Dosing Information

Usual Adult Dose for Hyperlipoproteinemia:

Initial: 20 mg-500 mg orally once daily at bedtime

Maintenance: 20 mg-500 mg to 40 mg-1000 mg orally once daily at bedtime.

Usual Adult Dose for Hyperlipoproteinemia Type IIa (Elevated LDL):

Initial: 20 mg-500 mg orally once daily at bedtime

Maintenance: 20 mg-500 mg to 40 mg-1000 mg orally once daily at bedtime.

Usual Adult Dose for Hyperlipoproteinemia Type IIb (Elevated LDL + VLDL):

Initial: 20 mg-500 mg orally once daily at bedtime

Maintenance: 20 mg-500 mg to 40 mg-1000 mg orally once daily at bedtime.

What other drugs will affect lovastatin and niacin?

Tell your doctor about all other medications you use, especially:

  • cimetidine (Tagamet);

  • colchicine (Colcrys);

  • a blood thinner such as warfarin (Coumadin, Jantoven);

  • drugs to treat high blood pressure or a prostate disorder, such as alfuzosin (Uroxatral), doxazosin (Cardura), prazosin (Minipress), silodosin (Rapaflo), terazosin (Hytrin), or tamsulosin (Flomax);

  • heart or blood pressure medication such as amiodarone (Cordarone, Pacerone), diltiazem (Cardizem, Cartia, Dilacor, Diltia, Diltzac, Taztia, Tiazac), felodipine (Plendil), nifedipine (Nifedical, Procardia), ranolazine (Ranexa), verapamil (Calan, Covera, Isoptin, Verelan), and others;

  • nitroglycerin (Nitro-Dur, Nitrolingual, Nitrostat, Transderm-Nitro, and others), isosorbide dinitrate (Dilatrate, Isordil, Isochron), or isosorbide mononitrate (Imdur, ISMO, Monoket); or

  • any other "statin" medication such as atorvastatin (Lipitor, Caduet), fluvastatin (Lescol), lovastatin (Altoprev, Mevacor), pravastatin (Pravachol), rosuvastatin (Crestor), or simvastatin (Zocor, Simcor, Vytorin).

This list is not complete and other drugs may interact with lovastatin and niacin. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

Where can I get more information?

  • Your pharmacist can provide more information about lovastatin and niacin.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 6.01. Revision Date: 2012-08-14, 11:26:32 PM.

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