Drug Interaction Report

The following interaction applies only if you are taking high dosages of niacin for the treatment of high cholesterol. It does not apply if you are taking niacin at dosages commonly used in nutritional supplements.

Using lovastatin together with niacin may increase the risk of a rare but serious condition called rhabdomyolysis that involves the breakdown of skeletal muscle tissue. In some cases, rhabdomyolysis can cause kidney damage and even death. The risk is greatest if you are elderly or have preexisting kidney disease. Talk to your doctor if you have any questions or concerns. Your doctor may already be aware of the risks, but has determined that this is the best course of treatment for you and has taken appropriate precautions and is monitoring you closely for any potential complications. Let your doctor know immediately if you have unexplained muscle pain, tenderness, or weakness during treatment with lovastatin or similar medications, especially if these symptoms are accompanied by fever or dark colored urine. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

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Ivosidenib may reduce the blood levels and effects of lovastatin. Talk to your doctor if you have any questions or concerns. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring to safely use both medications. Let your doctor know if lovastatin becomes less effective or is no longer controlling your symptoms. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

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Grapefruit juice can significantly increase the blood levels of lovastatin. This can increase the risk of side effects such as liver damage and a rare but serious condition called rhabdomyolysis that involves the breakdown of skeletal muscle tissue. In some cases, rhabdomyolysis can cause kidney damage and even death. You should avoid the consumption of grapefruit or grapefruit juice during treatment with lovastatin. Drinking green tea or taking green tea extracts may also increase the blood levels of lovastatin in some patients. Talk to your doctor or pharmacist if you have any questions or concerns. It may be advisable to avoid excessive consumption of green tea and green tea products while on lovastatin. Let your doctor know immediately if you have unexplained muscle pain, tenderness, or weakness during treatment, especially if these symptoms are accompanied by fever or dark colored urine. You should also seek immediate medical attention if you develop fever, chills, joint pain or swelling, unusual bleeding or bruising, skin rash, itching, loss of appetite, fatigue, nausea, vomiting, dark colored urine, and/or yellowing of the skin or eyes, as these may be signs and symptoms of liver damage. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

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Do not consume grapefruit or grapefruit juice during treatment with ivosidenib unless directed otherwise by your doctor. Grapefruit juice can increase the blood levels of ivosidenib. This may increase the risk of an irregular heart rhythm that may be serious and potentially life-threatening. You may be more susceptible if you have a heart condition called congenital long QT syndrome, other cardiac diseases, conduction abnormalities, or electrolyte disturbances (for example, magnesium or potassium loss due to severe or prolonged diarrhea or vomiting). Talk to your doctor if you have any questions or concerns. You may take ivosidenib with or without food, but avoid taking it with a high-fat meal, as this can also increase blood levels of the medication. An example of a high-fat meal includes 2 eggs fried in butter, 2 strips of bacon, 2 slices of white bread with butter, 1 croissant with 1 slice of cheese, and 8 ounces of whole milk (approximately 1,000 calories and 58 grams of fat). You should seek immediate medical attention if you develop sudden dizziness, lightheadedness, fainting, shortness of breath, or heart palpitations during treatment. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

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Lovastatin may cause liver problems and using it with substantial quantities of ethanol may increase that risk. You should limit the use of alcohol while being treated with these medications. Call your doctor immediately if you have fever, chills, joint pain or swelling, unusual bleeding or bruising, skin rash, itching, loss of appetite, fatigue, nausea, vomiting, abdominal pain, dark urine, pale stools, and/or yellowing of the skin or eyes, as these may be signs and symptoms of liver damage. Talk to your doctor or pharmacist if you have any questions or concerns. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

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Ask your doctor before using niacin together with ethanol. You should avoid drinking alcohol, it can increase some of the side effects of niacin. This can cause nausea, dizziness, itching, vomiting, upset stomach, and flushing (warmth, redness, or tingly feeling under your skin). Furthermore, consumption of large amounts of alcohol is associated with elevated cholesterol and triglycerides. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

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Information for this minor interaction is available on the professional version.