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Lovastatin and niacin

Pronunciation:  LOE va stah tin and NYE a sin
Generic:  lovastatin and niacin
Brand:  Advicor.

What is lovastatin and niacin?

Lovastatin blocks the production of cholesterol (a type of fat) in the body. Niacin, also known as nicotinic acid, is vitamin B3. It occurs naturally in plants and animals and is also added to many foods as a vitamin supplement. Niacin also blocks the production of cholesterol in the body.

Together, lovastatin and niacin are used to reduce levels of LDL (or "bad) cholesterol, total cholesterol, and triglycerides and to raise levels of "good (HDL)cholesterol. These actions are important in the prevention of heart disease and hardening of the arteries, which can lead to heart attacks, stroke, and peripheral vascular disease.

Lovastatin and niacin may also be used for purposes other than those listed in this medication guide.

How should I take lovastatin and niacin?

Take lovastatin and niacin exactly as directed by your doctor. If you do not understand these directions, ask your pharmacist, nurse, or doctor to explain them to you.

Take each dose with a full glass of water.

Do not crush, chew, or break the tablets. Swallow them whole. They are specially formulated to slowly release the medication into the body.

For the greatest effect, lovastatin and niacin is usually taken at bedtime with a low-fat snack. Lovastatin and niacin should not be taken on an empty stomach.

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

Flushing (redness, warmth, itching, and/or tingling) of the face, neck, and ears is a common side effect. Flushing usually lessens with continued use of the medication, however aspirin or a non-steroidal anti-inflammatory drug such as ibuprofen taken up to approximately 30 minutes before a dose of lovastatin and niacin, may be used to alleviate these symptoms. Taking the medication at bedtime may also be beneficial.

To minimize flushing, avoid alcohol and hot drinks around the time you take lovastatin and niacin.

Your doctor will probably want to monitor your liver function with blood tests before starting and during treatment with lovastatin and niacin. Depending on the results of these tests, your doctor can determine how much monitoring you will require.

Follow any diet and exercise plans outlined by your healthcare provider. Diet and exercise are important factors in controlling cholesterol levels.

Do not stop taking lovastatin and niacin without first talking to your doctor.

If treatment with lovastatin and niacin is stopped for more than 7 days, see your doctor before restarting the medication. It may be necessary for you to restart with a lower strength of lovastatin and niacin.

Store lovastatin and niacin at room temperature away from moisture and heat.

What are the possible side effects of lovastatin and niacin?

If you experience any of the following serious side effects, stop taking lovastatin and niacin and seek emergency medical attention or call your doctor immediately:

  • an allergic reaction (difficulty breathing; closing of the throat; swelling of the lips, tongue, or face; or hives);
  • unexplained muscle pain, tenderness, or weakness;
  • "flu-like symptoms, such as nausea, fever and a general feeling of discomfort;
  • blurred vision; or
  • dizziness.

Other, less serious side effects may be more likely to occur. Continue to take lovastatin and niacin and talk to your doctor if you experience

  • stomach upset, nausea, or vomiting;
  • diarrhea;
  • itching or rash; or
  • headache.

Flushing (redness, warmth, itching, and/or tingling) of the face, neck, and ears is a common side effect. Flushing usually lessens with continued use of the medication, however aspirin or a non-steroidal anti-inflammatory drug such as ibuprofen taken up to approximately 30 minutes before a dose of lovastatin and niacin, may be used to alleviate these symptoms. Taking the medication at bedtime may also be beneficial.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

What other drugs will affect lovastatin and niacin?

Do not take lovastatin and niacin without first talking to your doctor if you are taking any of the following medicines:

  • cyclosporine (Sandimmune, Neoral);
  • gemfibrozil (Lopid);
  • clofibrate (Atromid-S);
  • fenofibrate (Tricor);
  • nefazodone (Serzone);
  • erythromycin (E-Mycin, E.E.S., Ery-Tab, Ilotycin, Eryc, PCE, Ilosone, others);
  • clarithromycin (Biaxin);
  • warfarin (Coumadin);
  • a protease inhibitor such as amprenavir (Agenerase), indinavir (Crixivan), nelfinavir (Viracept), ritonavir (Norvir), or saquinavir (Invirase, Fortovase).
  • other cholesterol-lowering drugs such as cholestyramine (Questran) or colestipol (Colestid); or
  • itraconazole (Sporanox) or ketoconazole (Nizoral).

You may not be able to take lovastatin and niacin, or you may require a dosage adjustment or special monitoring during treatment if you are taking any of the medicines listed above.

Tell your doctor about all other prescription medications and over-the-counter products you are taking, especially vitamins, herbs, or other nutritional supplements containing niacin or related compounds such as nicotinamide.

Drugs other than those listed here may also interact with lovastatin and niacin. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines, including herbal products.

What should I avoid while taking lovastatin and niacin?

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

To minimize flushing, avoid alcohol and hot drinks around the time you take lovastatin and niacin.

Alcohol and lovastatin and niacin can both be harmful to the liver, especially when used together. Alcohol should be used only in moderation. Discuss the use of alcohol with your doctor so that the potential for adverse effects can be determined.

Tell your doctor about all other prescription medications and over-the-counter products you are taking, especially vitamins or other nutritional supplements containing niacin or related compounds such as nicotinamide.

Dizziness may occur, especially when you rise from a sitting or lying position. Rise slowly and use caution when driving or performing other hazardous activities.

What happens if I overdose?

Seek emergency medical attention.

Symptoms of a lovastatin and niacin overdose include severe flushing, nausea, vomiting, diarrhea, stomach distress, dizziness, fainting, and indigestion.

What happens if I miss a dose?

Take the missed dose as soon as you remember. However, if it is almost time for the next dose, skip the missed dose and take only the next regularly scheduled dose. Do not take a double dose of this medication.

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

Contact you doctor immediately if you experience unexplained muscle pain, tenderness, or weakness, especially if it is accompanied by a fever, flu-like symptoms, or yellowing of the skin or eyes.

Alcohol and lovastatin and niacin can both be harmful to the liver, especially when used together. Alcohol should be used only in moderation. Discuss the use of alcohol with your doctor so that the potential for adverse effects can be determined.

Do not take lovastatin and niacin if you are pregnant or could become pregnant during treatment, or if you are breast-feeding a baby.

Dizziness may occur, especially when you rise from a sitting or lying position. Rise slowly and use caution when driving or performing other hazardous activities.

Follow any diet and exercise plans outlined by your healthcare provider. Diet and exercise are important factors in controlling cholesterol levels.

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

Do not take lovastatin and niacin without first talking to your doctor if you have a history of:

  • stomach ulcer; or
  • arterial bleeding.

Before taking lovastatin and niacin, tell your doctor if you:

  • drink alcoholic beverages;
  • have heart disease, angina (chest pain), or a history of heart attack;
  • have unexplained muscle pain or tenderness or a chronic muscular disease;
  • have gallbladder disease;
  • have diabetes;
  • have gout; or
  • need to have surgery.

You may not be able to take lovastatin and niacin, or you may require a dosage adjustment or special monitoring during treatment if you have any of the conditions listed above.

The combination of lovastatin and niacin is in the FDA pregnancy category X which means that it is known to be harmful to an unborn baby. Lovastatin is known to cause birth defects if used during pregnancy. Cholesterol is very important for the proper development of a baby. Do not take lovastatin and niacin if you are pregnant or could become pregnant during treatment.

It is not known whether lovastatin and niacin passes into breast milk. Do not take lovastatin and niacin without first talking to your doctor if you are breast-feeding a baby.

Where can I get more information?

Your pharmacist has additional information about lovastatin and niacin written for health professionals that you may read.

What does my medication look like?

Lovastatin and niacin is available with a prescription under the brand name Advicor. Other brand or generic formulations may also be available. Ask your pharmacist any questions you have about this medication, especially if it is new to you.

  • Advicor 500 mg-20 mgcapsule-shaped, light yellow tablets
  • Advicor 750 mg- 20 mgcapsule-shaped, light orange tablets
  • Advicor 1,000 mg-20 mgcapsule-shaped, dark pink/light purple tablets

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.

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.
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