Wednesday, September 14, 2016

lovastatin and niacin


NYE-a-sin, loe-va-STAT-in


Commonly used brand name(s)

In the U.S.


  • Advicor

Available Dosage Forms:


  • Tablet

  • Tablet, Extended Release

Therapeutic Class: Antihyperlipidemic


Pharmacologic Class: Vitamin B


Chemical Class: Nicotinic Acid (class)


Uses For lovastatin and niacin


Niacin extended-release and Lovastatin combination medicine is used to help lower high cholesterol and fat levels in the blood. This may help prevent medical problems caused by cholesterol and fat clogging the blood vessels.


Niacin extended-release and lovastatin combination medicine combines two drugs that work together to treat cholesterol and lipid (fat) disorders. Niacin is a B-complex vitamin that reduces the amount of cholesterol in the blood. Lovastatin belongs to the group of medicines called 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors. It works by blocking an enzyme that is needed by the body to make cholesterol, thereby reducing the amount of cholesterol in the blood


lovastatin and niacin is available only with your doctor's prescription.


Before Using lovastatin and niacin


In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For lovastatin and niacin, the following should be considered:


This combination medicine should not be used until after your body has adjusted to each of the individual medicines. Be sure to check with your doctor about this.


Allergies


Tell your doctor if you have ever had any unusual or allergic reaction to lovastatin and niacin or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.


Pediatric


Studies on lovastatin and niacin have been done only in adult patients, and there is no specific information comparing use of niacin extended-release and lovastatin combination in children with use in other age groups.


Geriatric


lovastatin and niacin has been tested in a limited number of patients 65 years of age or older and has not been shown to cause different side effects or problems in older people than it does in younger adults.


Pregnancy








Pregnancy CategoryExplanation
All TrimestersXStudies in animals or pregnant women have demonstrated positive evidence of fetal abnormalities. This drug should not be used in women who are or may become pregnant because the risk clearly outweighs any possible benefit.

Breast Feeding


There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.


Interactions with Medicines


Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking lovastatin and niacin, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.


Using lovastatin and niacin with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.


  • Atazanavir

  • Boceprevir

  • Clarithromycin

  • Darunavir

  • Fosamprenavir

  • Itraconazole

  • Lopinavir

  • Mibefradil

  • Ritonavir

  • Saquinavir

  • Telaprevir

  • Tipranavir

Using lovastatin and niacin with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.


  • Amiodarone

  • Amprenavir

  • Atorvastatin

  • Bezafibrate

  • Cerivastatin

  • Ciprofibrate

  • Clofibrate

  • Colchicine

  • Conivaptan

  • Cyclosporine

  • Dalfopristin

  • Danazol

  • Daptomycin

  • Delavirdine

  • Erythromycin

  • Everolimus

  • Fenofibrate

  • Fluconazole

  • Gemfibrozil

  • Indinavir

  • Ketoconazole

  • Lovastatin

  • Nefazodone

  • Nelfinavir

  • Niacin

  • Pitavastatin

  • Posaconazole

  • Quinupristin

  • Ranolazine

  • Rosuvastatin

  • Simvastatin

  • Telithromycin

  • Verapamil

Using lovastatin and niacin with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.


  • Azithromycin

  • Bosentan

  • Diltiazem

  • Oat Bran

  • Pectin

  • St John's Wort

  • Voriconazole

  • Warfarin

Interactions with Food/Tobacco/Alcohol


Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.


Using lovastatin and niacin with any of the following may cause an increased risk of certain side effects but may be unavoidable in some cases. If used together, your doctor may change the dose or how often you use lovastatin and niacin, or give you special instructions about the use of food, alcohol, or tobacco.


  • Ethanol

  • Grapefruit Juice

Other Medical Problems


The presence of other medical problems may affect the use of lovastatin and niacin. Make sure you tell your doctor if you have any other medical problems, especially:


  • Bleeding problems or

  • Diabetes mellitus (sugar diabetes) or

  • Endocrine problems or

  • Gout or

  • Heart Disease or

  • Liver disease or

  • Low blood pressure or

  • Stomach Ulcer—Niacin extended-release and lovastatin combination may make these conditions worse.

  • Kidney Disease—Effects of niacin extended-release and lovastatin combination may be increased because of slower removal of medicine from the body.

Proper Use of lovastatin and niacin


Before prescribing medicine for your condition, your doctor will probably try to control your condition by prescribing a personal diet for you. Such a diet may be low in fats, particularly saturated fat, sugars, and/or cholesterol. Many people are able to control their condition by carefully following their doctor's orders for proper diet and exercise. Medicine is prescribed only when additional help is needed and is effective only when a schedule of diet and exercise is properly followed.


Make certain your doctor knows if you are on any special diet, such as a low-sodium or low-sugar diet.


Use lovastatin and niacin only as directed by your doctor. Do not use more or less of it, and do not use it more often or for a longer time than your doctor ordered. Also, lovastatin and niacin works best if there is a constant amount in the blood. To help keep this amount constant, do not miss any doses and take the medicine at the same time each day.


Remember that lovastatin and niacin will not cure your condition but it does help control it. Therefore, you must continue to take it as directed to keep your cholesterol levels down.


Follow carefully the special diet your doctor gave you.This is an important part of controlling your condition, and is necessary if the medicine is to work properly.


Do not drink any grapefruit juice around the time you take lovastatin and niacin. It may be best to drink any grapefruit juice approximately 12 hours before or after you take your medicine. In addition, do not drink grapefruit juice in large quantities (more than one quart per day) while you are being treated with niacin extended-release and lovastatin combination. To do so may increase the risk of developing muscle problems. Check with your doctor if you have any questions.


Take lovastatin and niacin at bedtime after eating a low fat snack. Swallow the tablet whole. Do not crush, break, or chew the tablet before you swallow it.


lovastatin and niacin may cause you to have skin flushing which makes your face, neck, arms and occasionally, your upper chest to feel warm and look red. Flushing usually starts about two to four hours after you take your medicine, and may last up to several hours. Flushing can also cause itching and/or a tingling sensation. A more intense episode of flushing may include dizziness or faintness. If you take your medicine at bedtime, you may sleep through any flushing that occurs. If awakened by flushing, rise slowly to minimize the potential for dizziness or fainting. Avoiding alcohol or hot drinks may reduce the flushing. This effect should lessen after several weeks as your body gets used to the medicine. However, if the problem continues or gets worse, check with your doctor.


Dosing


The dose of lovastatin and niacin will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of lovastatin and niacin. If your dose is different, do not change it unless your doctor tells you to do so.


The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.


  • For oral dosage form (tablets):

      • Adults—The starting dose is usually, 500 milligrams (mg) of niacin extended-release and 20 mg of lovastatin (combined in one tablet) one time a day, at bedtime with a low fat snack. Then your doctor may increase your dose a little at a time every 4 weeks, as your body gets used to the medicine, until your cholesterol is controlled.

      • Children—Use and dose must be determined by your doctor.



Missed Dose


If you miss a dose of lovastatin and niacin, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.


If you have not taken lovastatin and niacin for more than 7 days, check with your doctor. You may need to have your dose reduced before you can start taking lovastatin and niacin again.


Storage


Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.


Keep out of the reach of children.


Do not keep outdated medicine or medicine no longer needed.


Ask your healthcare professional how you should dispose of any medicine you do not use.


Precautions While Using lovastatin and niacin


Check with your doctor immediately if you have dark-colored urine, a fever, muscle cramps or spasms, muscle pain or stiffness, or feel very tired or weak.Niacin extended-release and lovastatin combination may cause a serious, but rare, problem called rhabdomyolysis. It is important to call your doctor right away if you have any of these symptoms.


It is very important that your doctor check your progress at regular visits.This will allow your doctor to see if the medicine is working properly to lower your cholesterol and triglyceride (fat) levels and that it does not cause unwanted side effects. At regular intervals, your doctor will want to do routine blood tests.


For diabetic patients: lovastatin and niacin may affect blood sugar levels. If you notice a change in the results of your blood or urine sugar tests or if you have any questions, check with your doctor.


Do not stop taking niacin extended-release and lovastatin combination without first checking with your doctor. When you stop taking lovastatin and niacin, your blood cholesterol levels may increase again.


Check with your doctor immediately if you think that you may be pregnant. Niacin extended-release and lovastatin combination may cause birth defects or other problems in the baby if taken during pregnancy.


Before having any kind of surgery (including dental surgery) or emergency treatment, tell the medical doctor or dentist in charge that you are taking lovastatin and niacin.


lovastatin and niacin Side Effects


Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.


Check with your doctor immediately if any of the following side effects occur:


More common
  • Asthenia, such as, lack or loss of strength

  • infection, such as, cough or hoarseness, fever or chills, lower back or side pain, painful or difficult urination

  • pain

Less common
  • Abdominal pain, such as, stomach pain

  • hyperglycemia, such as, abdominal pain, blurred vision, dry mouth, fatigue, dry skin, fruit-like breath odor, increased hunger, increased thirst, increased urination, nausea, unexplained weight loss, vomiting

  • myalgia, such as, difficulty in moving, joint pain, muscle aching, cramping pain or stiffness, swollen joints

  • myopathy, such as, muscle aches, weakness, tenderness, or pain

  • stomach pain

Rare
  • Rhabdomyolysis, such as, dark-colored urine, fever, muscle cramps, pain, spasm, or stiffness, unusual tiredness or weakness

Symptoms of Overdose

Get emergency help immediately if any of the following symptoms of overdose occur:


  • Cardiac arrhythmia, such as, chest pain or discomfort, dizziness, fainting, fast, slow or irregular heartbeat, lightheadedness, pounding or rapid pulse

  • diarrhea

  • dizziness

  • flushing, severe, such as, feeling of warmth, redness, itching, and/or tingling of the face, neck, arms, and occasionally, upper chest, dizziness, fainting

  • hypotension, such as, blurred vision, confusion, dizziness, faintness, lightheadedness when getting up from a lying or sitting position, sudden sweating, unusual tiredness or weakness

  • nausea and vomiting

  • syncope, such as, fainting

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:


More Common
  • Chills

  • diarrhea

  • flu syndrome, such as, chills, diarrhea, fever, general feeling of discomfort or illness, headache, joint pain, loss of appetite, muscle aches and pains, nausea, runny nose, shivering, sore throat, sweating, trouble sleeping, unusual tiredness or weakness, vomiting

  • flushing, such as, feeling of warmth, redness, itching, and/or tingling of the face, neck, arms, and occasionally, upper chest

  • edema, such as, swelling

  • headache

  • nausea

  • pruritus, such as, itching skin

  • rash

  • shortness of breath

  • sweating

  • syncope, such as, feeling faint or fainting

  • tachycardia, such as, fast, pounding, or irregular heartbeat or pulse

Less common
  • dyspepsia, such as, acid or sour stomach, belching, heartburn, indigestion, stomach discomfort, upset or pain

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.


Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.



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More lovastatin and niacin resources


  • Lovastatin and niacin Use in Pregnancy & Breastfeeding
  • Lovastatin and niacin Drug Interactions
  • Lovastatin and niacin Support Group
  • 1 Review for Lovastatin and niacin - Add your own review/rating


Compare lovastatin and niacin with other medications


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  • Hyperlipoproteinemia
  • Hyperlipoproteinemia Type IIa, Elevated LDL
  • Hyperlipoproteinemia Type IIb, Elevated LDL VLDL

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