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lovastatin - niacin
How does this medication work? What will it do for me?
[August 2, 2012]
Lovastatin – niacin is no longer being manufactured for sale in Canada. This article is being kept available for reference purposes only. If you are using this medication, speak with your doctor or pharmacist for information about your treatment options.
Lovastatin – niacin is a combination of 2 medications: lovastatin and extended release niacin. Lovastatin belongs to the family of medications known as HMG CoA reductase inhibitors. It works by blocking an enzyme that is needed to make cholesterol in the body. By lowering cholesterol production by the body, levels of cholesterol in the blood will decrease. Niacin, also known as nicotinic acid, is a vitamin (vitamin B3). The way it works is not clear but it is known that niacin decreases the amount of cholesterol made by the body.
This combination medication is used to lower high cholesterol levels when exercise and diet alone have not worked. It lowers LDL cholesterol ("bad cholesterol") and triglycerides and increases HDL cholesterol ("good cholesterol"). This combination medication is prescribed when your doctor feels it is appropriate for you to be taking both medications and you have taken niacin or lovastatin as separate medications without any problems.
Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. As well, some forms of this medication may not be used for all of the conditions discussed here. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.
Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.
What form(s) does this medication come in?
Advicor is no longer being manufactured for sale in Canada and is no longer available under any brand names. This article is being kept available for reference purposes only. If you are using this medication, speak with your doctor or pharmacist for information about your treatment options.
How should I use this medication?
Before starting lovastatin – niacin, you should follow a cholesterol-lowering diet. If appropriate, a program of weight control and physical exercise should also be followed.
The usual recommended adult dose is one tablet taken once a day, preferably in the evening after a low-fat snack. The dose is individualized and is based on the strength of lovastatin or niacin you have been taking. This combination product provides a fixed dose of lovastatin and niacin, once you and your doctor have determined a stable dose of each individual medication that’s the most appropriate for you.
Swallow the tablet whole – do not break, chew, or crush it.
Many things can affect the dose of a medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.
It is important to take this medication exactly as prescribed by your doctor. If you miss a dose, skip the missed dose and continue with your regular schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice. If you stop taking the medication for more than 7 days, contact your doctor.
Store this medication at room temperature and keep it out of the reach of children.
Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.
Who should NOT take this medication?
Lovastatin – niacin should not be taken by anyone who:
- is allergic to lovastatin, niacin, or to any of the ingredients of the medication
- is pregnant or breast-feeding
- has an active stomach ulcer or active bleeding elsewhere in the body
- has active liver disease or unexplained increases in liver function tests
What side effects are possible with this medication?
Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent. The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.
The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.
Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.
- abdominal pain
- back pain
- flu-like symptoms
- flushing (warmth and redness to skin on face, neck, and upper back)
- nausea or vomiting
- stomach upset
Although most of the side effects listed below don’t happen very often, they could lead to serious problems if you do not check with your doctor or seek medical attention.
Check with your doctor as soon as possible if any of the following side effects occur:
- blurred vision
- changes to blood sugar control (if you have diabetes)
- mood changes, depression, or difficulty sleeping
- severe flushing sensation (e.g., warmth, redness to skin)
- skin rash
- signs of liver damage (e.g., yellow skin or eyes, abdominal pain, dark urine, clay-coloured stools, loss of appetite, nausea and vomiting, or itching)
- signs of muscle damage (e.g., muscle pain, tenderness or weakness, or brown or discoloured urine – especially if you also have a fever or a general feeling of being unwell)
- signs of nerve damage (e.g., muscle weakness, decreased sensation in the hands or feet, loss of balance, numbness, tingling or prickling sensations)
Stop taking the medication and seek immediate medical attention if any of the following occur:
- severe skin rash, including skin blistering and peeling (possibly with headache, fever, coughing, or aching before the rash begins)
- signs of a serious allergic reaction (e.g., swelling of face or throat, hives, or difficulty breathing)
Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.
Are there any other precautions or warnings for this medication?
Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.
HEALTH CANADA ADVISORY
January 24, 2013
Health Canada has issued new restrictions concerning the use of Advicor (lovastatin – niacin). To read the full Health Canada Advisory, visit Health Canada’s web site at www.hc-sc.gc.ca.
Alcohol use: People who consume more alcohol than the daily suggested amounts should discuss with their doctor if any special monitoring is needed.
Blood sugar: People with diabetes may experience small increases in their blood sugar while taking this medication. Your doctor may need to adjust the medications you take to control your blood sugar. You should continue to monitor your blood sugar levels regularly while taking this medication.
Flushing: People may develop a warm, itchy feeling on their skin (face, neck, back, and chest) after starting lovastatin – niacin. This is caused by the niacin part of the medication. Flushing may last for several hours after taking this medication and will usually go away after several weeks of taking the medication. Taking the medication at bedtime will help you deal with flushing by making it more likely to happen while you are asleep. If you are woken up by flushing, get up slowly to minimize dizziness or fainting. Avoid alcohol or hot drinks around the time you take niacin extended release, as these may increase flushing. Taking acetylsalicylic acid (ASA) about 30 minutes before taking lovastatin – niacin may also help with the flushing; check with your doctor first to see if this is appropriate for you.
Grapefruit juice: Drinking grapefruit juice has been found to increase the blood levels of lovastatin – niacin. Let your doctor know if you drink this beverage regularly.
Kidney problems: People with decreased kidney function should discuss with their doctor how this medication may affect their medical condition, how their medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
Liver effects: This medication may cause increases in laboratory test results called liver function tests. These increases may indicate harmful effects to the liver. When the medication is stopped, the laboratory tests usually slowly return to normal. Your doctor will likely monitor your liver function regularly while you are taking this medication. People with a history of liver disease should be closely monitored by their doctors while they are taking this medication. People with an active liver disease or with unexplained liver function tests should not take lovastatin – niacin.
Medical conditions and surgery: People with gout, ulcers, or heart problems should discuss with their doctor how this medication may affect their medical condition, how their medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. This medication should be stopped a few days before elective surgery and during acute medical conditions or surgery.
Muscle effects: In rare cases, serious muscle damage has been associated with the use of lovastatin, especially at higher doses. Report any unexplained muscle pain, tenderness, weakness or cramps, or any brown or discoloured urine to your doctor immediately, particularly if you are also experiencing malaise (a general feeling of being unwell) or fever. The risk of experiencing these muscle effects is increased for people with kidney problems or who are taking certain medications (e.g., gemfibrozil, danazol, cyclosporine). Before taking this medication, tell your doctor or pharmacist if you:
- are over the age of 70
- are taking other cholesterol-lowering medications such as fibrates (gemfibrozil, fenofibrate) or niacin
- are taking other medications, including prescription, non-prescription, and natural health products, as drug interactions are possible
- do excessive physical exercise
- drink 3 or more alcoholic drinks daily
- have a family history of muscular disorders
- have diabetes
- have had any past problems with the muscles (pain, tenderness) after using a statin
- have kidney or liver problems
- have thyroid problems
- have undergone surgery or other tissue injury
Previous niacin use: If you were taking another form of niacin (e.g., immediate release), your doctor will change you to extended release niacin before starting this medication. When you are stabilized on a specific dose of extended release niacin and lovastatin taken separately, your doctor will be able to determine the appropriate dose of this combination medication for you. Do not substitute another form of niacin without consulting with your doctor first – doing so can cause severe liver disorders.
Pregnancy: The medication should not be used during pregnancy. This medication can cause serious injury to the fetus. An effective and reliable method of contraception should be used while taking lovastatin – niacin. If you become pregnant while taking this medication, stop taking the medication and contact your doctor immediately.
Breast-feeding: It is not known if this medication passes into breast milk. This medication should not be used by women who are breast-feeding.
Children: The safety and effectiveness of using this medication have not been established for children.
What other drugs could interact with this medication?
There may be an interaction between lovastatin – niacin and any of the following:
If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:
- stop taking one of the medications,
- change one of the medications to another,
- change how you are taking one or both of the medications, or
- leave everything as is.
An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.
Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.
All material copyright MediResource Inc. 1996 – 2021. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source: www.medbroadcast.com/drug/getdrug/Advicor