niacin and lovastatin, Advicor

  • Pharmacy Author:
    Omudhome Ogbru, PharmD

    Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.

  • Medical and Pharmacy Editor: Jay W. Marks, MD
    Jay W. Marks, MD

    Jay W. Marks, MD

    Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.

What is niacin and lovastatin, and how does it work (mechanism of action)?

Advicor is an oral drug that is used for lowering cholesterol levels in the blood. It is a combination of extended-release niacin and lovastatin. It reduces blood levels of total cholesterol, low density lipoprotein (LDL) cholesterol, and triglycerides and increases blood levels of high density lipoprotein (HDL) cholesterol.

Niacin (nicotinic acid, vitamin B3) is a part of the normal diet that is essential for various chemical reactions in the body. Doses of niacin larger than normal dietary needs reduce cholesterol and triglyceride levels in the blood. Niacin reduces bad cholesterol (LDL cholesterol) and increases good cholesterol (HDL cholesterol). It is not clear how niacin causes its effects on cholesterol and triglyceride levels, but it may be by reducing the production of proteins that transport cholesterol and triglycerides in the blood.

Lovastatin belongs to a class of cholesterol-lowering drugs called HMG-CoA reductase inhibitors, or, more commonly, "statins." Other statins include simvastatin (Zocor), atorvastatin (Lipitor), fluvastatin (Lescol), and rosuvastatin (Crestor). Statins reduce cholesterol by inhibiting an enzyme in the liver (HMG-CoA reductase) that is necessary for the production of cholesterol. In the blood, statins lower LDL cholesterol and triglycerides. LDL cholesterol is believed to be an important cause of coronary artery disease. Lowering LDL cholesterol levels slows and may even reverse coronary artery disease. Statins also increase HDL cholesterol. Raising HDL cholesterol levels, like lowering LDL cholesterol may slow coronary artery disease.The combination of niacin and lovastatin is better than either drug alone in reducing cholesterol, reducing triglycerides and increasing HDL. The FDA approved Advicor in December 2001.

What brand names are available for niacin and lovastatin?

Advicor

Is niacin and lovastatin available as a generic drug?

GENERIC AVAILABLE: No

Do I need a prescription for niacin and lovastatin?

Yes

What are the side effects of niacin and lovastatin?

The most common side effects are:

Flushing may be reduced by taking 325 mg of aspirin 30 minutes before the niacin and by increasing the dose of niacin slowly.

Drinking hot liquids or alcohol shortly before or after niacin is taken may increase the occurrence of flushing.

Other important side effects include:

Lovastatin shares side effects, such as liver and muscle damage associated with all statins. Serious liver damage caused by statins is rare. More often, statins cause abnormalities of liver tests. Abnormal tests usually return to normal even if a statin is continued, but if the abnormal test value is greater than three times the upper limit of normal, the statin usually is stopped. Liver function tests should be performed at the beginning of treatment then as needed thereafter.

Inflammation of the muscles caused by statins can lead to a serious breakdown of muscle cells called rhabdomyolysis. Rhabdomyolysis causes the release of muscle protein (myoglobin) into the blood. Myoglobin can cause kidney failure and even death. When used alone, statins cause rhabdomyolysis in less than one percent of patients. To prevent the development of rhabdomyolysis, patients taking lovastatin should contact their health care professional immediately if they develop unexplained muscle pain, weakness, or muscle tenderness.

Statins have been associated with increases in HbA1c and fasting serum glucose levels as are seen in diabetes.

There are also post-marketing reports of memory loss, forgetfulness, amnesia, confusion, and memory impairment. Symptoms may start 1 day to years after starting treatment and resolve within a median of 3 weeks after stopping the statin.

Medically Reviewed by a Doctor on 7/22/2015

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