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Drug Interactions With Niacin Extended-Release/Lovastatin

Diltiazem
Taking diltiazem with niacin extended-release/lovastatin may increase the risk for serious muscle problems, such as myopathy or rhabdomyolysis. The medications should only be used together if the benefits of their use outweigh the potential risks of muscle side effects. If you take these medications together, the lovastatin component of your niacin extended-release/lovastatin dose should not exceed 20 mg a day.
  
Fibrates
Combining a fibrate with niacin extended-release/lovastatin increases the risk of serious muscle problems. Niacin extended-release/lovastatin should not be used in combination with gemfibrozil. The combination of niacin extended-release/lovastatin and other fibrates should generally be avoided unless the potential benefits outweigh the risks of the drug interaction.
 
Grapefruit
People taking niacin extended-release/lovastatin should avoid drinking grapefruit juice, eating grapefruit, or using grapefruit supplements because it can increase the levels of medication in the blood. Consuming the equivalent of a quart or more a day of grapefruit juice increases the chances for developing a serious muscle problem (myopathy or rhabdomyolysis), which can cause the kidneys to stop working.
 
If you are taking niacin extended-release/lovastatin and want to continue drinking grapefruit juice, talk to your doctor about other cholesterol medications that you can take (see Grapefruit and Advicor for more information).
 
Nefazodone
Combining nefazodone with niacin extended-release/lovastatin increases the risk of serious muscle problems. These medications should not be taken together.
 
Nitrates
Taking niacin extended-release/lovastatin with a nitrate medication may increase the risk of low blood pressure (hypotension). Be sure to let your healthcare provider know if you develop any signs of this problem, such as lightheadedness, dizziness, or fainting. Check with your healthcare provider before combining these two medications, especially if you have recently had a heart attack or if you have unstable angina (a certain type of chest pain).
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Niacin Extended-Release and Lovastatin Information

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