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Precautions and Warnings With Niacin Extended-Release/Lovastatin

Specific Niacin Extended-Release/Lovastatin Precautions and Warnings

Some warnings and precautions to be aware of prior to taking niacin extended-release/lovastatin include the following:
 

 

  • There have been reports of liver problems, including liver failure, in people who were switched from immediate-release niacin to extended-release niacin products (such as the niacin contained in niacin extended-release/lovastatin) at equivalent doses. Therefore, you will need to start niacin extended-release/lovastatin at the lowest recommended dosage if you are switching over from any niacin product other than Niaspan® (niacin extended-release). 

 

  • If you drink large amounts of alcohol or drink alcohol frequently, discuss this with your healthcare provider prior to starting treatment with this drug. This medication may not be safe for you. 
     
  • Statins (such as lovastatin, one of the components of niacin extended-release/lovastatin) have been known to cause an increase in liver enzymes. The medication has also been rarely reported to cause liver failure. In some cases the liver failure caused death. Therefore, you should have a blood test that looks at your liver function before starting niacin extended-release/lovastatin and as necessary thereafter. These tests may also be recommended if the dosage is changed (see Advicor and Liver Problems).

Contact your healthcare provider immediately if you develop any symptoms of liver problems, such as:

    • Fatigue
    • Loss of appetite
    • Right upper stomach pain
    • Dark urine
    • Yellowing of the skin or whites of the eyes (jaundice).
  
  • Niacin extended-release/lovastatin and other statin medications have been reported to cause serious muscle problems, including rhabdomyolysis. Rhabdomyolysis is the breakdown of muscles, which causes muscle fibers to be released into the bloodstream, potentially damaging the kidneys. Muscle problems can occur in anyone taking a statin medication; however, you are at greater risk if you:

  

    • Have kidney damage
 
 
 
  • Make sure to contact your healthcare provider immediately if you experience any unexplained muscle pain, weakness, or tenderness, especially if it is with a fever or if you feel ill, as this could signify muscle problems (see Advicor and Muscle Pain).

 

  • People who are experiencing a condition that increases their risk for kidney failure from rhabdomyolysis should temporarily stop taking niacin extended-release/lovastatin until the condition resolves. Such conditions include:

 

    • A blood infection (sepsis)
    • Low blood pressure (hypotension)
    • Major surgery or trauma
    • Uncontrolled seizure disorder (uncontrolled epilepsy)
    • Severe metabolic, endocrine, or electrolyte problems (such as severe diabetes, thyroid problems, or disturbances in body salts).

 

  • If you have chest pain or any other form of coronary artery disease, check with your healthcare provide before taking niacin extended-release/lovastatin. Serious side effects could occur due to the niacin component of the medication.
     
  • Niacin extended-release/lovastatin can increase blood sugar levels. If you have diabetes, check with your healthcare provider before taking this medication. You may need to check your blood sugar levels more closely, especially in the first few months of niacin extended-release/lovastatin treatment, or when your dosage is increased.

 

  • Niacin extended-release/lovastatin can increase the level of uric acid in the blood, which can worsen (and possibly even cause) gout.
     
  • Because it contains niacin, this medication can cause flushing, which is a sudden redness, warmth, and tingling of the skin. Flushing can last for several hours, and may be more severe in some people than others. Niacin extended-release/lovastatin must be started at a low dose and increased gradually in order to reduce this intolerable side effect (see Niacin Extended-Release/Lovastatin Dosage and Niacin Flush for more information).

 

  • Taking aspirin up to 30 minutes before your niacin extended-release/lovastatin dose can help reduce flushing. Taking the medication at bedtime can also help, as the flushing will most likely occur while you are sleeping. If the flushing wakes you up, be sure to get up slowly, to help minimize any feelings of dizziness or fainting, especially if you take blood pressure medications.

  

  • Niacin extended-release/lovastatin may increase the risk of bleeding, possibly due to decreased blood platelets.
     
  • Niacin extended-release/lovastatin is a pregnancy Category X medicine, which means it could cause harm to your unborn child. The safety of this medicine in pregnant women has not been established. If you are pregnant and taking niacin extended-release/lovastatin, talk to your healthcare provider immediately (see Advicor and Pregnancy).
     
  • If you are nursing, it is not known whether niacin extended-release/lovastatin passes through breast milk. Therefore, ask your healthcare provider whether to stop nursing or stop taking the medication.
     
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Niacin Extended-Release and Lovastatin Information

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