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Drug Interactions With Niacin Extended-Release/Simvastatin

Grapefruit
It is recommended that people on niacin extended-release/simvastatin avoid drinking large quantities of grapefruit juice, eating grapefruit, or using grapefruit supplements because it can increase the levels of niacin extended-release/simvastatin in the blood. This can increase the chances for developing a serious muscle problem (myopathy or rhabdomyolysis), which can cause the kidneys to stop working.
 
If you are being treated with niacin extended-release/simvastatin and want to continue drinking grapefruit juice, talk to your doctor about other cholesterol medications that you can take (see Simcor and Grapefruit for more information).
 
Nefazodone
Combining nefazodone with niacin extended-release/simvastatin increases the risk of serious muscle problems. In general, these medications should not be taken together.
 
Protease Inhibitors
Combining a protease inhibitor with niacin extended-release/simvastatin increases the risk of serious muscle problems. In general, these medications should not be taken together.
 
Verapamil
Taking both verapamil and niacin extended-release/simvastatin together may increase the chance for developing serious muscle problems, such as myopathy or rhabdomyolysis.
 
Warfarin
Niacin extended-release/simvastatin can potentially interact with warfarin, possibly increasing the risk of bleeding. Your healthcare provider may need to monitor you more often and adjust your warfarin dosage as necessary.
 

Summary

There are several drugs that can interact with niacin extended-release/simvastatin. It is possible that not all drug interactions were discussed in this article. Therefore, you should talk with your doctor about any specific drug interactions that may apply to you.
 
Also, because a number of these medicines can increase the risk of serious muscle problems, if you have any unexplained muscle pain or weakness (especially with a fever or if you feel ill), contact your healthcare provider immediately.
 
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Niacin Extended-Release/Simvastatin Information

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