lovastatin/nicotinic acid (Advicor, Nicostatin)

1st niacin/statin combination for dyslipidemia. Indications: 1) hypercholesterolemia 2) not for initial therapy 3) reserve for patients who don't reach their goals with either agent alone Dosage: 1) start 1 tab (niacin 500 mg) QHS 2) increase by no more than 500 mg of niacin every 4 weeks 3) maximum 2000 mg of niacin/day 4) take with food: a) increases absorption of both agents b) reduces nausea & flushing Tablets: lovastatin 20 mg plus niacin 500, 750 or 1000 mg Monitor: -> liver function tests a) prior to therapy b) every 6-12 weeks for 6 months c) then every 6 months Adverse effects: 1) see lovastatin & niacin 2) myopathy 3) hepatotoxicity 4) hyperglycemia in diabetics Notes: Manufacturer: Kos

References

Prescriber's Letter 9(2):10, S1 2002

Components

lovastatin (Mevacor, Altocor, monacolin-K, Altoprev) nicotinic acid (niacin, vitamin B3, Niaspan)