HMG-CoA Reductase Inhibitors/Niacin (Greater Than or Equal To 250 mg) Interactions

This information is generalized and not intended as specific medical advice. Consult your healthcare professional before taking or discontinuing any drug or commencing any course of treatment.

Medical warning:

Serious. These medicines may interact and cause very harmful effects. Contact your healthcare professional (e.g. doctor or pharmacist) for more information.

How the interaction occurs:

The cause of the interaction is not known.

What might happen:

When the two medicines are taken together, you may experience muscle aches, tenderness, and weakness.

What you should do about this interaction:

Contact your healthcare professionals (e.g. doctor or pharmacist) as soon as possible about taking these two medicines together. They may already be aware of this interaction and may be monitoring you for it. If your doctor prescribes these medicines together, report any symptoms of muscle aches, tenderness, weakness, changes in the color of your urine, or flu-like symptoms. Do not start, stop, or change the dosage of any medicine before checking with them first.

View Reference
  • 1.Mevacor (lovastatin) US prescribing information. Merck & Co., Inc. February, 2014.
  • 2.Niaspan (niacin) US prescribing information. Abbott Laboratories May, 2022.
  • 3.Lipitor (atorvastatin) US prescribing information. Pfizer Inc. November, 2020.
  • 4.Livalo (pitavastatin) US prescribing information. Kowa Pharmaceuticals America, Inc. November, 2022.
  • 5.Crestor (rosuvastatin calcium) US prescribing information. AstraZeneca Pharmaceuticals LP July, 2023.
  • 6.Zocor (simvastatin) US prescribing information. Merck & Co., Inc. March, 2023.
  • 7.Vytorin (ezetimibe/simvastatin) US prescribing information. Merck/Schering-Plough Pharmaceuticals September, 2020.
  • 8.USFood and Drug Administration. FDA Drug Safety Communication: Ongoing safety review of high-dose Zocor (simvastatin) and increased risk of muscle injury. available at: http://wayback.archive-it.org/7993/20170112165500/http://www.fda.gov/Safet y/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm205404 .htm March 19, 2010.
  • 9.Lescol (fluvastatin sodium) US prescribing information. Novartis Pharmaceuticals Corporation August, 2017.
  • 10.Pravachol (pravastatin sodium) US prescribing information. Bristol-Myers Squibb Company May, 2022.
  • 11.Norman DJ, Illingworth DR, Munson J, Hosenpud J. Myolysis and acute renal failure in a heart-transplant recipient receiving lovastatin. N Engl J Med 1988 Jan 7;318(1):46-7.
  • 12.Reaven P, Witztum JL. Lovastatin, nicotinic acid, and rhabdomyolysis. Ann Intern Med 1988 Oct 1;109(7):597-8.
  • 13.Phansalkar S, van der Sijs H, Tucker AD, Desai AA, Bell DS, Teich JM, Middleton B, Bates DW. Drug-drug interactions that should be non-interruptive in order to reduce alert fatigue in electronic health records. J Am Med Inform Assoc 2012 Sep 25.
  • 14.Alsheikh-Ali AA, Karas RH. Safety of lovastatin/extended release niacin compared with lovastatin alone, atorvastatin alone, pravastatin alone, and simvastatin alone (from the United States Food and Drug Administration adverse event reporting system). Am J Cardiol 2007 Feb 1; 99(3):379-81.
  • 15.Kosoglou T, Zhu Y, Statkevich P, Triantafyllou I, Taggart W, Xuan F, Kim KT, Cutler DL. Assessment of potential pharmacokinetic interactions of ezetimibe/simvastatin and extended-release niacin tablets in healthy subjects. Eur J Clin Pharmacol 2011 May;67(5):483-92.
  • 16.HPS2-THRIVE randomized placebo-controlled trial in 25 673 high-risk patients of ER niacin/laropiprant: trial design, pre-specified muscle and liver outcomes, and reasons for stopping study treatment. Eur Heart J 2013 May;34(17):1279-91.
  • 17.Boden WE, Probstfield JL, Anderson T, Chaitman BR, Desvignes-Nickens P, Koprowicz K, McBride R, Teo K, Weintraub W. Niacin in patients with low HDL cholesterol levels receiving intensive statin therapy. N Engl J Med 2011 Dec 15;365(24):2255-67.
  • 18.Landray MJ, Haynes R, Hopewell JC, Parish S, Aung T, Tomson J, Wallendszus K, Craig M, Jiang L, Collins R, Armitage J. Effects of extended-release niacin with laropiprant in high-risk patients. N Engl J Med 2014 Jul 17;371(3):203-12.
  • 19.Kalil RS, Wang JH, de Boer IH, Mathew RO, Ix JH, Asif A, Shi X, Boden WE. Effect of extended-release niacin on cardiovascular events and kidney function in chronic kidney disease: a post hoc analysis of the AIM-HIGH trial. Kidney Int 2015 Jun;87(6):1250-7.
  • 20.Schandelmaier S, Briel M, Saccilotto R, Olu KK, Arpagaus A, Hemkens LG, Nordmann AJ. Niacin for primary and secondary prevention of cardiovascular events. Cochrane Database Syst Rev 2017 Jun 14; 6(6):CD009744.
  • 21.Goldberg RB, Bittner VA, Dunbar RL, Fleg JL, Grunberger G, Guyton JR, Leiter LA, McBride R, Robinson JG, Simmons DL, Wysham C, Xu P, Boden WE. Effects of Extended-Release Niacin Added to Simvastatin/Ezetimibe on Glucose and Insulin Values in AIM-HIGH. Am J Med 2016 Jul; 129(7):753.e13-22.
Full Drug Information

Selected from data included with permission and copyrighted by First Databank, Inc. This copyrighted material has been downloaded from a licensed data provider and is not for distribution, except as may be authorized by the applicable terms of use.

CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.