2011502014 Health Library | Health and Wellness | Wellmont Health System
  • Niacin

    (nye' a sin)

    WHY is this medicine prescribed?

    Niacin is used with diet changes (restriction of cholesterol and fat intake) to reduce the amount of cholesterol and certain fatty substances in your blood. Niacin is also used to prevent and treat pellagra (niacin deficiency), a disease caused by inadequate diet and other medical problems. Niacin is a B-complex vitamin.

    HOW should this medicine be used?

    Niacin comes as a tablet and an extended-release (long-acting) tablet to take by mouth. The regular tablet usually is taken two to three times a day with meals, and the extended-release tablet is taken once a day, at bedtime, with food. Follow the directions on your prescription label or package label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take niacin exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.
    Swallow the extended-release tablets whole; do not split, chew, or crush them.
    Your doctor will probably start you on a low dose of niacin and gradually increase your dose.
    Continue to take niacin even if you feel well. Do not stop taking niacin without talking to your doctor.

    Are there OTHER USES for this medicine?

    This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.

    What SPECIAL PRECAUTIONS should I follow?

    Before taking niacin,
    • tell your doctor and pharmacist if you are allergic to niacin, aspirin, tartrazine (a yellow dye in some processed foods and drugs), or any other drugs.
    • tell your doctor and pharmacist what prescription and nonprescription medications you are taking, especially anticoagulants ('blood thinners') such as warfarin (Coumadin), medications for high blood pressure or diabetes and other vitamins. If you take insulin or oral diabetes medication, your dose may need to be changed because niacin may increase the amount of sugar in your blood and urine.
    • tell your doctor if you drink large amounts of alcohol and if you have or have ever had diabetes; gout; ulcers; allergies; jaundice (yellowing of the skin or eyes); or gallbladder, heart, or liver disease.
    • tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking niacin, call your doctor.
    • if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking niacin.
    • you should know that this drug may make you drowsy. Do not drive a car or operate machinery until you know how this drug affects you.
    • remember that alcohol can add to the drowsiness caused by this drug.
    • you should know that niacin causes flushing (redness) of the face and neck. This side effect usually goes away after taking the medicine for a few weeks. Avoid drinking alcohol or hot drinks around the time you take niacin. Taking aspirin or another nonsteroidal anti-inflammatory drug such as ibuprofen (Advil, Motrin) or naproxen (Aleve, Naprosyn) 30 minutes before niacin may reduce the flushing. If you take extended-release niacin at bedtime, the flushing will probably happen while you are asleep. If you wake up and feel flushed, get up slowly, especially if you feel dizzy or faint.

    What SPECIAL DIETARY instructions should I follow?

    Eat a low-cholesterol, low-fat diet, which includes cottage cheese, fat-free milk, fish, vegetables, poultry, and egg whites. Use monounsaturated oils such as olive, peanut, and canola oils or polyunsaturated oils such as corn, safflower, soy, sunflower, cottonseed, and soybean oils. Avoid foods with excess fat in them such as meat (especially liver and fatty meat), egg yolks, whole milk, cream, butter, shortening, pastries, cakes, cookies, gravy, peanut butter, chocolate, olives, potato chips, coconut, cheese (other than cottage cheese), coconut oil, palm oil, and fried foods.

    What should I do IF I FORGET to take a dose?

    Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

    What SIDE EFFECTS can this medicine cause?

    Niacin may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:
    • itching, stinging, tingling, or burning of the skin
    • headache
    • blurred vision
    • nausea
    • vomiting
    • diarrhea
    • heartburn
    • bloating
    If you experience any of the following symptoms, call your doctor immediately:
    • dizziness
    • faintness
    • fast heartbeat
    • yellowing of the skin or eyes
    If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online [at http://www.fda.gov/Safety/MedWatch ] or by phone [1-800-332-1088].

    What should I know about STORAGE and DISPOSAL of this medication?

    Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.

    What should I do in case of OVERDOSE?

    In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.

    What OTHER INFORMATION should I know?

    Keep all appointments with your doctor and the laboratory. Your doctor will order certain lab tests to check your response to niacin.
    Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.
    It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

    Brand Names

    • Niacor®
    • Niaspan®
    • Nicolar®[¶]
    • Slo-Niacin®[§]
    • Advicor® (as a combination product containing Lovastatin, Niacin)
    • Simcor® (as a combination product containing Niacin, Simvastatin)

    Other Names

    • Nicotinic acid
    § These products are not currently approved by the FDA for safety, effectiveness, and quality. Federal law generally requires that prescription drugs in the U.S. be shown to be both safe and effective prior to marketing. Please see the FDA website for more information on unapproved drugs ( http://www.fda.gov/AboutFDA/Transparency/Basics/ucm213030.htm) and the approval process ( http://www.fda.gov/Drugs/ResourcesForYou/Consumers/ucm054420.htm).
    This branded product is no longer on the market. Generic alternatives may be available.

    Lovastatin

    (loe' va sta tin)

    WHY is this medicine prescribed?

    Lovastatin is used together with diet, weight-loss, and exercise to reduce the risk of heart attack and stroke and to decrease the chance that heart surgery will be needed in people who have heart disease or who are at risk of developing heart disease. Lovastatin is also used to decrease the amount of cholesterol (a fat-like substance) and other fatty substances in the blood. Lovastatin is in a class of medications called HMG CoA reductase inhibitors (statins). It works by slowing the production of cholesterol in the body to decrease the amount of cholesterol that may build up on the walls of the arteries and block blood flow to the heart, brain, and other parts of the body.

    HOW should this medicine be used?

    Lovastatin comes as a tablet and an extended-release (long-acting) tablet to take by mouth. The regular tablet usually is taken once or twice a day with meals. The extended-release tablet usually is taken once a day at bedtime. Take lovastatin at around the same time(s) every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take lovastatin exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.
    Swallow the extended-release tablets whole; do not split, chew, or crush them.
    Your doctor may start you on a low dose of lovastatin and gradually increase your dose, not more than once every 4 weeks.
    Continue to take lovastatin even if you feel well. Do not stop taking lovastatin without talking to your doctor.

    Are there OTHER USES for this medicine?

    This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

    What SPECIAL PRECAUTIONS should I follow?

    Before taking lovastatin,
    • tell your doctor and pharmacist if you are allergic to lovastatin, any other medications, or any of the ingredients in lovastatin tablets or extended-release tablets. Ask your pharmacist for a list of the ingredients in lovastatin tablets or extended release tablets.
    • tell your doctor if you are taking any of the following medications: bocepravir (Victrelis); clarithromycin (Biaxin); erythromycin (E.E.S.,EryC); itraconazole (Sporanox); ketoconazole (Nizoral); nefazodone; certain HIV protease inhibitors including amprenavir (Agenerase), atazanavir (Reyataz), darunavir (Prezista), fosamprenavir (Lexiva), indinavir (Crixivan), lopinavir (in Kaletra), nelfinavir (Viracept), ritonavir (Norvir, in Kaletra), saquinavir (Invirase), and tipranavir (Aptivus); posaconazole (Noxafil); telapravir (Incivek); and telithromycin (Ketek). Your doctor will probably tell you not to take lovastatin if you are taking one or more of these medications.
    • tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: amiodarone (Cordarone, Pacerone); anticoagulants ('blood thinners') such as warfarin (Coumadin); cimetidine (Tagamet); colchicine (Colcrys); cyclosporine (Neoral, Sandimmune); danazol (Danocrine);diltiazem (Cardizem, Dilacor, Tiazac); erythromycin (E.E.S., E-Mycin, Erythrocin); other cholesterol-lowering medications such as fenofibrate (Tricor), gemfibrozil (Lopid), and niacin (nicotinic acid, Niacor, Niaspan); spironolactone (Aldactone); ranolazine (ranexa); verapamil (Calan, Covera, Isoptin, Verelan), and voriconazole (Vfend). Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
    • tell your doctor if you have liver disease. Your doctor will order laboratory tests to see how well your liver is working even if you do not think you have liver disease. Your doctor will probably tell you not to take lovastatin if you have liver disease or if the tests show that you may be developing liver disease.
    • tell your doctor if you drink more than two alcoholic beverages daily, if you have ever had liver disease or if you have or have ever had seizures, low blood pressure, diabetes, or kidney disease.
    • tell your doctor if you are pregnant or plan to become pregnant. If you become pregnant while taking lovastatin, stop taking lovastatin and call your doctor immediately. Lovastatin may harm the fetus.
    • do not breast-feed while you are taking this medication.
    • if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking lovastatin. If you are hospitalized due to serious injury or infection, tell the doctor who treats you that you are taking lovastatin.
    • ask your doctor about the safe use of alcoholic beverages while you are taking lovastatin. Alcohol can increase the risk of serious side effects.

    What SPECIAL DIETARY instructions should I follow?

    Eat a low-cholesterol, low-fat diet, which includes cottage cheese, fat-free milk, fish, vegetables, poultry, and egg whites. Use monounsaturated oils such as olive, peanut, and canola oils or polyunsaturated oils such as corn, safflower, soy, sunflower, cottonseed, and soybean oils. Avoid foods with excess fat in them such as meat (especially liver and fatty meat), egg yolks, whole milk, cream, butter, shortening, pastries, cakes, cookies, gravy, peanut butter, chocolate, olives, potato chips, coconut, cheese (other than cottage cheese), coconut oil, palm oil, and fried foods.
    Avoid drinking large amounts (more than 1 quart [approximately 1 liter] per day) of grapefruit juice while taking lovastatin.

    What should I do IF I FORGET to take a dose?

    Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

    What SIDE EFFECTS can this medicine cause?

    Lovastatin may cause side effects. Tell your doctor if these symptoms are severe or do not go away:
    • constipation
    • memory loss or forgetfulness
    • confusion
    Some side effects can be serious. The following symptoms are uncommon, but if you experience any of them, call your doctor immediately or get emergency medical help:
    • muscle pain, tenderness, or weakness
    • lack of energy
    • weakness
    • fever
    • dark colored urine
    • yellowing of the skin or eyes
    • pain in the upper right part of the stomach
    • nausea
    • unusual bleeding or bruising
    • loss of appetite
    • flu-like symptoms
    • rash
    • hives
    • itching
    • difficulty breathing or swallowing
    • swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs
    • hoarseness
    Lovastatin may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.
    If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online [at http://www.fda.gov/Safety/MedWatch ] or by phone [1-800-332-1088].

    What should I know about STORAGE and DISPOSAL of this medication?

    Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.

    What should I do in case of OVERDOSE?

    In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.

    What OTHER INFORMATION should I know?

    Keep all appointments with your doctor and the laboratory. Your doctor may order laboratory tests during your treatment, especially if you develop symptoms of liver damage.
    Before having any laboratory test, tell your doctor and the laboratory personnel that you are taking lovastatin.
    Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.
    It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

    Brand Names

    • Altocor®[¶]
    • Altoprev®
    • Mevacor®
    • Advicor® (as a combination product containing Lovastatin, Niacin)
    • Also available generically
    This branded product is no longer on the market. Generic alternatives may be available.
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