Niacin and Lovastatin (Advicor)

Advicor is an oral drug used to lower cholesterol levels in the blood. It combines extended-release niacin and lovastatin. It reduces total cholesterol, LDL cholesterol, and triglycerides while increasing HDL cholesterol.

Niacin is a vital part of the diet necessary for various chemical reactions in the body. It lowers LDL cholesterol and raises HDL cholesterol levels. The mechanism behind niacin’s effects on cholesterol and triglyceride levels is unclear, but it may involve reducing the production of proteins that transport cholesterol and triglycerides in the blood.

Lovastatin belongs to a class of cholesterol-lowering drugs called statins. It inhibits an enzyme necessary for cholesterol production, leading to lower LDL cholesterol and triglyceride levels, and higher HDL cholesterol levels. The combination of niacin and lovastatin is more effective than either drug alone in reducing cholesterol and triglycerides and increasing HDL. The FDA approved Advicor in December 2001.

Brand names for niacin and lovastatin

Generic availability of niacin and lovastatin

No generic available.

Prescription requirement for niacin and lovastatin

Uses of niacin and lovastatin

The combination of niacin and lovastatin treats elevated blood levels of cholesterol, LDL cholesterol, triglycerides, and low levels of HDL cholesterol.

Side effects of niacin and lovastatin

The most common side effects include flushing, redness, warm sensation, rash, itching, headache, stomach upset, nausea, vomiting, muscle pain, and tingling in extremities. Flushing can be reduced by taking aspirin and increasing the dose of niacin slowly.

Other important side effects include liver test abnormalities, muscle damage, kidney failure, increases in HbA1c and fasting serum glucose, memory loss, forgetfulness, amnesia, confusion, and memory impairment. Statins can also raise blood glucose levels in individuals with diabetes.

Caution should be taken with drug interactions, especially with erythromycin, ketoconazole, clarithromycin, cyclosporine, and grapefruit juice, as they can increase the risk of muscle toxicity from lovastatin. Lovastatin may also interact with warfarin and affect blood clotting. Niacin should not be combined with bile acid sequestrants or alcohol.

Dosage of niacin and lovastatin

The recommended starting dose for Advicor is one tablet (500/20 mg). Doses can be increased by 500 mg of niacin every 4 weeks. Doses greater than 2000/40 mg are not recommended. Advicor should be taken at bedtime with a low-fat snack.

Pregnancy and breastfeeding

Advicor should not be used by pregnant women, as it can be harmful to the fetus. Niacin is excreted in breast milk and may cause side effects in the infant.

Available preparations of niacin and lovastatin

Tablets: 500/20 mg, 750/20 mg, 1000/20 mg, 1000/40 mg

Storage of niacin and lovastatin

Advicor should be stored at room temperature, between 20°C – 25°C (68°F – 77°F).

Summary

Advicor is a combination drug used to lower cholesterol levels. It is effective in reducing total cholesterol, LDL cholesterol, triglycerides, while raising HDL cholesterol. It should be taken with caution due to possible side effects and drug interactions.