Lovastatin blocks the production of cholesterol (a type of fat) in the body. Niacin, also known as nicotinic acid, is vitamin B3. It occurs naturally in plants and animals and is also added to many foods as a vitamin supplement. Niacin also blocks the production of cholesterol in the body.

Together, lovastatin and niacin are used to reduce levels of LDL (or "bad”) cholesterol, total cholesterol, and triglycerides and to raise levels of "good” (HDL)cholesterol. These actions are important in the prevention of heart disease and hardening of the arteries, which can lead to heart attacks, stroke, and peripheral vascular disease.

Lovastatin and niacin may also be used for purposes other than those listed in this medication guide.

Do not take lovastatin and niacin without first talking to your doctor if you are taking any of the following medicines:

• cyclosporine (Sandimmune, Neoral);

• gemfibrozil (Lopid);

• clofibrate (Atromid-S);

• fenofibrate (Tricor);

• nefazodone (Serzone);

• erythromycin (E-Mycin, E.E.S., Ery-Tab, Ilotycin, Eryc, PCE, Ilosone, others);

• clarithromycin (Biaxin);

• warfarin (Coumadin);

• a protease inhibitor such as amprenavir (Agenerase), indinavir (Crixivan), nelfinavir (Viracept), ritonavir (Norvir), or saquinavir (Invirase, Fortovase).

• other cholesterol-lowering drugs such as cholestyramine (Questran) or colestipol (Colestid); or

• itraconazole (Sporanox) or ketoconazole (Nizoral).

You may not be able to take lovastatin and niacin, or you may require a dosage adjustment or special monitoring during treatment if you are taking any of the medicines listed above.

Tell your doctor about all other prescription medications and over-the-counter products you are taking, especially vitamins, herbs, or other nutritional supplements containing niacin or related compounds such as nicotinamide.

Drugs other than those listed here may also interact with lovastatin and niacin. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines, including herbal products.

Grapefruit and grapefruit juice may interact with lovastatin and niacin. The interaction could lead to potentially dangerous effects. Discuss the use of grapefruit and grapefruit juice with your doctor. Do not increase or decrease the amount of grapefruit products in your diet without first talking to your doctor. Do not take a dose of lovastatin and niacin with grapefruit juice.

To minimize flushing, avoid alcohol and hot drinks around the time you take lovastatin and niacin.

Alcohol and lovastatin and niacin can both be harmful to the liver, especially when used together. Alcohol should be used only in moderation. Discuss the use of alcohol with your doctor so that the potential for adverse effects can be determined.

Tell your doctor about all other prescription medications and over-the-counter products you are taking, especially vitamins or other nutritional supplements containing niacin or related compounds such as nicotinamide.

Dizziness may occur, especially when you rise from a sitting or lying position. Rise slowly and use caution when driving or performing other hazardous activities.

Seek emergency medical attention.

Symptoms of a lovastatin and niacin overdose include severe flushing, nausea, vomiting, diarrhea, stomach distress, dizziness, fainting, and indigestion.

Take the missed dose as soon as you remember. However, if it is almost time for the next dose, skip the missed dose and take only the next regularly scheduled dose. Do not take a double dose of this medication.

Contact you doctor immediately if you experience unexplained muscle pain, tenderness, or weakness, especially if it is accompanied by a fever, flu-like symptoms, or yellowing of the skin or eyes.

Alcohol and lovastatin and niacin can both be harmful to the liver, especially when used together. Alcohol should be used only in moderation. Discuss the use of alcohol with your doctor so that the potential for adverse effects can be determined.

Do not take lovastatin and niacin if you are pregnant or could become pregnant during treatment, or if you are breast-feeding a baby.

Dizziness may occur, especially when you rise from a sitting or lying position. Rise slowly and use caution when driving or performing other hazardous activities.

Follow any diet and exercise plans outlined by your healthcare provider. Diet and exercise are important factors in controlling cholesterol levels.

Do not take lovastatin and niacin without first talking to your doctor if you have a history of:

• liver disease or jaundice (yellowing of the skin or eyes);

• stomach ulcer; or

• arterial bleeding.

Before taking lovastatin and niacin, tell your doctor if you:

• have kidney disease;

• drink alcoholic beverages;

• have heart disease, angina (chest pain), or a history of heart attack;

• have unexplained muscle pain or tenderness or a chronic muscular disease;

• have gallbladder disease;

• have diabetes;

• have gout; or

• need to have surgery.

You may not be able to take lovastatin and niacin, or you may require a dosage adjustment or special monitoring during treatment if you have any of the conditions listed above.

The combination of lovastatin and niacin is in the FDA pregnancy category X which means that it is known to be harmful to an unborn baby. Lovastatin is known to cause birth defects if used during pregnancy. Cholesterol is very important for the proper development of a baby. Do not take lovastatin and niacin if you are pregnant or could become pregnant during treatment.

It is not known whether lovastatin and niacin passes into breast milk. Do not take lovastatin and niacin without first talking to your doctor if you are breast-feeding a baby.

Your pharmacist has additional information about lovastatin and niacin written for health professionals that you may read.

Lovastatin and niacin is available with a prescription under the brand name Advicor. Other brand or generic formulations may also be available. Ask your pharmacist any questions you have about this medication, especially if it is new to you.

• Advicor 500 mg-20 mg—capsule-shaped, light yellow tablets

• Advicor 750 mg- 20 mg—capsule-shaped, light orange tablets

• Advicor 1,000 mg-20 mg—capsule-shaped, dark pink/light purple tablets