lipitor and B3 500 gr Interactions

Interactions between lipitor(atorvastatin) and B3 500 gr (niacin)

niacin and atorvastatin (Major Drug-Drug)

GENERALLY AVOID: Severe myopathy and rhabdomyolysis have been reported with concomitant use of lovastatin and niacin. Other HMG-CoA reductase inhibitors may have a similar interaction with niacin. The mechanism of interaction is unknown, although the use of lipid-lowering dosages of niacin (1 gram/day or more) alone has been associated with development of myopathy.

MANAGEMENT: Concurrent use of lipid-lowering dosages of niacin and HMG-CoA reductase inhibitors should generally be avoided unless the benefit of further alterations in lipid levels is anticipated to outweigh the potential risks. Addition of niacin to HMG-CoA reductase inhibitor therapy typically provides little additional reduction in LDL cholesterol, but further reductions of triglycerides and increases in HDL cholesterol may be obtained. If the combination is prescribed, lower dosages of the HMG-CoA reductase inhibitor should be considered. Lovastatin labeling recommends that the dosage not exceed 20 mg daily when prescribed with lipid-lowering dosages of niacin. Patients should be advised to promptly report any unexplained muscle pain, tenderness, or weakness, particularly if accompanied by malaise or fever. The drugs should be discontinued if creatine kinase is markedly elevated (more than 10 times the upper limit of normal) or if myopathy is suspected or diagnosed.