Advicor

Generic name: Lovastatin, NiacinBrand names: Advicor

Why is Advicor prescribed?

Advicor is a cholesterol-lowering drug. Excess cholesterol in the bloodstream can lead to hardening of the arteries and heart disease. Advicor lowers total cholesterol and LDL ("bad") cholesterol, while raising the amount of HDL ("good") cholesterol.

Advicor is a combination of two cholesterol-fighting ingredients: extended-release niacin and lovastatin. It is prescribed only when other drugs and a program of diet, exercise, and weight reduction have been unsuccessful in lowering cholesterol levels.

Most important fact about Advicor

Although you cannot feel any symptoms of high cholesterol, it is important to take Advicor every day. The drug will be more effective if it is taken as part of a program of diet, exercise, and weight loss. All these efforts keep your cholesterol levels normal and lower your risk of heart disease.

How should you take Advicor?

Advicor should be taken at bedtime, with a low-fat snack. Do not take Advicor on an empty stomach.

Advicor is an extended-release medication. Swallow the tablets whole. Do not break, chew, or crush the tablets.

If you stop taking Advicor for more than a week, check with your doctor; you may need to gradually build up your dosage again.

• If you miss a dose...Take it as soon as you remember. If it is almost time for your next dose, skip the one you missed and go back to your regular schedule. Do not take two doses at once.

• Storage instructions...Store at room temperature.

What side effects may occur?

Side effects cannot be anticipated. If any develop or change in intensity, inform your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking Advicor.

• Side effects may include:Abdominal pain, back pain, diarrhea, flu-like symptoms, flushing, headache, high blood sugar, indigestion, infection, itching, muscle pain, nausea, pain, rash, vomiting, weakness

Why should Advicor not be prescribed?

If you are allergic to niacin or lovastatin, you cannot take Advicor. You also should avoid Advicor if you have liver disease, an ulcer, or arterial bleeding. Never take Advicor during pregnancy or while you are breastfeeding.

Special warnings about Advicor

Advicor can cause liver problems. Your doctor will test your liver function before you start taking Advicor, then every 6 to 12 weeks for the first 6 months after you begin therapy, and every 6 months thereafter. If the tests reveal a problem, you may have to stop taking Advicor. Individuals who regularly drink alcohol or have a history of liver disease should use Advicor with caution. Avoid Advicor completely if you currently have liver disease.

The extended-release niacin in Advicor is not interchangeable with immediate-release niacin. Substituting doses of extended-release niacin for immediate-release niacin can cause severe liver damage.

Drugs like Advicor may trigger a muscle-wasting condition that also can affect the kidneys. The risk is increased if Advicor is taken with certain drugs or grapefruit juice. Contact your doctor immediately if you experience unexplained muscle pain, tenderness, or weakness. You may have to stop taking Advicor. Use Advicor with caution if you have kidney disease, gout, or the chest pain of angina.

Advicor may cause flushing. This side effect usually goes away after taking the medication for several weeks. Flushing can be accompanied by dizziness, fainting, heartbeat irregularities, chills, shortness of breath, or swelling. Notify your doctor if you experience dizziness. If you awaken because of flushing, rise slowly to avoid dizziness and fainting. Taking aspirin or ibuprofen before taking Advicor may help decrease the flushing. Avoid drinking alcohol or hot drinks near the time you take Advicor; these can increase flushing.

If you have diabetes, Advicor may affect your blood sugar levels. Tell your doctor if you note any changes.

Advicor can cause abnormalities in the blood. If you are scheduled for surgery, your doctor will have you stop taking Advicor a few days before the operation.

Tell your doctor if you are taking any nutritional supplements that contain niacin.

Advicor is not recommended for children.

Possible food and drug interactions when taking Advicor

Avoid drinking large amounts of grapefruit juice (more than a quart a day) while on Advicor therapy. It can increase the risk of muscle wasting.

If Advicor is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining Advicor with any of the following:

Antifungal drugs such as itraconazole and ketoconazoleBlood pressure medications such as atenolol, metoprolol tartrate, and propranolol hydrochlorideCalcium channel blockers such as amlodipine besylate, felodipine, and nifedipineCholesterol-lowering drugs called fibrates such as gemfibrozilCimetidineClarithromycinCyclosporineErythromycinHIV protease inhibitors such as nelfinavir mesylate and ritonavirNefazodoneNitroglycerinNutritional supplements containing niacin or nicotinamideSpironolactoneWarfarin

Special information if you are pregnant or breastfeeding

Developing babies need plenty of cholesterol, so cholesterol-lowering drugs should never be used during pregnancy or while breastfeeding. Advicor should be taken by women of childbearing age only if it is very unlikely that they will become pregnant. If you do become pregnant while taking Advicor, stop taking the medication immediately and contact your doctor.

Recommended dosage for Advicor

ADULTS

The usual starting dose of Advicor is one tablet containing 500 milligrams of extended-release niacin and 20 milligrams of lovastatin, taken at bedtime with a low-fat snack. After four weeks, your doctor may increase the dosage if the initial dose has not been effective. The maximum recommended dosage is 2,000 milligrams of extended-release niacin and 40 milligrams of lovastatin.

Overdosage

Any medication taken in excess can have dangerous consequences. If you suspect an overdose, seek medical attention immediately.

• Symptoms of Advicor overdose may include:Diarrhea, dizziness, fainting, heartbeat irregularities, indigestion, nausea, severe flushing, vomiting