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Niacin Capsules and Tablets and Pravastatin Sodium

Determining the interaction of Niacin Capsules and Tablets and Pravastatin Sodium and the possibility of their joint administration.

Check result:
Niacin Capsules and Tablets <> Pravastatin Sodium
Relevance: 11.12.2023 Reviewer: Shkutko P.M., M.D., in

In the database of official manuals used in the service creation an interaction registered by statistical results of studies was found, which can either lead to negative consequences for the patient health or strengthen a mutual positive effect. A doctor should be consulted to address the issue of joint drug administration.

Consumer:

Talk to your doctor before using niacin and pravastatin. This combination may cause unexplained muscle pain, tenderness, or weakness, particularly if accompanied by chills or fever. If you take both medications together, tell your doctor if you have any of these symptoms. You may need a dose adjustment or special test if you take both medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Professional:

ADJUST DOSE: The concomitant use of pravastatin and niacin may increase the risk of severe myopathy and rhabdomyolysis. Although this reaction has not been reported in clinical trials where pravastatin and niacin were used in combination, the manufacturer warns of an increased risk of myopathy when HMG-CoA reductase inhibitors are used concurrently with niacin.

MANAGEMENT: The concurrent use of niacin and pravastatin should be avoided unless the benefit outweighs risk. Some authorities suggest that a dose reduction for pravastatin should be considered if concomitant therapy is required. It should also be noted that the risk of adverse effects is increased with niacin doses greater than 1 gram per day. In addition, if patients do receive this combination, they should be instructed to promptly report symptoms of muscular pain, weakness, or tenderness. Creatine kinase should be measured if such symptoms appear. If creatine kinase is elevated or if myopathy is suspected, the drugs should be discontinued.

References
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  • Pasternak RC, Brown LE, Stone PH, Silverman DI, Gibson CM, Sacks FM "Effect of combination therapy with lipid-reducing drugs in patients with coronary heart disease and "normal" cholesterol levels: a randomized, placebo-controlled trial." Ann Intern Med 125 (1996): 529-40
  • Pan HY "Clinical pharmacology of pravastatin, a selective inhibitor of HMG- CoA reductase." Eur J Clin Pharmacol 40 (1991): s15-8
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  • Arntz HR, Agrawal R, Wunderlich W, Schnitzer L, Stern R, Fischer F, Schultheiss HP "Beneficial effects of Pravastatin (+/- colestyramine/niacin) initiated immediately after a coronary event (The randomized lipid-coronary artery disease [L-CAD] study)." Am J Cardiol 86 (2000): 1293-8
  • "Product Information. Pravachol (pravastatin)." Bristol-Myers Squibb, Princeton, NJ.
  • Haria M, McTavish D "Pravastatin. A reappraisal of its pharmacological properties and clinical effectiveness in the management of coronary heart disease." Drugs 53 (1997): 299-336
  • Ayanian JZ, Fuchs CS, Stone RM "Lovastatin and rhabdomyolysis." Ann Intern Med 109 (1988): 682-3
  • McTavish D, Sorkin EM "Pravastatin. A review of its pharmacological properties and therapeutic potential in hypercholesterolaemia [published erratum appears in Drugs 1991 Dec;42(6):944]." Drugs 42 (1991): 65-89
  • Quion JAV, Jones PH "Clinical pharmacokinetics of pravastatin." Clin Pharmacokinet 27 (1994): 94-103
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  • Okeefe JH, Harris WS, Nelson J, Windsor SL "Effects of pravastatin with niacin or magnesium on lipid levels and postprandial lipemia." Am J Cardiol 76 (1995): 480-4
Niacin Capsules and Tablets

Generic Name: niacin

Brand name: B-3-50, B3-500-Gr, Niacin SR, Niacor, Niaspan ER, Slo-Niacin

Synonyms: Niacin

Pravastatin Sodium

Generic Name: pravastatin

Brand name: Pravachol

Synonyms: Pravastatin

In the course of checking the drug compatibility and interactions, data from the following reference sources was used: Drugs.com, Rxlist.com, Webmd.com, Medscape.com.

Interaction with food and lifestyle