Before Using This Medicine

This combination medicine should not be used until after your body has adjusted to each of the individual medicines. Be sure to check with your doctor about this.

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For niacin extended-release and lovastatin combination, the following should be considered:

Allergies—Tell your doctor if you have ever had any unusual or allergic reaction to niacin and lovastatin. Also tell your doctor and pharmacist if you are allergic to any other substances, such as foods, preservatives, or dyes.

Diet—Before prescribing medicine for your condition, your doctor will probably try to control your condition by prescribing a personal diet for you. Such a diet may be low in fats, particularly saturated fat, sugars, and/or cholesterol. Many people are able to control their condition by carefully following their doctor's orders for proper diet and exercise. Medicine is prescribed only when additional help is needed and is effective only when a schedule of diet and exercise is properly followed.

Make certain your doctor knows if you are on any special diet, such as a low-sodium or low-sugar diet.

Pregnancy—Niacin extended-release and lovastatin combination should not be used during pregnancy or by women who plan to become pregnant in the near future. This medicine blocks the formation of cholesterol, which is necessary for the fetus to develop properly. Niacin extended-release and lovastatin combination may cause birth defects or other problems in the baby if taken during pregnancy. If you are a woman of child-bearing age and your doctor wants you to take this medicine, it is very important that an effective form of birth control be used during treatment with this medicine. Check with your doctor immediately if you think you have become pregnant while taking this medicine. Be sure you have discussed this with your doctor.

Breast-feeding—Niacin extended-release and lovastatin combination is not recommended for use during breast-feeding because it may cause unwanted effects in nursing babies.

Children—Studies on this medicine have been done only in adult patients, and there is no specific information comparing use of niacin extended-release and lovastatin combination in children with use in other age groups.

Older adults—This medicine has been tested in a limited number of patients 65 years of age or older and has not been shown to cause different side effects or problems in older people than it does in younger adults.

Other medicines—Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking niacin extended-release and lovastatin combination, it is especially important that your doctor and pharmacist know if you are taking any of the following:

• Alcohol, excessive use—Excessive amounts of alcohol while taking niacin extended-release and lovastatin combination can worsen the adverse effects of this medicine on the liver

• Anticoagulants (blood thinners such as warfarin [Coumadin])—Use with niacin extended-release and lovastatin combination may increase the risk of bleeding.

• Antihypertensives (medicine for high blood pressure)—Effects on blood pressure may be increased.

• Clarithromycin (e.g., Biaxin) or
• Clofibrate (e.g., Atromid-S) or
• Cyclosporine (e.g., Neoral, Sandimmune) or
• Erythromycin (e.g., E-Mycin) or
• Fenofibrate (e.g., Tricor) or
• Gemfibrozil (e.g., Lopid) or
• Itraconazole (e.g., Sporanox) or
• Ketoconazole (e.g., Nizoral) or
• Nefazodone (e.g., Serzone) or
• Protease Inhibitors (medicine used to treat HIV and AIDS such as indinavir [Crixivan], nelfinavir [Viracept], ritonavir [Norvir], and saquinavir [Invirase])—Use of these medicines with niacin extended-release and lovastatin combination may increase the risk of developing muscle problems.

• Vitamins or supplements containing niacin or related compounds such as nicotinamide—Use of these medicines may increase the risk of developing adverse effects from niacin extended-release and lovastatin combination.

Other medical problems—The presence of other medical problems may affect the use of niacin extended-release and lovastatin combination. Make sure you tell your doctor if you have any other medical problems, especially:

• Bleeding problems or
• Diabetes mellitus (sugar diabetes) or
• Endocrine problems or
• Gout or
• Heart Disease or
• Liver disease or
• Low blood pressure or
• Stomach Ulcer—Niacin extended-release and lovastatin combination may make these conditions worse.

• Kidney Disease—Effects of niacin extended-release and lovastatin combination may be increased because of slower removal of medicine from the body.