Niacin and Vytorin: An Overview
There are a number of possible drug interactions with
Vytorin® (
ezetimibe/simvastatin), which are problems that can occur when Vytorin and another drug are used together. One of these interactions is with
niacin, a medicine often used to lower total
cholesterol,
LDL cholesterol, and
triglyceride levels, while
raising HDL cholesterol levels. When the two medicines are used together, there is an increased risk of developing serious muscle problems.
Muscle Problems Associated with Niacin and Vytorin
One of the more common side effects of Vytorin is muscle pain, weakness, or muscle aches (in up to 3.6 percent of people). For most people, muscle pain does not indicate a serious problem. However, in rare cases, people can develop myopathy or rhabdomyolysis while on Vytorin. Rhabdomyolysis is quite serious because it can cause muscles to break down, which can ultimately lead to acute kidney failure and, in some cases, lead to loss of life.
Niacin, when used alone, also increases a person's chances for developing myopathy or rhabdomyolysis. Therefore, it is believed that people taking both niacin and Vytorin are at increased risk for these serious muscle problems because of the combined effect of the two medicines.
Niacin and Vytorin: Recommendations
Generally, it is recommended that people not take niacin and Vytorin together.
If you are taking niacin and Vytorin or a supplement with niacin in it, let your healthcare provider know. This is not an issue for supplements with very small amounts of niacin (such as multivitamins).
However, there may be times when your healthcare provider recommends both niacin and Vytorin. This is most often the case when either Vytorin or niacin alone is not able to
lower cholesterol to "normal" levels. For some people, a combination of the two drugs is needed to reach
healthy cholesterol levels. Your healthcare provider may feel that the risk of a niacin and Vytorin interaction is less than the risk of
high cholesterol in your particular situation.
If you are taking Vytorin and/or niacin and you develop muscle pain, tenderness, or weakness (especially if you also have a fever or feel ill), call your healthcare provider immediately. This could be a sign that you have a serious condition that needs treatment right away
(see Vytorin and Muscle Pain).
