Medical Editor: Jay Marks, M.D.

GENERIC NAME: niacin and lovastatin

BRAND NAME: Advicor

DRUG CLASS AND MECHANISM: Advicor is an oral drug that is used for lowering cholesterol levels. It is a combination of extended-release niacin and lovastatin. It reduces blood levels of total cholesterol, low density lipoprotein (LDL) cholesterol, and triglycerides and increases blood levels of high density lipoprotein (HDL) cholesterol. For further information, please see the individual monographs for niacin and lovastatin .

PRESCRIPTION: Yes.

GENERIC AVAILABLE: No.

PREPARATIONS: Tablets: 500/20 and 1000/20 mg niacin/mg lovastatin

STORAGE: Store at room temperature between 20-25°C (68-77°F).

PRESCRIBED FOR: Advicor is used for treating elevated blood levels of total cholesterol, LDL ("bad") cholesterol, and triglycerides, and for raising low levels of HDL ("good") cholesterol.

DOSING: The recommended starting dose for Advicor is one tablet (500/20 mg). Doses can be increased by 500 mg of niacin every 4 weeks based on the response of the blood cholesterol level. Doses greater than 2000/40 mg are not recommended. Individuals already stabilized on niacin extended-release tablets can be directly switched to the niacin equivalent dose of Advicor. Individuals taking extended-release niacin and lovastatin separately can be switched to an equivalent dose of Advicor. Other forms of niacin (e.g., sustained-release, timed-release or immediate-release) are not equivalent to extended-release niacin in Advicor. Therefore, Advicor is not interchangeable with these niacin preparations, and patients taking these preparations should be switched and stabilized on extended-release niacin before switching to Advicor.

Advicor should be administered at bedtime since there is evidence that at least some drugs in the same class as lovastatin lower cholesterol more when taken at night than in the morning. If Advicor causes nausea it may be taken with a snack. If Advicor is discontinued for longer than 7 days, therapy should be resumed at the lowest dose.

DRUG INTERACTIONS: Please see the individual monographs for niacin and lovastatin .

PREGNANCY: Advicor should not be administered to pregnant women because lovastatin can be harmful to the fetus. Niacin has not been evaluated in pregnant women at doses used for treating levels of cholesterol and triglycerides.

NURSING MOTHERS: Niacin in Advicor is excreted in breast milk and may cause side effects if ingested by the infant.

SIDE EFFECTS: Please see the individual monographs for niacin and lovastatin .

References: Advicor Full Prescribing Information, 2004. Kos Pharmaceuticals, Inc., Miami, FL 33131

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