NIACIN AND SIMVASTATIN

(NYE a sin and SIM va stat in) Brand: Simcor

What is the most significant information I must know about niacin and simvastatin?

• You must not take this medicine if you are allergic to niacin (Niaspan, Niacor, and others) or simvastatin (Zocor, Vytorin), if you are pregnant or breast-feeding, or if you have liver malady, severe bleeding, or a stomach ulcer.

• In rare cases, simvastatin can reason a condition that results in the breakdown of skeletal muscle tissue, leading to kidney failure. Call your doctor right away if you have unexplained muscle pain, tenderness, or weakness especially if you also have fever, unusual tiredness, and dark colored urine.

• Never take niacin and simvastatin in larger amounts, or for longer than recommended by your doctor. Follow your doctor's dosing instructions very carefully. Taking too many of this medicine may reason serious or life-threatening side effects.

• There are much another drugs that must not be used together with niacin and simvastatin. Speak your doctor about all medications you use. Hold a list of all your medicines and show it to any healthcare provider who treats you.

• Simvastatin can harm an unborn child or reason birth defects. Do not use niacin and simvastatin if you are pregnant.

• Till taking niacin and simvastatin, speak your doctor if you have ever had liver or kidney malady, diabetes, gout, or a thyroid mess, if you are of Chinese descent, or if you drink more than 2 alcoholic beverages daily.

What is niacin and simvastatin?

• Niacin, also called nicotinic acid, is a B vitamin (vitamin B3). It occurs naturally in plants and animals, and is also added to much foods as a vitamin supplement. Niacin is also gift in much multiple vitamins and nutritional supplements.

• Simvastatin is in a group of drugs called HMG CoA reductase inhibitors, or "statins." Simvastatin reduces levels of "bad" cholesterol (low-density lipoprotein, or LDL) and triglycerides in the blood, while increasing levels of "good" cholesterol (high-density lipoprotein, or HDL).

• The combination of niacin and simvastatin is used to lower cholesterol and triglycerides (types of fat) in the blood.

• Niacin and simvastatin may also be used for purposes not listed in this medicine guide.

What must I discuss with my healthcare provider till taking niacin and simvastatin?

• You must not take this medicine if you are allergic to niacin (Niaspan, Niacor, and others) or simvastatin (Zocor, Vytorin), if you are pregnant or breast-feeding, or if you have liver malady, severe bleeding, or a stomach ulcer.

• In rare cases, niacin and simvastatin can reason a condition that results in the breakdown of skeletal muscle tissue, leading to kidney failure. This condition may be more likely to occur in older adults and in people who have kidney malady or poorly controlled hypothyroidism (underactive thyroid). You may also be more likely to develop this condition if you are of Chinese descent

• The next drugs can magnify your risk of serious muscle problems if you take them together with simvastatin. These drugs must not be used while you are taking niacin and simvastatin:

· amiodarone (Cordarone, Pacerone);

· cyclosporine (Gengraf, Neoral, Sandimmune);

· danazol (Danocrine);

· diltiazem (Cardizem, Cartia, Dilacor, Diltia, Diltzac, Taztia, Tiazac);

· gemfibrozil (Lopid);

· nefazodone (an antidepressant);

· verapamil (Calan, Covera, Isoptin, Verelan);

· the antibiotics clarithromycin (Biaxin), erythromycin (E.E.S., EryPed, Ery-Tab, Erythrocin), and telithromycin (Ketek);

· the antifungal medications itraconazole (Sporanox), ketoconazole (Nizoral), and posaconazole (Noxafil);

· hepatitis C medications such as boceprevir (Victrelis) or telaprevir (Incivek); or

· the HIV/AIDS medications atazanavir (Reyataz), darunavir (Prezista), fosamprenavir (Lexiva), indinavir (Crixivan), nelfinavir (Viracept), ritonavir (Norvir, Kaletra), saquinavir (Invirase), or tipranavir (Aptivus).

• Before you start taking niacin and simvastatin, speak your doctor if you are already using any of these another medicines:

· amlodipine (Norvasc, Caduet, Exforge, Lotrel, Tekamlo, Tribenzor, Twynsta, Amturnide); or

· ranolazine (Ranexa).

• To create certain you can safely take niacin and simvastatin at any doze, speak your doctor if you have any of these another conditions:

· history of liver or kidney disease;

· diabetes;

· gout;

· a thyroid disorder;

· if you drink more than 2 alcoholic beverages daily; or

· if you are switched to this medicine from regular niacin, nicotinic acid, or nicotinamide (or vitamin supplements that contain niacin).

• FDA pregnancy category X. This medicine can harm an unborn child or reason birth defects. Do not take niacin and simvastatin if you are pregnant. Stop taking this medicine and speak your doctor right away if you become pregnant. Use effective birth control to avoid pregnancy while you are taking niacin and simvastatin.

• Niacin and simvastatin may pass into breast milk and could harm a nursing child. Do not breast-feed while you are taking niacin and simvastatin.

How must I take niacin and simvastatin?

• Take exactly as predesigned. Never take this medication in larger amounts, or for longer than recommended by your doctor. Follow your doctor's dosing instructions very carefully. Taking too many of this medicine may reason serious or life-threatening side effects.

• Niacin and simvastatin is generally taken at bedtime with a low-fat snack. Follow your doctor's instructions. Do not take niacin and simvastatin on an empty stomach.

• Do not crush, chew, or interrupt an extended-release tablet. Swallow it whole.

• Niacin can reason determined side effects such as dizziness, sweating, chills, flushing (warmth, redness, or tingly feeling under your skin), quick or pounding heartbeats, shortness of breath, or feeling like you might pass out. These effects can be made worse if you drink alcohol or hot beverages shortly after you take niacin and simvastatin. These effects must disappear over time as you hold taking the medicine.

• Your doctor may recommend you take aspirin 30 minutes till you take niacin and simvastatin to prevent determined side effects. Do not take aspirin without your doctor's advice. Follow the label directions or your doctor's instructions about how many aspirin to take.

• You may need to stop using niacin and simvastatin for a short time if you have:

· uncontrolled seizures;

· an electrolyte imbalance (such as tall or low potassium levels in your blood);

· severely low blood pressure;

· a severe infection or illness;

· dehydration; or

· surgery or a medical emergency.

• If you stop taking niacin and simvastatin for longer than 7 days in a row, conversation with your doctor till restarting the medicine. You may need to start with a lower dose.

• Niacin can raise your blood sugar, and may reason unusual results with determined medical trials. Speak any doctor who treats you that you are using niacin and simvastatin.

• To be certain this medication is helping your condition and is not causing deleterious effects, your blood will need to be tested often. Visit your doctor regularly.

• You may need to take niacin and simvastatin on a long-term basis for the treatment of tall cholesterol. Do not stop taking this medicine unless your doctor tells you to.

• Store at room temperature away from moisture and heat.

What happens if I miss a dose?

• Take the missed doze as soon as you remember. Skip the missed doze if it is nearly time for your following scheduled doze. Do not take extra medication to create up the missed dose.

What happens if I overdose?

• Search abnormal medical attention or call the Poison Help line at 1-800-222-1222.

What must I avoid while taking niacin and simvastatin?

• Grapefruit and grapefruit juice may interact with simvastatin and lead to potentially dangerous effects. Do not drink more than 1 quart of grapefruit juice daily.

• If you also take cholestyramine (Prevalite, Questran) or colestipol (Colestid), avoid taking them within 4 to 6 hours till or after you take niacin and simvastatin.

• Avoid eating foods that are tall in thick or cholesterol. Niacin and simvastatin will not be as effective in lowering your cholesterol if you do not follow a cholesterol-lowering diet plan.

• Avoid drinking alcohol. It can raise triglyceride levels and may magnify your risk of liver damage.

What are the possible side effects of niacin and simvastatin?

• Get abnormal medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your person, lips, tongue, or throat.

• Stop taking niacin and simvastatin and call your doctor at once if you have any of these serious side effects:

· unexplained muscle pain, tenderness, or weakness;

· confusion, memory problems;

· fever, unusual tiredness, and dark colored urine;

· swelling, weight gain, urinating smaller than normal or not at all;

· heighten thirst, heighten urination, famine, dry mouth, fruity breath odor, drowsiness, dry skin, blurred vision, weight loss; or

· nausea, upper stomach pain, itching, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes).

• Smaller serious side effects may include:

· headache, mild dizziness;

· diarrhea, mild nausea;

· mild skin rash;

· back pain; or

· flushing (warmth, redness, or tingly feeling).

• This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may message side effects to FDA at 1-800-FDA-1088.

What another drugs will affect niacin and simvastatin?

• Speak your doctor about all another medications you use, especially:

· colchicine (Colcrys);

· digoxin (Lanoxin);

· blood pressure medication;

· a blood thinner such as warfarin (Coumadin, Jantoven);

· another medicines that contain niacin (Advicor, Niaspan, Niacor, Slo-Niacin, and others); or

· any another "statin" medicine such as atorvastatin (Lipitor, Caduet), fluvastatin (Lescol), lovastatin (Altoprev, Mevacor), pravastatin (Pravachol), rosuvastatin (Crestor), or simvastatin (Zocor, Vytorin).

• This list is not complete and another drugs may interact with niacin and simvastatin. Speak your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal commodity. Do not start a new medicine without telling your doctor.

Where can I get more information?

• Your pharmacist can provide more information about niacin and simvastatin.

Remember, hold this and all another medicines out of the reach of children, never share your medicines with others, and use this medicine only for the indication prescribed.

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