Drug interactions
Niacin + Simvastatin
Severity: Moderate
Niacin and Simvastatin: moderate interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Niacin at lipid-lowering doses combined with simvastatin may increase the risk of myopathy and rhabdomyolysis. Risk appears higher in patients of Chinese ancestry, in the elderly and with renal impairment.
What this interaction means in plain words
Niacin and Simvastatin can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Niacin belongs to Cardiovascular; Simvastatin belongs to Cardiovascular.
Why it happens
Additive myotoxicity, with an incompletely understood mechanism.
What to do
Use the lowest effective doses and educate the patient about muscle symptoms. Check CK and renal function if symptoms develop.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Simvastatin
- Atazanavir + Simvastatin Contraindicated
- Clarithromycin + Simvastatin Contraindicated
- Cobicistat + Simvastatin Contraindicated
- Cyclosporine + Simvastatin Contraindicated
- Cyclosporin + Simvastatin Contraindicated
- Danazol + Simvastatin Contraindicated
Other interactions of Niacin
- Alogliptin-metformin + Niacin Moderate
- Atorvastatin + Niacin Moderate
- Canagliflozin-metformin + Niacin Moderate
- Cholestyramine + Niacin Moderate
- Colestipol + Niacin Moderate
- Dapagliflozin-metformin + Niacin Moderate
Frequently asked questions
Can I take Niacin with Simvastatin?
MediHelp rates the interaction as moderate. Niacin and Simvastatin can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Niacin at lipid-lowering doses combined with simvastatin may increase the risk of myopathy and rhabdomyolysis. Risk appears higher in patients of Chinese ancestry, in the elderly and with renal impairment.
How serious is the interaction between Niacin and Simvastatin?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Use the lowest effective doses and educate the patient about muscle symptoms. Check CK and renal function if symptoms develop.
What other medicines interact with Simvastatin?
MediHelp also lists interactions of Simvastatin with, for example, Atazanavir, Clarithromycin, Cobicistat. The full list is on the Simvastatin page.
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