The combination of simvastatin and niacin is used to help lower triglyceride and cholesterol levels in the blood. These substances can clog blood vessels and cause heart problems if allowed to accumulate unchecked in the blood. This therapy is typically reserved for patients who have not been able to successfully lower their triglyceride and cholesterol levels despite a low-fat diet and exercise or by taking simvastatin or niacin alone. The combination of simvastatin and niacin was approved by the United States Food and Drug Administration on 15 February 2008 and is marketed in America under the brand name Simcor®.
A high level of cholesterol and other fatty substances in the blood can cause heart attacks and strokes. The liver makes cholesterol, which is used as a cellular building block. As the human body can make all the necessary cholesterol, individuals who eat a diet of foods high in cholesterol can end up with too much of the substance in their blood.
Of the two types of cholesterol, HDL helps remove surplus cholesterol from the body while LDL can build up on artery walls and block blood flow. As a result, LDL levels should be as low as possible while higher levels of HDL can protect against cardiovascular events. Simvastatin and niacin can lower LDL levels and triglycerides while increasing the amount of HDL.
When taken in combination, simvastatin and niacin treat lipid and cholesterol disorders. Simvastatin is a HMG-CoA inhibitor, or what is more commonly known as a statin. It blocks an enzyme that the body needs to make cholesterol and thus lowers the overall level of cholesterol in the blood. Niacin is a B-complex vitamin that also reduces cholesterol blood levels.
Simvastatin and niacin are available as an extended release tablet swallowed whole. The dosage, number of doses taken daily, and length of the regimen vary from patient to patient and depend on the medical problem treated. In most cases, simvastatin and niacin are taken at bedtime with a snack. Patients with high cholesterol or those on simvastatin or niacin therapy will likely have distinct therapeutic programs.
A common side effect of simvastatin and niacin is flushing, or a feeling of warmth accompanied by redness of the face, arms, and neck. Flushing may stop after several weeks of treatment and can vary in severity. Taking the tablet before bed increases the likelihood of flushing while sleeping that can wake the patient up. Flushing can be managed by avoiding alcohol, spicy foods, and hot beverages when taking simvastatin and niacin or by taking an aspirin with the medication if the patient’s doctor approves.
Other typical side effects of simvastatin and niacin include back pain, diarrhea, and nausea. This medication can also cause blood sugar and liver enzyme levels to increase. Patients taking high doses are at an increased risk of developing a muscle disorder called rhabdomyolysis that can damage kidneys. Individuals with liver problems, pregnant women, or women who may become pregnant should consult with their health care providers before starting this treatment.
This medication will not cure a patient’s cholesterol problem but can help control it. Simvastatin and niacin are most effective when part of treatment regimen that includes a low-fat diet and exercise. A patient taking this drug combination will likely be monitored during regular office visits with his or her health care provider to ensure that the treatment is effective and the dose appropriate.
