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Advicor (Lovastatin) - Drug Interactions, Contraindications, Overdosage, etc

 
 



DRUG INTERACTIONS

Drug Interactions

Niacin

Antihypertensive Therapy - Niacin may potentiate the effects of ganglionic blocking agents and vasoactive drugs resulting in postural hypotension.

OVERDOSAGE

Information on acute overdose with ADVICOR in humans is limited. Until further experience is obtained, no specific treatment of overdose with ADVICOR can be recommended. The patient should be carefully observed and given supportive treatment.

Niacin

The s.c. LD50 of niacin is 5 g/kg in rats.

The signs and symptoms of an acute overdose of niacin can be anticipated to be those of excessive pharmacologic effect: severe flushing, nausea/vomiting, diarrhea, dyspepsia, dizziness, syncope, hypotension, possibly cardiac arrhythmias and clinical laboratory abnormalities. Insufficient information is available on the potential for the dialyzability of niacin.

Lovastatin

After oral administration of lovastatin to mice the median lethal dose observed was >15 g/m2.

Five healthy human volunteers have received up to 200 mg of lovastatin as a single dose without clinically significant adverse experiences. A few cases of accidental overdose have been reported; no patients had any specific symptoms, and all patients recovered without sequelae. The maximum dose taken was 5 to 6 g. The dialyzability of lovastatin and its metabolites in man is not known at present.

CONTRAINDICATIONS

ADVICOR is contraindicated in patients with a known hypersensitivity to niacin, lovastatin or any component of this medication, active liver disease or unexplained persistent elevations in serum transaminases (see WARNINGS), active peptic ulcer disease, or arterial bleeding.

Concomitant administration with strong CYP3A4 inhibitors (e.g., itraconazole, ketoconazole, posaconazole, HIV protease inhibitors, boceprevir, telaprevir, erythromycin, clarithromycin, telithromycin and nefazodone) (see WARNINGS, Myopathy/Rhabdomyolysis).

Pregnancy and lactation - Atherosclerosis is a chronic process and the discontinuation of lipid-lowering drugs during pregnancy should have little impact on the outcome of long-term therapy of primary hypercholesterolemia. Moreover, cholesterol and other products of the cholesterol biosynthesis pathway are essential components for fetal development, including synthesis of steroids and cell membranes. Because of the ability of inhibitors of HMG-CoA reductase, such as lovastatin, to decrease the synthesis of cholesterol and possibly other products of the cholesterol biosynthesis pathway, ADVICOR is contraindicated in women who are pregnant and in lactating mothers. ADVICOR may cause fetal harm when administered to pregnant women. ADVICOR should be administered to women of childbearing age only when such patients are highly unlikely to conceive. If the patient becomes pregnant while taking this drug, ADVICOR should be discontinued immediately and the patient should be apprised of the potential hazard to the fetus (see PRECAUTIONS, Pregnancy).

DRUG ABUSE AND DEPENDENCE

Neither niacin nor lovastatin is a narcotic drug. ADVICOR has no known addiction potential in humans.

REFERENCES

  1. Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA 2001; 285:2486-2497.
  2. Downs JR, et al. JAMA 1998; 279:1615-1622.
  3. Bradford RH, et al. Arch Intern Med 1991;151:43-49.
  4. Bradford RH, et al. Am J Cardiol 1994; 74:667-673.
  5. Manson JM, et al. Reprod Toxicol 1996; 10(6): 439-446.

Manufactured by AbbVie LTD, Barceloneta, PR 00617
for AbbVie Inc., North Chicago, IL 60064, U.S.A.

© 2013 AbbVie Inc.



03-A745 February, 2013

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