Monograph Details
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Cardiovascular System
> Hyperlipoproteinemias
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ADVICOR 500mg/20mg |
| Manufacturer |
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Abbott Laboratories |
| Legal Classification |
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Rx
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| Pharmacological Class |
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Nicotinic acid deriv. + HMG-CoA reductase inhibitor. |
| Generic Name |
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Niacin ext-rel 500mg, lovastatin 20mg; tabs. |
| Also |
• ADVICOR 1000mg/20mg
• ADVICOR 1000mg/40mg
• ADVICOR 750mg/20mg
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| Indications |
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Adjunct to diet in primary hypercholesterolemia and mixed dyslipidemia in patients treated with lovastatin who need further decreases in TG or increases in HDL-C, or those treated with niacin who need further decreases in LDL-C, and who may benefit from combination therapy. |
| Children |
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<18yrs: not recommended. |
| Adults |
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≥18yrs: not for initial therapy. Patients on stable doses of Niaspan: switch to niacin equivalent of Advicor. Patients not on Niaspan: see literature. Swallow whole at bedtime with low-fat snack. Avoid concomitant alcohol, hot drinks, grapefruit juice; may pre-treat with aspirin or other NSAID ½ hour before dosing (to reduce flushing). May increase by up to 500mg (niacin component) every 4 weeks. Max 2000mg/40mg daily. If discontinued for >7 days, retitrate from lowest dose. |
| Contraindications |
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Active liver or peptic ulcer disease. Unexplained persistent elevated serum transaminases. Arterial bleeding. Pregnancy (Cat.X). Nursing mothers. |
| Precautions |
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Do not substitute for equivalent doses of immediate-release niacin (hepatotoxicity may occur). Substantial alcohol consumption. History of liver or hepatobiliary disease. Monitor serum transaminase levels (at baseline, every 6–12 weeks for first 6 months, then periodically); discontinue if levels ≥3xULN persist or if signs of liver disease occur. Discontinue if myopathy is diagnosed or suspected (may monitor creatine kinase). Renal dysfunction. Cardiovascular disease (eg, unstable angina, acute MI). Gout. Hypophosphatemia. Suspend before surgery; monitor PT, platelets. Diabetes. Follow-up if endocrine dysfunction occurs. |
| Interactions |
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Avoid fibrates, alcohol, grapefruit juice, other sources of niacin or nicotinamide. Suspend before giving azole antifungals, macrolides. May potentiate ganglionic blockers, vasoactive drugs. Caution with drugs metabolized by CYP3A4. Separate dosing of bile acid sequestrants by 4–6 hours. Monitor warfarin, antidiabetics; and for myopathy with cyclosporine. |
| Adverse Reactions |
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Flushing, headache, pain, pruritus, dyspepsia, flu syndrome, rash, asthenia, hyperglycemia, myalgia, orthostatic hypotension, elevated ALT/AST, myopathy, rhabdomyolysis with renal dysfunction. |
| How Supplied |
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Tabs—90 |
| Additional Resources |
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• Related Prescribing Note |
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