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What is a Niacin and Statin Combination?

By Madeleine A.
Updated Feb 25, 2024
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A niacin and statin combination is a treatment for lowering blood lipid or fats. Typically, statin medications lower total cholesterol levels, while niacin is effective in lower levels of triglycerides, another fat present in the blood. A prescription medication called Niaspan is typically given in conjunction with statin medications to those who have elevated total cholesterol levels and elevations in triglycerides. Although over-the-counter niacin supplements are available, they should not be taken unless under the direction of a health care provider. In addition, niacin therapy can cause side effects such as facial flushing and headache. Niacin and statin therapy is generally well tolerated, however, side effects should be reported at once.

Typically, hypercholesterolemia, or high cholesterol, responds not only to niacin and statin therapy, but also to dietary changes and exercise. It is important for the physician to incorporate healthy lifestyle changes into a cholesterol- and triglyceride-lowering routine for optimal effects. Statin medications work by blocking or interfering with the amount of total cholesterol produced by the liver. Generally, they are especially effective in lowering low-density lipoproteins. These cholesterol components are also known as LDLs or "bad" cholesterol. Usually, when low-density lipoproteins rise and high-density lipoproteins or HDLs fall, the risk of coronary artery disease, stroke, and heart attack rises.

Commonly used medications employed in a niacin and statin protocol include atorvastatin. This medication is also known Lipitor and marketed by the pharmaceutical company Pfizer. Generally, Lipitor is taken once daily in conjunction with Niaspan or a regular niacin supplement, also usually taken once a day.

Lipitor can lower "bad" cholesterol levels and might also be effective in lowering triglyceride levels, much like Niaspan. Like most cholesterol-lowering medications, Lipitor can have side effects such as muscle pain, stomach upset, and abnormalities in liver function tests. While receiving this therapy, the physician should closely monitor one's blood chemistry to reveal early signs of abnormal liver function.

Another medication sometimes used in niacin and statin therapy is lovastatin, also known as Advicor. Typically, this is also used in conjunction with dietary modifications that include fat and cholesterol restriction. Like Lipitor, this medication can be taken once a day, or if the physician deems necessary, twice a day.

Similar to other statin medications, it can be taken with a niacin supplement or prescription preparation and can cause side effects. Typically, Advicor side effects can include gas, heartburn, muscle pain, and blurred vision. If side effects worsen and compromise medication compliance, the physician should be notified for an alternative treatment plan to niacin and statin therapy.

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Discussion Comments

By bluedolphin — On Feb 15, 2015

@ZipLine-- I haven't heard very good things about niacin and statin combinations either. But that doesn't mean that all cholesterol medications cause a lot of side effects and problems. I'm sure there are good ones out there.

If it's possible to control cholesterol with diet, that's ideal. But some people can't and niacin and statin can be very effective and worthwhile in these cases. Either way, the decision has to be the patient's and the doctor's.

By ZipLine — On Feb 14, 2015

@bear78-- I understand what you're saying but niacin and statin combination medication isn't great either. They also cause problems like flushing, itching, rash and dizziness. So any side effect experienced form over the counter niacin supplements can be experienced on niacin and statin combination medication as well. It doesn't really matter that one is OTC and one is prescription.

Of course, people should take supplements after checking with their doctor. But if an over the counter niacin supplement at recommended doses is helping to reduce cholesterol, I don't see why people shouldn't use it.

Niacin and statin combination is prescribed frequently because there really aren't many prescription alternatives for it. But it's far from being the ideal cholesterol drug if you ask me.

By bear78 — On Feb 14, 2015

So many people use over the counter niacin supplements for cholesterol and I don't think that all are using them under the supervision of their doctor. It's absolutely true that niacin has negative side effects, especially at the very high doses people use them for cholesterol reduction. It causes flush, low blood pressure and even allergic reactions.

I know that cholesterol medications like statin medications don't have the best reputation, but this doesn't mean that we can treat our cholesterol with abnormally high doses of niacin. It can be very dangerous.

A niacin and statin combination may work, but only when prescribed by the doctor and taken under his or her care and supervision.

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