Is it safe to take Vytorin and Niacin at the same time? - High Cholesterol Message Board

BKSinAZ · 01-29-2005, 01:40 PM

Will it have any additional cholesterol lowering benefits if I take both?
If it is safe, what dosage of niacin per day?

Lenin · 01-29-2005, 03:07 PM

BKS,

As a general rule, I'd say it was unsafe. You would be taking 3 cholesterol drugs all of which are capable of causing liver problems and myalgia (muscle pain.)
Taking 3 is just ASKING for trouble.

Ward · 01-29-2005, 03:42 PM

Quote:

Originally Posted by Lenin

BKS, As a general rule, I'd say it was unsafe. You would be taking 3 cholesterol drugs all of which are capable of causing liver problems and myalgia (muscle pain.) Taking 3 is just ASKING for trouble.

My understanding so far is that there are two ways of reducing cholesterol levels in the blood. One way is in the intestines by reducing the absorption of cholesterol from foods we ingest. An example of this would be soluble fiber. The other way of reducing cholesterol is lowering the amount the liver produces. An example of this would be by statins (Lipitor etc.) I am curious about the method of reduction for many remedies suggested. For example does niacin work in the intestines or the liver? Where do omega-3 fatty acids work?

My high cholesterol is probably caused by over-manufacture in the liver. So is soluble fiber not particularly beneficial to me?

Many thanks.

Lenin · 01-29-2005, 05:08 PM

Atually WARD there are several ways of reducing cholesterol in the blood.

Among them is eating less saturated and trans fats (dietary methods), by blocking the action of HmgCoA reductase in the liver (how statins work), attaching to cholesterol rich bile in the intestines thus preventing it's recycling (bile sequesterants and probably the effect of a high soluble fiber diet), and using fibrates like gemfibrozil that work in the liver also by causing less fat to be produced overall.
Niacin methhodology is not too well defined but certainly involves the liver in a couple of ways as well:

Quote:

It may
involve several actions including partial inhibition of release of free fatty acids from adipose
tissue, and increased lipoprotein lipase activity, which may increase the rate of chylomicron
triglyceride removal from plasma. Niacin decreases the rate of hepatic synthesis of VLDL
and LDL, and does not appear to affect fecal excretion of fats, sterols, or bile acids.

So you can see that almost EVERY method involves intervention at the liver with the least liver dependent being the bile sequesterants which aren't very popular these days...hard on digestion.

I guess the root word "LIVE" was well applied to the LIVER.

ARIZONA73 · 01-29-2005, 05:14 PM

I would say niacin works in the liver. But, as Lenin said, it probably isn't a good idea to start taking niacin on top of a statin without consulting with your doctor first. Although statins excel at lowering TC and LDL, niacin possessus other advantages. It's ability to increase HDL is unsurpassed. It can potentially lower lipoprotein(a), another dangerous risk factor, and it is capable of promoting a favorable shift towards increased LDL particle size, or Pattern A LDL, the more benign form of LDL. In addition, it is a great circulatory agent.

If you are currently taking a statin such as Lipitor or Zocor, and wish to include the benefits of niacin, why not ask your doctor about switching to Advicor. Advicor is a statin and niacin (Niaspan) all in one pill. In fact, I'm puzzled that it is seldom mentioned on these boards. We hear so much about Lipitor, Zocor, and Crestor. But that's about it. Overall, I tend to believe that Advicor would be more advantageous if you must choose between statins. Otherwise, my preference would naturally be plain, simple niacin.