Is Niacin (Vitamin B3) Safe with simvastatin?
Free · No account · based on published sources including NIH ODS, FDA drug labels, and peer-reviewed literature
Concomitant use of simvastatin with lipid-modifying dosages of niacin (≥1 gram/day) is not recommended in Chinese patients. For non-Chinese patients, carefully weigh the benefit versus the increased risk of myopathy and rhabdomyolysis. If used together, monitor for signs and symptoms of myopathy, especially during initiation of therapy and during upward dose titration of either product.
Why this interaction occurs
Cases of myopathy and rhabdomyolysis have been observed with concomitant use of lipid-modifying dosages of niacin-containing products (≥1 gram/day) with simvastatin. The risk of myopathy is greater in Chinese patients. A clinical study also showed no incremental cardiovascular benefit when adding lipid-modifying doses of niacin to simvastatin therapy.
Evidence
Evidence level: strong.
Data source
FDA Drug Label
Reported safety data
The FDA’s adverse event reporting system (FAERS) has received 213,170 reports mentioning simvastatin. This reflects reported cases involving the medication in general — not confirmed causation, and not specific to the simvastatin + supplement combination on this page.
FAERS reports are voluntary and cannot prove that a drug caused an event. Do not use report counts to assess the safety of this specific drug-supplement pair.
Frequently asked questions
Related interactions
All Niacin (Vitamin B3) interactions → · All simvastatin interactions →
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Educational only — not medical advice.
Always confirm with your doctor or pharmacist.