NutriStack
Lovastatin and Vitamin B3, a caution.
High-dose Vitamin B3 as niacin can add muscle, liver, and glucose-related adverse effects to statin therapy. Large statin-era niacin trials found no cardiovascular outcome benefit from adding high-dose niacin, while adverse events increased. Low-dose nutritional niacin is different from pharmacologic niacin doses.
One pair, every claim cited. The two substances, the type, the mechanism, the recommendation, and the primary literature.
Same shape as the other 1,729 pairs in the public database.
From the interaction database
What the row says.
Every entry follows the same shape: what is happening, the mechanism, the recommendation, and the primary literature.
At a glance
- Substances
- Lovastatin and Vitamin B3
- Pair type
- Caution
- Evidence (highest tier)
- Strong
- Source citations
- 3 sources
- Stack Score effect
- −5 to your Stack Score (per scored caution row).
- Scope
- Supplement × Prescription
- Last verified
- May 30, 2026
Caution · Strong evidence
Caution
What is happening. High-dose Vitamin B3 as niacin can add muscle, liver, and glucose-related adverse effects to statin therapy. Large statin-era niacin trials found no cardiovascular outcome benefit from adding high-dose niacin, while adverse events increased. Low-dose nutritional niacin is different from pharmacologic niacin doses.
Mechanism. Both statins and pharmacologic niacin can contribute to myopathy and liver enzyme elevations. Niacin can also worsen glycemic control, creating additional risk in patients with diabetes or metabolic syndrome.
Recommendation. Avoid high-dose niacin, especially 500 mg/day or more, with lovastatin unless it is specifically prescribed and monitored. If the combination is used, monitor liver enzymes, glucose control, and any new muscle pain or weakness.
Sources (3)
- Boden WE, Probstfield JL, Anderson T, Chaitman BR, Desvignes-Nickens P, Koprowicz K, et al. Niacin in patients with low HDL cholesterol levels receiving intensive statin therapy. N Engl J Med. 2011;365(24):2255-2267. PMID 22085343
- Landray MJ, Haynes R, Hopewell JC, Parish S, Aung T, Tomson J, et al. Effects of extended-release niacin with laropiprant in high-risk patients. N Engl J Med. 2014;371(3):203-212. PMID 25014686
- Haynes R, Valdes-Marquez E, Hopewell JC, Chen F, Li J, Parish S, et al. Serious Adverse Effects of Extended-release Niacin/Laropiprant: Results From the Heart Protection Study 2-Treatment of HDL to Reduce the Incidence of Vascular Events (HPS2-THRIVE) Trial. Clin Ther. 2019;41(9):1767-1777. PMID 31447131
Stack Score
How this pair moves the number.
Effect on the composite score
If both Lovastatin and Vitamin B3 are in the same stack, this pair applies −5 to your Stack Score (per scored caution row).
The full algorithm, the clamping rules, and four worked stacks are documented at /methodology/stack-score.
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