NutriStack
Rosuvastatin and Vitamin B3, a caution.
High-dose niacin combined with rosuvastatin increases myopathy risk. Clinical trials have shown that adding niacin to statin therapy does not provide additional cardiovascular benefit but does increase the incidence of muscle-related adverse effects.
One pair, every claim cited. The two substances, the type, the mechanism, the recommendation, and the primary literature.
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What the row says.
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At a glance
- Substances
- Rosuvastatin and Vitamin B3
- Pair type
- Caution
- Evidence (highest tier)
- Strong
- Source citations
- 2 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 niacin combined with rosuvastatin increases myopathy risk. Clinical trials have shown that adding niacin to statin therapy does not provide additional cardiovascular benefit but does increase the incidence of muscle-related adverse effects.
Mechanism. High-dose niacin and statins both independently increase myopathy risk. Combined use creates additive stress on skeletal muscle through overlapping mechanisms affecting mitochondrial function and muscle protein homeostasis.
Recommendation. Avoid high-dose niacin (>500mg/day) with rosuvastatin without medical supervision. Low-dose niacin for general health purposes is generally safe. Report any muscle pain or weakness promptly.
Sources (2)
- HPS2-THRIVE Collaborative Group. Effects of extended-release niacin with laropiprant in high-risk patients. N Engl J Med. 2014;371(3):203-212. PMID 25014686
- Kang Y, Park JM, Lee SH. Moderate-Intensity Rosuvastatin/Ezetimibe Combination versus Quadruple-Dose Rosuvastatin Monotherapy: A Meta-Analysis and Systemic Review. Yonsei Medical Journal. 2024. PMID 38154476
Stack Score
How this pair moves the number.
Effect on the composite score
If both Rosuvastatin 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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