As with all medicines, the risks must be compared to how much a medication will help you. This is a decision that you and your doctor will make together.
For this medication, there are many things that need to be considered:
Allergies: Inform your doctor if you have ever had an allergic reaction to doxorubicin or to any other medications.
It is also important to inform your doctor of any non-medicine allergies such as foods, dyes, preservatives or animals.
Pediatric Usage: The use of this medication is not recommended in children
Geriatric Usage: Up-to-date studies have not shown any problems specific to the elderly that would limit the use of this medication in the elderly population.
Pregnancy: This medication is listed as Pregnancy Category X. This means that studies in pregnant animals or women have shown positive evidence of fetal abnormalities.
This medication should not be used in women who are pregnant or may become pregnant, as the risk clearly outweighs any potential benefit.
Breastfeeding: There are no up-to-date studies in women for determining infant risk when using this medication while breastfeeding.
Weigh the potential risks with the benefits before taking this medication while breastfeeding.
Drug Interactions: Certain medications should not be used together. However, in certain cases, two medications may be used together, even if an interaction might occur.
In these cases, your doctor may want to change your dose or take other precautions. When taking this medication, it is important that you inform your doctor if you are taking any of the medications listed below.
The following interactions were selected on the basis of potential significance and are not all-inclusive. Using this medication with any of the following medication is not recommended.
Your doctor may make the decision not to treat you with this medication or change some of the other medications you take:
Using this medication with the following medications are not usually recommended. However, it may be required in some cases.
If both medications are prescribed together, your doctor may change the dose or how often you use one or both of the medications:
Sepsis (infection in the blood) - Patients with these conditions may be at risk of developing muscle and kidney problems.
Kidney disease - Use with caution. The effects of this medication may be increased because of slower removal of the medication from the body.
3 Proper Usage
Only take this medication as directed by your doctor. Do not take more, less or for a longer or shorter period of time than your doctor tells you.
This medication works best if there is a constant amount in the blood. To help keep this amount constant, do not miss any doses and take the medication at the same time each day.
In addition to prescribing this medication, your doctor may change your diet to one that is low in fat, sugar, and cholesterol. Follow your doctor’s directions about any special diet.
Swallow the extended-release tablet whole. Do not break, crush or chew it.
It is best to take this medication in the evening with a low-fat meal or snack. Do not take this medication on an empty stomach.
If you are taking danazol (Danocrine), diltiazem (Cardizem) or verapamil (Calan, Isoptin, Verelan) with lovastatin, your lovastatin dose should not be higher than 20mg per day, unless your doctor says otherwise.
Do not use more than 40mg per day of lovastatin with amiodarone (Cordarone). When used together with higher doses of lovastatin, these medications may increase your risk of muscle injury and may result in kidney problems.
Tell your doctor immediately if you drink grapefruit juice on a regular basis. Drinking more than 1 quart each day while taking this medication may result in kidney problems or muscle injury.
Do not drink large amounts of alcohol with lovastatin. This could cause liver injury.
Dosing: Different patients will be given a different dose of this medication based on the strength of the medication.
The number of doses you take each day, the time between doses and the length of time you take this medication depends on the reason you are taking this medication.
The following information only includes the average dose of this medication. If your dose is different, do not change it without first speaking to your doctor.
Adults: At first, 500mg of niacin extended-release and 20mg of lovastatin (combined in one tablet) once a day in the evening.
Your doctor may gradually increase your dose every four weeks until your cholesterol is under control. The dose is not usually more than 2000mg of niacin extended-release and 40mg of lovastatin per day.
Children: Use is not recommended.
Missed Dose: If you miss a dose of this medication, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular schedule.
Do not take two doses at once or within a short time of each other.
Storage: Store the medication in a closed container at room temperature. Keep it away from heat, moisture, and direct light. Do not freeze.
Keep out of reach of children. Do not keep expired medication or medication you no longer need.
Ask your doctor how to dispose of any medication you don’t use.
4 Precautions to Take
It is very important that your doctor checks in with you often while you are receiving this medication to make sure that it is working properly. Blood tests may be needed to check for unwanted effects.
Using this medication while pregnant can cause serious harm to your unborn child. Use an effective form of birth control to keep from becoming pregnant while taking this medication.
If you think you have become pregnant while using this medication, tell your doctor immediately.
Do not use lovastatin/niacin if you are using the following medications, as using these medications together can cause serious side effects:
Call your doctor immediately if you experience unexplained muscle pain, tenderness or weakness. These may be symptoms of a serious muscle problem such as myopathy or immune-related necrotizing myopathy (IMNM).
Call your doctor immediately if you have dark-colored urine, develop a fever, experience muscle cramps or spasms, have muscle pain or stiffness, experience fatigue or weakness or have diarrhea.
These may be symptoms of a serious muscle problem called rhabdomyloysis, which can cause kidney problems.
Stop using this medication and check immediately with your doctor if you have pain or tenderness in the upper stomach, pale stool, dark urine, loss of appetite, nausea, unusual fatigue or weakness, or yellow eyes or skin. These could be symptoms of liver damage.
This medication may affect your blood sugar levels. This is important if you are diabetic or pre-diabetic.
Contact your doctor if you notice a change in the results of your blood or urine sugar tests, or if you have any questions.
Make sure you know how you react to this medication before you drive, use machinery or do anything else that may be dangerous if you are dizzy or unalert.
Change positions slowly when sitting or standing up.
This medication should not be taken with vitamins containing niacin or nicotinamide.
Inform any doctor or dentist treating you that you are on this medication. You may need to stop using this medication before major surgery, if you have a major injury, or if you develop another serious health problem.
This medication may also affect the result of certain medical tests.
This medication may cause flushing (a feeling of warmth or redness in the face, neck arms and/or upper chest).
To avoid flushing, avoid alcohol, hot beverages, and spicy foods around the time you take this medication.
Your doctor may also recommend that you take aspirin thirty minutes before taking this medication to prevent flushing.
Do not take other medications unless you have discussed them with your doctor. This includes prescription or over the counter medications and herbal or vitamin supplements.
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