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Niacin + statin refers to fixed-dose combination drugs that include both niacin (vitamin B3) and a statin (such as simvastatin or lovastatin). These combinations were developed to treat dyslipidemia by leveraging the complementary mechanisms of action of each component. Statins inhibit HMG-CoA reductase, reducing cholesterol synthesis in the liver and lowering LDL cholesterol. Niacin reduces hepatic synthesis of VLDL (very low-density lipoprotein), which leads to decreased LDL cholesterol and triglycerides while also increasing HDL cholesterol. The combination is used as an adjunct to diet for patients with primary hypercholesterolemia or mixed dyslipidemia when monotherapy is inadequate. Both Simcor (niacin ER/simvastatin) and Advicor (niacin ER/lovastatin) were approved for these indications but are no longer marketed in the United States due to limited additional benefit over statins alone and increased risk of adverse effects such as myopathy[1][2][3][4][9].
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