Possible Interaction: Niacin and Fenofibrate

“The combination of fenofibrate + nicotinic acid also appears to have a beneficial effect on lipoproteins.”

“ Fenofibric acid led to a +23% (CI +10 to +36, p = 0.001) increase in PCSK9; the addition of niacin resulted in a subsequent -17% decrease (CI -19 to -5, p = 0.004).”

“However, niacin worsened the parameters of glycemic control, whereas fenofibrate improved them.”

“A drug interaction between concomitantly administered single doses of IDD-P fenofibrate and ER niacin could not be ruled out.”

“The mean C(max), AUC from the time of administration to the last quantifiable concentration (AUC(0-t)), and AUC from the time … fenofibrate alone; and the mean C(max), AUC(0-t), and AUC(0-infinity) were 12%, 6%, and 5% lower, respectively, with IDD-P fenofibrate … niacin ….”

“Although monotherapy with cerivastatin is well tolerated and has a low frequency of adverse events, the combination with nicotinic acid (i.e., niacin) or a fibric-acid derivative (i.e., gemfibrozil, fenofibrate ) may result in severe skeletal muscle toxicity and rhabdomyolysis.”

“ Niacin showed a potential atheroprotective effects suggesting possible co-administration with fenofibrate with a potential for development of fixed dose combination.”