Rosuvastatin and Niacin: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Rosuvastatin
Niacin
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
What happens
An increased risk of myopathy or rhabdomyolysis
Interaction Deep Dive
The risk of myopathy may be enhanced when rosuvastatin is used in combination with lipid-modifying doses of niacin (1 g/day or higher)1. Cases of myopathy and rhabdomyolysis have occurred with concomitant use of niacin with rosuvastatin. Consider if the benefit of using niacin concomitantly with rosuvastatin/ezetimibe outweighs the increased risk of myopathy and rhabdomyolysis. If concomitant use is decided, monitor patients for signs and symptoms of myopathy, particularly during initiation of therapy and during upward dose titration of either drug 2. Interrupt therapy with acute, serious conditions that suggest myopathy or predispose to the development of renal failure, and discontinue rosuvastatin for markedly elevated creatine kinase levels of suspicion or diagnosis of myopathy 12.
Why it happens (mechanism)
Unknown
Common questions
Can I take Rosuvastatin and Niacin together?
An increased risk of myopathy or rhabdomyolysis Always confirm with your pharmacist or prescriber before making any change.
How serious is the Rosuvastatin and Niacin interaction?
It is rated major. Potentially serious — often needs a change or close monitoring.
How quickly could this interaction happen?
The documented onset is "delayed". Effects tend to build up gradually over days to weeks.
How strong is the evidence for this interaction?
The evidence is graded "probable". Good supporting evidence, though not definitively proven.
Questions for your pharmacist
- Does my dose of Rosuvastatin or Niacin need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there a safer alternative to one of these medications for me?
References (2)
- Product Information: CRESTOR(R) oral tablets, rosuvastatin calcium oral tablets. AstraZeneca Pharmaceuticals LP (per FDA), Wilmington, DE, 2023. DailyMed
- Product Information: ROSZET oral tablets, rosuvastatin ezetimibe oral tablets. Althera Pharmaceuticals LLC (per FDA), Morristown, NJ, 2021.
Keep reading about Rosuvastatin
Keep reading about Niacin
These medications also interact with supplements
Prescription drugs aren't the whole picture — herbal and dietary supplements can interact with them too. From the evidence-graded Natural Medicines database:
major · moderate · minor — check everything you take with our drug–supplement interaction checker.
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