Quick answer

Ask your pharmacist or doctor before combining. Official sources document three supplements for statins: niacin, vitamin D and vitamin C. Statin labels report muscle damage with niacin at 1 g a day or more, NIH says high vitamin D intake might make three statins less potent, and one study found vitamin C blunted a cholesterol effect.^1,2,3

Key facts

Labels for prescription niacin, atorvastatin, rosuvastatin and simvastatin report muscle damage when a statin is taken with niacin at 1 g a day or more.^1,4
NIH says high vitamin D intake, mostly from supplements, might make atorvastatin, lovastatin and simvastatin less potent.^2,5
One study found vitamin C with other antioxidants blunted the HDL rise from simvastatin taken with niacin.³
A meta-analysis of 12 randomized trials found that statins lower blood levels of CoQ10.⁶
MedlinePlus asks people to tell their doctor and pharmacist about every vitamin and supplement, and to ask about grapefruit.⁷

What do statins do, and why do supplements come up?

MedlinePlus describes statins as medicines that slow how much cholesterol the body makes, and uses atorvastatin as its example: it is prescribed to lower cholesterol and to reduce the risk of heart attack and stroke. The same page asks you to tell your doctor and pharmacist about every vitamin, nutritional supplement and herbal product, and to talk to your doctor about grapefruit and grapefruit juice.⁷

Supplement questions about statins tend to fall into three kinds: a vitamin that also comes as a prescription tablet (niacin), a vitamin that may compete with some statins for the enzyme that breaks them down (vitamin D), and an antioxidant combination that blunted a cholesterol effect in one study (vitamin C). The entries below follow that order.^4,5,8

Can you take niacin with a statin?

Ask your pharmacist or doctor first

Myopathy and rhabdomyolysis, muscle damage that can be severe, have been reported when statins were combined with niacin at 1 g a day or more. The labels of prescription niacin, atorvastatin, rosuvastatin and simvastatin all describe this, and the simvastatin label advises against the combination at that dose in Chinese patients. NIH says experts do not recommend high doses of nicotinic acid for people taking a statin.^1,4,9,10,11

On the medicine's label

Of the three, niacin has the firmest footing, because four drug labels describe the muscle problem: prescription niacin, atorvastatin, rosuvastatin and simvastatin. The reports involve niacin at 1 g a day or more, the range of prescription tablets.^1,4,9,10

Supplement amounts matter here, and NIH's fact sheet for health professionals says what some products contain.¹²

Some supplements that contain only niacin provide 500 mg or more per serving, far above the recommended amount.¹²

The labels do not say what smaller amounts do alongside a statin, so tell your prescriber about every product that contains niacin or nicotinic acid.¹

Does vitamin D interfere with statins?

Ask your pharmacist or doctor first

High intakes of vitamin D, especially from supplements, might make atorvastatin, lovastatin and simvastatin less potent, because they appear to compete for the same enzyme that breaks them down. Statins may also reduce the body's own production of vitamin D.^2,5

Reported in studies

The entry is specific. It concerns atorvastatin, lovastatin and simvastatin, and it concerns high intakes, especially from supplements. It does not mention rosuvastatin, which is not a finding either way, so ask your pharmacist whether your own statin is one of the three. Ask before starting or stopping vitamin D.^2,5

Does vitamin C interfere with statins?

Your doctor may want to check on you

In one study, vitamin C taken with other antioxidants such as vitamin E, selenium and beta-carotene blunted the rise in HDL cholesterol from simvastatin taken with niacin. It is not known whether this happens with other cholesterol medicines, and NIH says doctors should check cholesterol levels in people taking both.^3,8

Reported in studies

This is the narrowest of the three entries. It describes one study of simvastatin taken with niacin, in which vitamin C combined with vitamin E, selenium and beta-carotene blunted the rise in HDL cholesterol. It does not describe vitamin C taken alone with a statin. NIH's fact sheets list statins among the medicines vitamin C may interact with.^3,8

Do statins lower CoQ10, and what does that mean?

Statins lower the amount of CoQ10 in the blood. Across 12 randomized trials with 1,776 people, levels fell whatever the type or intensity of the statin.^6,13

This is a different kind of entry: the medicine lowers a compound the body makes, and the finding is about blood levels. The National Cancer Institute's summary of CoQ10 says the same. The sources checked do not say what, if anything, a person should do about it, so ask your doctor or pharmacist before starting a CoQ10 product.^6,13

How firm is each entry: on the label, in studies or expected?

The three statin entries, with how each is known and the label shown^1,2,3
Supplement	What is reported	How it is known	Label shown
Niacin	Muscle damage with a statin and niacin at 1 g a day or more	On the medicine's label	Ask your pharmacist or doctor first
Vitamin D	High intakes may make three statins less potent	Reported in studies	Ask your pharmacist or doctor first
Vitamin C	Blunted a cholesterol effect in one combination study	Reported in studies	Your doctor may want to check on you

Only niacin rests on drug labels. The other two are study findings, one of them from a single combination of drugs and antioxidants. No entry carries the avoid label: the sources say to ask first, or that a doctor may want to check on you.

What to ask your pharmacist if you take a statin

Which statin am I taking, and is it one of the three named for vitamin D?²
Does anything I take contain niacin, nicotinic acid or nicotinamide, including a B complex or multivitamin?
Should my cholesterol be rechecked if I add or stop a vitamin or antioxidant product?⁸
Do I need to avoid grapefruit juice with my statin?⁷

Questions people ask

What supplements should you not take with statins?

Official sources document three: niacin, vitamin D and vitamin C. None is labeled avoid, but niacin has the firmest warning, since the labels of four medicines report muscle damage with niacin at 1 g a day or more. Ask your pharmacist before combining.^1,2,3

What vitamins interfere with statins?

NIH says high vitamin D intake, especially from supplements, might make atorvastatin, lovastatin and simvastatin less potent, and that vitamin C with other antioxidants blunted an HDL rise in one study. Both are reports with limits, so ask your pharmacist.^2,3

Can you take supplements with statins?

That depends on the supplement and the statin. This page documents three to ask about, and the sources checked do not address the rest. That is not a finding either way, so ask your pharmacist.¹

What supplements should not be taken with statins?

The firmest entry is niacin: the prescription niacin, atorvastatin, rosuvastatin and simvastatin labels report muscle damage, sometimes severe, with niacin at 1 g a day or more. NIH says experts do not recommend high doses of nicotinic acid with a statin.^4,10,11

What vitamins not to take with statins?

Niacin, vitamin D and vitamin C are the vitamins in the sources checked. Niacin comes from drug labels and the other two from studies, so ask your pharmacist before starting or stopping any of them.^1,5

Do statins lower CoQ10?

A meta-analysis of 12 randomized trials with 1,776 people found statins lowered circulating CoQ10 compared with placebo, whatever the statin. What that means for a person is not settled by these sources, so ask your doctor.⁶

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Sources

This page is information, not medical advice. Talk to your doctor or pharmacist about your own situation.