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  • Intervention
    Are supplemental vitamins C and E, beta-carotene and selenium safe to take with Simvastatin-niacin drug combinations?
    • Conclusion

      Supplemental Vitamin C and E, Beta-carotene, and Selenium should not be taken with Simvastatin-Niacin drug combination because the combination of these antioxidants may lower HDL2-C, a beneficial subfraction of HDL-C.

    • Grade: II
      • Grade I means there is Good/Strong evidence supporting the statement;
      • Grade II is Fair;
      • Grade III is Limited/Weak;
      • Grade IV is Expert Opinion Only;
      • Grade V is Not Assignable.
      • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
      • Moderate (B) means we are moderately confident in the effect estimate;
      • Low (C) means our confidence in the effect estimate is limited;
      • Very Low (D) means we have very little confidence in the effect estimate.
      • Ungraded means a grade is not assignable.
    In patients at risk for lung cancer, what effect does supplemental Beta-carotene have on the risk for all-cause mortality and cardiovascular death?
    • Conclusion

      Supplemental Beta-carotene (60-120 mg/day) is associated with an increase in all-cause mortality and cardiovascular death in patients at increased risk for lung cancer.

    • Grade: II
      • Grade I means there is Good/Strong evidence supporting the statement;
      • Grade II is Fair;
      • Grade III is Limited/Weak;
      • Grade IV is Expert Opinion Only;
      • Grade V is Not Assignable.
      • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
      • Moderate (B) means we are moderately confident in the effect estimate;
      • Low (C) means our confidence in the effect estimate is limited;
      • Very Low (D) means we have very little confidence in the effect estimate.
      • Ungraded means a grade is not assignable.
    What is the relationship between supplemental vitamin E, vitamin C or beta-carotene and all-cause mortality in adults?
    • Conclusion

      Supplementation with the antioxidants vitamin C, vitamin E and/or beta-carotene does not decrease, and in some cases may increase, all-cause mortality. Two meta-analyses of beta-carotene supplementation (1.2mg to 50mg) both reported increased mortality. Two of six meta-analyses of vitamin E supplementation (ranging from 16.5 IU to 5,000 IU) reported increased mortality. The one meta-analysis regarding supplementation with vitamin C (60mg to 2,000mg) reported no effect on mortality. Meta-analyses included 79 randomized controlled trials.

    • Grade: II
      • Grade I means there is Good/Strong evidence supporting the statement;
      • Grade II is Fair;
      • Grade III is Limited/Weak;
      • Grade IV is Expert Opinion Only;
      • Grade V is Not Assignable.
      • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
      • Moderate (B) means we are moderately confident in the effect estimate;
      • Low (C) means our confidence in the effect estimate is limited;
      • Very Low (D) means we have very little confidence in the effect estimate.
      • Ungraded means a grade is not assignable.