Even though adding a specific niacin pill to statins lowers bad cholesterol and raises good cholesterol in people with heart disease, it doesn’t actually help prevent heart attacks, strokes, or the need for heart procedures—so it’s not worth the extra pills.

Taking a special combo pill (niacin + laropiprant) along with your statin for heart disease might make your cholesterol numbers look better, but it also causes more dangerous side effects — so overall, it does more harm than good.

For people with heart disease who are already taking statins, taking a special slow-release niacin pill plus another pill called laropiprant for about 4 years can slightly lower their bad cholesterol by 10 points and raise their good cholesterol by 6 points.

For people with heart disease already taking statins, adding this combo of niacin and laropiprant slightly raises the chance of nasty side effects like stomach problems, muscle pain, rashes, infections, and bleeding — about 1 extra case of infection for every 100 people over 4 years.

If you already have heart disease and are taking a statin to lower cholesterol, adding this special niacin pill with another drug called laropiprant might make your blood sugar harder to control and could even cause you to develop diabetes — about 4 more people out of 100 will have serious blood sugar problems, and 1 more out of 100 will get diagnosed with diabetes over a few years.

For older adults with hardened arteries who are already taking statins to lower their bad cholesterol, adding a common supplement called niacin doesn’t make the plaque in their neck arteries shrink any more than statins alone—even though it raises their good cholesterol.