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Nicotinic Acid for High Cholesterol

Examples

These medicines contain the nicotinic acid form of niacin.

Immediate-release form

Generic NameBrand Name
niacinNiacor

Sustained-release form

Generic NameBrand Name
niacinSlo-Niacin

Extended-release form

Generic NameBrand Name
niacinNiaspan

How It Works

Nicotinic acid reduces the production of triglycerides and VLDL (very low-density lipoprotein, which is converted to LDL in the blood). This leads to decreased LDL ("bad") cholesterol, increased HDL ("good") cholesterol, and lowered triglycerides. Nicotinic acid raises HDL cholesterol more than other lipid-lowering medicines.

Why It Is Used

Nicotinic acid is especially useful in people who have low HDL levels and high triglyceride levels, because it raises HDL and lowers triglycerides. Niacin may not be appropriate for some people who have:

  • Gout.
  • Active stomach ulcer.
  • Oversensitivity to niacin.
  • Glaucoma.
  • Type 2 diabetes and do not have their blood sugar levels controlled.
  • Clotting disorders, such as hemophilia.
  • Active liver disease.
  • Alcoholism.

How Well It Works

  • LDL can be reduced by 5% to 25%.1
  • HDL can be increased by 15% to 35%.1
  • Triglycerides can be reduced by 20% to 35%.1

Side Effects

All medicines have side effects. But many people don't feel the side effects, or they are able to deal with them. Ask your pharmacist about the side effects of each medicine you take. Side effects are also listed in the information that comes with your medicine.

Here are some important things to think about:

  • Usually the benefits of the medicine are more important than any minor side effects.
  • Side effects may go away after you take the medicine for a while.
  • If side effects still bother you and you wonder if you should keep taking the medicine, call your doctor. He or she may be able to lower your dose or change your medicine. Do not suddenly quit taking your medicine unless your doctor tells you to.

Call 911 or other emergency services right away if you have:

  • Trouble breathing.
  • Swelling of your face, lips, tongue, or throat.

Call your doctor if you have:

  • Hives.
  • Severe stomach pain.
  • Loss of appetite.
  • Yellow eyes or skin (symptoms of jaundice).

Common side effects of this medicine include:

  • Flushing or redness of skin on face and neck.
  • Itching.
  • Headache.
  • Dizziness or lightheadedness.
  • Diarrhea.

These side effects are more severe when higher doses are used.

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

What To Think About

Flushing side effect

Facial flushing and itching gradually diminish over time for most people. Starting with a low dose and gradually increasing the dose may reduce the flushing and itching. If you need to relieve flushing, talk with your doctor to find a method that works for you.

Over-the-counter niacin

Talk to your doctor before you start taking over-the-counter (nonprescription) niacin. If you choose to take it, ask your doctor to help you know which medicine to buy and how much to take.

Nicotinic acid is a B vitamin that is available without a prescription as a vitamin supplement (niacin). The nicotinic acid form of niacin lowers cholesterol, but other forms of niacin do not. These other forms that do not lower cholesterol include nicotinamide and inositol nicotinate (also called no-flush niacin).

Ask your doctor how much niacin you should take. You want to take a dose that will work. But you do not want to take more niacin than you need. Larger doses of niacin can be dangerous, because they can damage your liver.

Activity and diet

Be active and eat a cholesterol-lowering diet in addition to taking this medicine. Ask your doctor for advice on a diet that can help lower cholesterol. An example is the Therapeutic Lifestyle Changes (TLC) diet. For more information, see:

Click here to view an Actionset. High Cholesterol: Using the TLC Diet.

Taking medicine

Medicine is one of the many tools your doctor has to treat a health problem. Taking medicine as your doctor suggests will improve your health and may prevent future problems. If you don't take your medicines properly, you may be putting your health (and perhaps your life) at risk.

There are many reasons why people have trouble taking their medicine. But in most cases, there is something you can do. For suggestions on how to work around common problems, see the topic Taking Medicines as Prescribed.

Advice for women

If you are pregnant, breast-feeding, or trying to get pregnant, do not use any medicines unless your doctor tells you to. Some medicines can harm your baby. This includes prescription and over-the-counter medicines, vitamins, herbs, and supplements. And make sure that all your doctors know that you are pregnant, breast-feeding, or planning to get pregnant.

Checkups

If you take niacin as a prescription or over-the-counter medicine, your doctor will likely have you get regular blood tests to check for liver problems.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

Complete the new medication information form (PDF) (What is a PDF document?) to help you understand this medication.

References

Citations

  1. Drugs for lipids (2011). Treatment Guidelines From The Medical Letter, 9(103): 13–20.

Credits

By Healthwise Staff
Primary Medical Reviewer Kathleen Romito, MD - Family Medicine
Specialist Medical Reviewer Robert A. Kloner, MD, PhD - Cardiology
Specialist Medical Reviewer Rakesh K. Pai, MD, FACC - Cardiology, Electrophysiology
Last Revised June 29, 2012

Last Revised: June 29, 2012

Author: Healthwise Staff

Medical Review: Kathleen Romito, MD - Family Medicine & Robert A. Kloner, MD, PhD - Cardiology & Rakesh K. Pai, MD, FACC - Cardiology, Electrophysiology

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