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Niacin (Oral route)

Pronunciation:

NYE-a-sin

Brand Names:

  • Niacinol
  • Niacor
  • Niaspan
  • Nicotinex
  • Slo-Niacin

Dosage Forms:

  • Tablet
  • Tablet, Extended Release
  • Capsule
  • Capsule, Extended Release
  • Elixir

Classifications:

Therapeutic—

Antihyperlipidemic

Pharmacologic—

Vitamin B (class)

Chemical—

Nicotinic Acid (class)

Uses of This Medicine:

Niacin is used to help lower high cholesterol and fat levels in the blood. This may help prevent medical problems caused by cholesterol and fat clogging the blood vessels.

Some strengths of niacin are available only with your doctor's prescription.

Before prescribing medicine for your condition, your doctor will probably try to control your condition by prescribing a personal diet for you. Such a diet may be low in fats, sugars, and/or cholesterol. Many people are able to control their condition by carefully following their doctor's orders for proper diet and exercise. Medicine is prescribed only when additional help is needed and is effective only when a schedule of diet and exercise is properly followed.

Also, this medicine is less effective if you are greatly overweight. It may be very important for you to go on a reducing diet. However, check with your doctor before going on any diet.

Make certain your health care professional knows if you are on any special diet, such as a low-sodium or low-sugar diet.

Before Using This Medicine:

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies—

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Children—

There is no specific information comparing the use of niacin for high cholesterol in children with use in other age groups. However, use is not recommended in children under 2 years of age since cholesterol is needed for normal development.

Older adults—

Many medicines have not been studied specifically in older people. Therefore, it may not be known whether they work exactly the same way they do in younger adults or if they cause different side effects or problems in older people. Although there is no specific information comparing the use of niacin for high cholesterol in the elderly with use in other age groups, it is not expected to cause different side effects or problems in older people than in younger adults.

Pregnancy—

Pregnancy CategoryExplanation
All TrimestersCAnimal studies have shown an adverse effect and there are no adequate studies in pregnant women OR no animal studies have been conducted and there are no adequate studies in pregnant women.

Breast-feeding—

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Other medicines—

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Atorvastatin
  • Cerivastatin
  • Lovastatin
  • Pitavastatin
  • Rosuvastatin
  • Simvastatin

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Warfarin

Other interactions—

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following may cause an increased risk of certain side effects but may be unavoidable in some cases. If used together, your doctor may change the dose or how often you use this medicine, or give you special instructions about the use of food, alcohol, or tobacco.

  • Ethanol

Other medical problems—

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

  • Bleeding problems or
  • Diabetes mellitus (sugar diabetes) or
  • Glaucoma or
  • Gout or
  • Liver disease or history of jaundice
  • Low blood pressure or
  • Stomach ulcer—Niacin may make these conditions worse
  • Kidney problems—Niacin (extended release tablets) may make your kidney problems worse.

Proper Use of This Medicine:

Use this medicine only as directed by your doctor. Do not use more or less of it, do not use it more often, and do not use it for a longer time than your doctor ordered. To do so may increase the chance of unwanted effects.

Remember that niacin will not cure your condition but it does help control it. Therefore, you must continue to take it as directed if you expect to keep your cholesterol levels down.

Follow carefully the special diet your doctor gave you. This is the most important part of controlling your condition, and is necessary if the medicine is to work properly.

If this medicine upsets your stomach, it may be taken with meals or milk. If stomach upset (nausea or diarrhea) continues, check with your doctor.

For patients taking the extended-release capsule form of this medicine:

  • Swallow the capsule whole. Do not crush, break, or chew before swallowing. However, if the capsule is too large to swallow, you may mix the contents of the capsule with jam or jelly and swallow without chewing.

For patients taking the extended-release tablet form of this medicine:

  • Swallow the tablet whole. If the tablet is scored, it may be broken, but not crushed or chewed, before being swallowed.
  • Tablet (Niaspan) should be taken at bedtime after a low-fat snack.
  • To decrease flushing of your face (redness), take aspirin or ibuprofen (e.g., Advil, Motrin) 30 minutes before taking tablet (Niaspan).
  • Avoid drinking alcohol or hot drinks around the time you take your tablet (Niaspan). This helps decrease flushing of your face (redness).
  • Take this medication exactly as your doctor ordered. If you stop taking this medication for any period of time, contact your doctor prior to restarting taking niacin.

Dosing—

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For oral dosage form (extended-release capsules, extended-release tablets, oral solution, or regular tablets):
    • For treatment of high cholesterol:
      • Adults and teenagers—500 milligrams to 2 grams one to three times a day: use and dose will be determined by your doctor. Do not exceed the amount the doctor prescribes.
      • Children—Use and dose must be determined by your doctor.

Missed dose—

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage—

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Precautions While Using This Medicine:

It is very important that your doctor check your progress at regular visits. This will allow your doctor to see if the medicine is working properly to lower your cholesterol and triglyceride (fat) levels and if you should continue to take it.

Do not stop taking niacin without first checking with your doctor. When you stop taking this medicine, your blood cholesterol levels may increase again. Your doctor may want you to follow a special diet to help prevent this from happening.

Do not take vitamins or other dietary supplements unless they have been discussed with your doctor. This especially includes vitamins or dietary supplements that contain niacin or similar ingredients.

This medicine may affect blood sugar levels. If you notice a change in the results of your blood or urine sugar tests or if you have any questions, check with your doctor.

This medicine may cause you to feel dizzy or faint, especially when you get up from a lying or sitting position. Getting up slowly may help. This effect should lessen after a week or two as your body gets used to the medicine. However, if the problem continues or gets worse, check with your doctor.

Side Effects of This Medicine:

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

Less common
With prolonged use of extended-release niacin
Darkening of urine
light gray-colored stools
loss of appetite
severe stomach pain
yellow eyes or skin

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Less common
Abdominal pain
feeling of warmth
flushing or redness of skin, especially on face and neck
headache
rash
runny nose
sneezing
stuffy nose
With high doses
Diarrhea
dizziness or faintness
dryness of skin
fever
frequent urination
itching of skin
joint pain
muscle aching or cramping
nausea or vomiting
side, lower back, or stomach pain
swelling of feet or lower legs
unusual thirst
unusual tiredness or weakness
unusually fast, slow, or irregular heartbeat

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.


Last Updated: 11/4/2014

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