Cholesterol (cont.)
What is nicotinic acid (niacin)?
Nicotinic acid (niacin) is a B vitamin. An average American diet contains
15-30 mg of niacin per day. However, in treating blood cholesterol and
triglyceride disorders, high doses (1-3 grams a day) of nicotinic acid are
necessary. Nicotinic acid is available in several preparations that include
immediate release niacin, sustained release prescription brand Niaspan, and
over- the- counter (OTC) sustained release niacin. OTC preparations are not
federally regulated, and some OTC preparations may have no active ingredient.
Thus, they would be ineffective in either lowering LDL or raising HDL
cholesterol. Some formulations of OTC sustained release niacin have been
associated with liver toxicity and rare cases of fulminant (usually fatal
without liver transplantation) hepatitis have been reported. The prescription
brand sustained release Niaspan has been found in clinical trials to cause only
minor elevations in blood liver enzymes without causing significant liver
disease.
Nicotinic acid is most effective in increasing HDL cholesterol and it is also
modestly effective in lowering LDL cholesterol, Lp(a) cholesterol, and
triglyceride levels (see below). Nicotinic acid is most suited for individuals
whose only problem is low HDL cholesterol. Nicotinic acid used alone can raise
HDL cholesterol levels by 30% or more. Nicotinic acid is not as effective as a
statin in lowering LDL cholesterol levels. Therefore, when low HDL cholesterol
is accompanied by high LDL cholesterol, most doctors use a statin to decrease
the LDL cholesterol first. If necessary, nicotinic acid can be added to a statin
to further raise HDL cholesterol levels.
Advicor is a combination product approved for use in the United States. It is
a combination of sustained release niacin with
lovastatin. Advicor is useful in
patients who need to both significantly lower their LDL cholesterol and increase
HDL cholesterol. For more, please read our article on
Nicotinic acid.
Next: What are fibric acid derivatives (fibrates)? »
- Statins - Read about statins, cholesterol lowering medications like Levacor, Zocor, Pravachol, Lipitor, Crestor, and more. Side effects, drug interactions, and patient information is also provided.
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- Diabetes - Learn about type 1 and 2 diabetes (Diabetes Mellitus) symptoms including increased urination, thirst, weight loss, fatigue, nausea, vomiting, skin infections, and blurred vision. Causes and diagnosis information is provided in the information.
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