niacin, Niacor, Niaspan, Slo-Niacin, Nicolar (discontinued) (cont.)

Pharmacy Author:
Medical and Pharmacy Editor:

PRESCRIPTION: Most formulations are available over the counter.

GENERIC AVAILABLE: Yes

PREPARATIONS: Tablets: 250, 500, 750, and 1000 mg. Capsules: 250 and 500 mg

STORAGE: Niacin should be stored at room temperature between 15-30 C (59-86 F).

PRESCRIBED FOR: Niacin is used for treating niacin deficiency. It is also used for reducing elevated blood cholesterol and triglyceride levels and increasing HDL cholesterol. In patients with high cholesterol, coronary artery disease that increase the risk of heart attacks, niacin reduces the risk of heart attacks, and slows progression or promotes regression of coronary artery disease.

DOSING: The recommended oral dose of immediate release niacin for treating high cholesterol levels in adults is 1-2 g two to three times daily. The maximum recommended dose is 6 g daily. When using extended release tablets, the maximum recommended dose is 2 g per day. Niacin should be started at low doses and increased slowly over several weeks. To avoid stomach upset, niacin should be taken with meals.

Extended release tablets should be swallowed whole and should not be crushed or chewed. Extended release formulations should not be substituted with equivalent doses of immediate release niacin since this leads to an overdose of niacin that may cause liver failure.

Pellagra may be treated with up to 500 mg per day of oral niacin.

DRUG INTERACTIONS: Use of niacin with drugs that cause liver or muscle injury, for example, lovastatin (Mevacor) or simvastatin (Zocor) may increase the occurrence of liver or muscle injury.

Niacin may increase blood glucose levels in individuals with diabetes. Therefore, medications for controlling blood glucose may need to be adjusted when niacin is taken by those with diabetes.

Bile acid sequestrants (for example, cholestyramine [Questran]) bind and prevent absorption of niacin. Administration of bile acid sequestrants and niacin should be separated by 4-6 hours.

PREGNANCY: It is not known whether the high doses of niacin used in treating elevated cholesterol levels are harmful to the fetus during pregnancy.



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