SIDE EFFECTS: The most common side effects of niacin are:
- stomach upset,
- reduced blood pressure upon standing (orthostatic hypotension),
- itching and
- tingling sensations of the extremities.
Flushing may be reduced by taking 325 mg of aspirin 30 minutes before the niacin and by increasing the dose of niacin slowly. Drinking hot liquids or alcohol shortly before or after niacin is taken may increase the occurrence of flushing. Extended release formulations of niacin may cause flushing less frequently than immediate release formulations.
Rare cases of liver failure or muscle injury have occurred from the use of niacin. Blood tests to monitor for liver injury should be performed before niacin therapy begins, every 6-12 weeks for the first year, and then occasionally thereafter. Niacin should be discontinued if liver tests are greater than three times the upper limit of normal, are persistently elevated, or are accompanied by nausea, vomiting, or weakness.
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 from 15 C to 30 C (59 F to 86 F).
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.
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