What is Niacin?
Niacin, one of the oldest drugs used to treat dyslipidemia, favorably affects virtually all lipid parameters. Niacin is a water-soluble B-complex vitamin that functions as a vitamin only after its conversion to NAD or NADP, in which it occurs as an amide. Niacin also is the only lipid-lowering drug that reduces Lp(a) levels significantly.
Manufactured By – Nouveau Medicament Pvt Ltd
Other variants and composition –
Niacin Nf Tablet – Inositol 1000 MG
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Uses of Niacin
- Nicotinic acid is very effective for increasing HDL and may raise levels by as much as 30%- 35%.
- Niacin also causes a decrease in LDL.
- Niacin is also used to treat dyslipidemia.
- Lowers levels of VLDL (Very-low-density lipoprotein).
- Raises levels of HDL (high-density lipoprotein).
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How does Niacin work?
- Nicotinic acid inhibits the hepatic production of VLDL and consequently its metabolite LDL.
- Nicotinic acid affects HDL metabolism by reducing the transfer of cholesterol from HDL to VLDL and by delaying hepatic HDL clearance.
How to take Niacin?
- Crystalline Niacin (immediate-release or regular) refers to niacin tablets that dissolve quickly after ingestion.
- Sustained-release Niacin refers to preparations that continuously release niacin for 6-8 hours after ingestion.
- Take Niacin with a full glass of cold or cool water.
- Swallow the tablets.
- The hypolipidemic effects of Niacin require larger doses than are required for its vitamin effects.
Niacin Price In India
|100mg Vial of 1 Injection||Rs 17|
|250mg Vial of 1 Injection||Rs 35|
|500mg Vial of 1 Injection||Rs 60|
|GNC Niacin:250mg Bottle of 100 Tablets||Rs 1239|
|GNC Niacin:500mg Bottle of 100 Tablets||Rs 1559|
|Nature’s Bounty Flush Free Niacin Capsules:50 Capsules||Rs 2036|
|Niacin NF:Strip of 10 Tablets||Rs 82|
|Biotrex Niacin:25mg Strip of 60 Capsules||Rs 630|
|Solgar Niacin(Vitamin B3):100mg Bottle of 100 Tablets||Rs 1350|
|Zenith Nutrition Niacin Capsules:Bottle of 100 Capsules||Rs 374|
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Common Dosage for Niacin
- The daily dose should not exceed 20 mg.
- Regular or crystalline Niacin in doses of 2-6 g/day reduces triglycerides by 35-50%; the maximal effect occurs within 4-7 days.
- Reductions of 25% in LDL-C levels are possible with doses of 4.5-6 g/day, but 3-6 weeks are required for the maximal effect.
- For lipid-lowering effects, nicotinic acid is given in much higher doses than are needed as a vitamin.
- Crystalline Niacin tablets are available over the counter (from 50- to 500-mg tablets).
- To minimize the flushing and pruritus, it is best to start with a low dose (100 mg twice daily taken after breakfast and supper). The dose may be increased stepwise every 7 days by 100-200 mg to a total daily dose of 1.5-2 g.
- Triple therapy with resins, Niacin, and statins can reduce LDL-C by up to 70%.
When to avoid Niacin?
- Combination therapy (statin plus niacin or statin plus fibrate) may be required, but caution is necessary with these combinations to avoid myopathy.
- Severe hepatotoxicity is more likely to occur when patients take more than 2 g of sustained-release, over-the-counter preparations. Affected patients experience flu-like fatigue and weakness.
- In patients with diabetes mellitus, Niacin should be used cautiously because niacin-induced insulin resistance can cause severe hyperglycemia.
- Niacin also elevates uric acid levels and may reactivate gout. A history of gout is a relative contraindication for niacin use.
Precautions when taking Niacin?
- Do not crush, chew, break, or open an extended-release tablet or capsule.
- Flushing recurs if only one or two doses are missed, and the flushing is more likely to occur when Niacin is consumed with hot beverages (coffee, tea) or with ethanol-containing beverages.
- Patients with any history of peptic ulcer disease should not take Niacin because it can reactivate ulcer disease.
- If Niacin is prescribed for patients with known or suspected diabetes, blood glucose levels should be monitored at least weekly until proven to be stable.
Side Effects of Niacin
- Flushing is the most common side effect and occurs in 80% of patients.
- Pruritus, paresthesia, and nausea are somewhat less common and occur in about 20% of patients.
- hyperglycemia, hyperuricemia
- Flushing and pruritus of the face and upper trunk, skin rashes, and acanthosis nigricans.
- Atrial tachyarrhythmia and atrial fibrillation have been reported, more commonly in elderly patients.
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Effects on organs?
- Liver- Niacin can cause chronic liver damage, as shown by elevated liver enzymes, although these drugs very rarely cause liver failure.
- Skin- Rash, pruritus.
- Gastrointestinal- Diarrhea, nausea, vomiting.
Storage Requirements for Niacin
- Keep it in a dry, airtight container.
- Keep Niacin away from direct heat or moisture.
- Keep it out of reach of the children.
Pro Tips When Taking Niacin
- Flushing is worse when therapy is initiated or the dosage is increased but ceases in most patients after 1-2 weeks of a stable dose. Taking an aspirin each day alleviates the flushing in many patients.
- Dry skin, a frequent complaint, can be dealt with by using skin moisturizers
- Acanthosis nigricans can be dealt with by using lotions or creams containing salicylic acid.
- Dyspepsia and rarer episodes of nausea, vomiting, and diarrhea are less likely to occur if the drug is taken after a meal.
- Side effects tend to be less common with sustained-released formulations.
- NIASPAN is the only preparation of Niacin that is FDA-approved for treating dyslipidemia and that requires a prescription.
- Both Niacin and its amide may be given orally as a source of Niacin for its functions as a vitamin, but only Niacin affects lipid levels.
Is Niacin addictive?
No, Niacin is not addictive.
Can I have Niacin with alcohol?
No. Drinking alcohol can cause nausea, dizziness, itching, vomiting, upset stomach and flushing.
Any particular food item to be avoided?
Avoid grapefruit juice.
Can I have Niacin when pregnant?
Niacin, at doses used in humans, has been associated with birth defects in experimental animals and should not be taken by pregnant women.
Can I have Niacin while feeding a baby?
Lipid-altering doses of this drug have the potential for serious adverse reactions in nursing infants.
Can I drive after taking Niacin?
No, driving after taking niacin may cause dizziness and blurred vision.
What happens if I overdose on Niacin?
Overdose symptoms may include dizziness, upset stomach, and flushing (warmth, redness, or tingly feeling).
What happens if I eat expired Niacin?
It is advised to not to take expired medicines.
What happens if I miss a dose of Niacin?
Take the next dose at the scheduled time. Never take more than the dose for a missed one.