Niacin: Uses, Dosage, Price, Side Effects, Precautions & More

September 5, 2018

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Niacin: Uses, Dosage, Price, Side Effects, Precautions & More

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

Specifics	Niacin Price
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.