Niacin (Oral)

Niacin is an organic compound found in many foods, but when diet and exercise alone cannot lower cholesterol levels, some patients are prescribed a dose of Niacin to improve their health.

Overview

Niacin is an oral medication that patients can use as part of a diet and exercise strategy to improve their cholesterol levels and their overall health. Found in many foods, Niacin is also known as vitamin B-3, which is one of the B-complex vitamin supplements. Other medications may also be prescribed at the same time. Lowering the amount of cholesterol in the blood can improve heart health and function as well as pancreatic function.

Even though Niacin can be found in many foods, some patients can benefit from a higher amount of Niacin than they can get through diet alone. The following foods are known to be niacin rich:

  • Tuna
  • Turkey
  • Pork
  • Venison
  • Veal
  • Sesame seeds
  • Ginger
  • Tarragon
  • Sweet peppers
  • Portabella mushrooms
  • Sunflower seeds
  • Apricots
  • Potatoes
  • Fortified breakfast cereals

The recommended daily allowance for Niacin in adults should be 16 milligrams per day, which is quite a high number considering some of these foods are less than 20 milligrams per one hundred gram serving. Niacin medications can be taken in oral tablet form to more efficiently have an effect on the fat levels in the blood. Niacin supplements are sold under the following names:

  • Niacor
  • Niacinol
  • Niaspan
  • Slo-Niacin
  • Nicotinex

Patients who lower their blood cholesterol experience a lower risk of heart attack and a lower chance of developing pancreatitis. Cholesterol is located in all people's bloodstreams and performs important processes such as digestion and other functions. Too much cholesterol in the blood, however, increases a person's risk for developing pancreatitis, a swelling or inflammation of the pancreas.

Two of the main forms of cholesterol include lipoprotein types known as low density and high density or LDL and HDL. These are often called bad cholesterol and good cholesterol respectively. Both types must be in balance, however, for healthy functioning of the body's cells. Supplementing a patient's diet with Niacin, control of cholesterol levels in patients who don't respond to diet changes was practically impossible to achieve, leaving these people at risk for many health consequences.

Conditions Treated

  • Fredrickson type IIb hyperlipidemia
  • Atherosclerosis
  • Pellagra
  • Myocardial Infarction (MI)
  • Severe hyperlipidemia
  • Mixed hypercholesterolemia

Type Of Medication

  • Micronutrient
  • Lipid regulator
  • Lipid modifier
  • Hypolipidemic agent

Side Effects

Though Niacin is a natural substance and a vitamin, it may cause effects on the health of some patients when taken in supplement form to lower blood cholesterol. If you have the following symptoms, alert your physician right away:

  • Dark colored urine
  • Gray, light colored stool
  • Little to no appetite
  • Pains in stomach
  • Yellow tinge to skin or eyes

Other adverse effects, though annoying, will typically disappear over time and use of Niacin in your everyday life. If you do experience these symptoms, it is best to alert your physician in case there are ways to alleviate them:

  • Stomach or abdominal pain
  • Coughing
  • Diarrhea
  • Warm feeling
  • Flushed, red skin on neck or face
  • Headache
  • Vomiting
  • Nausea
  • Skin rash
  • Itching
  • Nasal congestion, sneezing or running
  • Fainting spells or dizziness
  • Skin dryness
  • Elevated body temperature
  • Urinating more frequently than normal
  • Painful joints
  • Muscle cramps or aches
  • Pain in stomach, side or lower back
  • Swollen lower legs or feet
  • Raging thirst
  • Weak muscles
  • Fatigue
  • Heart rhythm irregularity, either slow or fast

Other patients may have health or mood changes that are unique to their circumstances. If you have any changes in your overall health since beginning Niacin supplements, be sure to communicate them to your doctor immediately.

Dosage

Your prescription for Niacin has been written especially for your condition and the improvement it will have on your health. Do not change what your doctor has prescribed for the amount of your dose and do not alter how often you take your Niacin. Altering your dosage may cause unwanted effects on your health that can become long-term issues.

Read and understand the patient information leaflet that comes with your Niacin supplement. Follow up with your physician or your pharmacist if you have any questions about what you have read in the leaflet.

Niacin does not cure high cholesterol but it can help control it if used properly in conjunction with diet and exercise plans. Continue to take Niacin for the control of your cholesterol, which your doctor will monitor through blood and urine testing at regular intervals.

You will be prescribed a special diet that works hand-in-hand with Niacin to control your blood cholesterol. This diet is necessary to the success of the Niacin supplement in controlling your high cholesterol and preventing diseases associated with this condition.

Take your Niacin with food or with milk if you find that your stomach becomes upset by taking it with just water. If you continue to have an upset stomach, get in touch with your physician for advice.

If you find that your face becomes red or flushed after taking Niacin supplements, take aspirin or ibuprofen a half hour before your dose of Niacin to combat this. Check with your physician if this symptom concerns you or for more advice.

Patients who are prescribed extended-release capsule forms of Niacin should swallow these capsules whole without chewing, breaking or crushing them. You do have the option of opening the capsule and stirring the contents into jelly or another non-liquid substance as long as you can swallow it without chewing. Check with your doctor if you have issues swallowing capsules for more suggestions.

If you are prescribed the Nispan brand of Niacin, take it before you go to bed with a snack that is low in fat such as fruit or non-fat yogurt.

Nispan brand of Niacin supplement should be taken with water or milk only, avoiding hot drinks, spicy foods and alcoholic beverages to keep potential reddening of your face and flushing to a minimum.

Do not stop taking your Niacin supplement for any length of time without checking with your physician first.

Your dosage may vary from the general dosage indications, which is normal. If you have any doubts about your prescribed amount of Niacin, check with your doctor.

In general, adult patients diagnosed with high triglycerides and cholesterol will be directed to take 500 to 2000 milligrams of Niacin one to three times in a 24 hour period in extended-release capsules, oral liquid solution or tablet forms. Children with these conditions may or may not be prescribed Niacin to combat them, which is up to their physician to decide along with their dosage amount.

The extended release tablet form will typically be prescribed in 500 milligram doses once per day just before going to bed for adults and children over 16 years old. This dosage may be increased to 1000 milligrams but will typically not exceed more than 2000 milligrams in a one day period. Children who are younger than 16 years of age will have their dosage determined by their physician, if required.

Missing a dose of Niacin should not cause you to double your dosage amount to catch up. If you are far enough out from your next dose, take the missing dose as soon as you remember. Otherwise, wait for your next dose, skipping the missing dose in order to stay on your schedule.

Interactions

If, in the past, you have experienced sensitivities to other medications or vitamin supplements, it is best to alert your doctor to this fact prior to being prescribed Niacin supplements. Include any information on your reactions to animals, foods, dyes or perfumes that have occurred.

Niacin extended-release tablets have not been studied with adequate data proving that this medication is safe for children under 16 years old. Niacin in general has not been studied for use in children under 2, but it is a well known fact that this age group requires cholesterol for proper growth and development. Use in this age group is not recommended.

Niacin can be useful in the geriatric population and has been proven safe with regard to use in this age group.

Pregnant women have not been studied in order to provide data that confirms the safety of fetal development with use of Niacin supplements. Avoid taking this medication if you are pregnant and, if you become pregnant during your Niacin therapy, let your doctor know immediately.

There have been no studies on breastfeeding women to determine if any levels of Niacin are passed on to their infants via their breast milk. If you are breastfeeding, discuss the use of Niacin supplements with your physician.

Niacin supplements may be prescribed with other medications as a multi-pronged therapy against your high cholesterol levels and other health symptoms you may be having. In general, it is safe to take Niacin supplements with other medications, but of course there are exceptions.

The following medicines should not be taken with Niacin supplements unless the dose of one or both of these medications is adjusted accordingly. Alert your doctor if you are currently on a prescription for:

  • Atorvastatin
  • Rosuvastatin
  • Lovastatin
  • Cerivastatin
  • Pitavastatin
  • Simvastatin

Certain ill effects on your health may increase in risk if you are taking Warfarin while you are on a prescription for Niacin supplements. Avoid taking Warfarin and Niacin at the same time or consult your physician.

Avoid the consumption of alcoholic beverages when you are taking Niacin, as this combination can increase symptoms for flushed, red skin. Also avoid spicy foods and hot beverages near the time of your dosage.

To benefit the most from taking Niacin supplements, it is important that you follow the special diet prescribed for you by your physician. Do not make dietary changes without consulting your doctor first.

Patients with the following medical conditions may experience worse symptoms than usual or may find that they react poorly to Niacin supplements. If you have the following illnesses, make sure your doctor is aware of them:

  • Angina
  • Alcoholism
  • Gout
  • Glaucoma
  • Heart attack
  • Hypotension
  • Heart disease
  • Jaundice
  • Tender, painful muscle conditions
  • Kidney disease
  • Weak muscle structure
  • Ulcers in stomach
  • Bleeding issues
  • Liver diseases
  • Diabetes
  • Underactive thyroid
  • Failure of the kidneys
  • Kidney dialysis requirements

Warnings

Your physician will want to schedule regular office visits with you to check your cholesterol levels through blood and urine testing. You may be asked to fast for a certain number of hours before blood is drawn for the most accurate test. You will also be checked for any adverse health effects you may be experiencing, so make sure you are ready to list any symptoms you've been having.

Patients are at an increased risk for rhabdomyolysis syndrome, which can lead to kidney problems. Alert your doctor if you have symptoms such as dark urine color, weak muscles, fatigue, cramps, stiffness, pain or spasms in your muscles, diarrhea or elevated body temperature after taking Niacin supplements.

Be on the alert for signs that your liver function has diminished, which is also possible with taking Niacin supplements. Pale stool color, urine darkness, tender, painful sensations in the upper stomach area, yellow skin or eyes and fatigue or muscle weakness are all signs of liver problems.

Your blood glucose levels could be affected when you take Niacin supplements. Diabetic patients are advised that they should check their sugar levels as advised by their physician during treatment with this medication.

You may feel dizzy or experience fainting spells when you rise from a seated or lying position. Rise slowly from these positions to lessen the severity of them, but if they continue be sure to consult your physician.

Do not stop taking your Niacin supplement without talking to your doctor, as your elevated cholesterol levels will return when you do. Your physician will want you to follow a special diet to prevent dangerous cholesterol levels.

Alert any physician giving you a medical test of any kind including other doctors and dentists, as the results may be skewed as a result of your Niacin supplements.

Other vitamins and supplements to your diet should be avoided unless you get permission from your physician first, as they could react adversely with your Niacin supplement.

Storage

Keep your Niacin supplement in the original container that it arrives in with your prescription, making sure the container is tightly closed to prevent any exposure to moisture or light. Keep Niacin at room temperature and don't allow it to freeze or be exposed to heat sources. It is best to store this and other medications out of sight and reach of children and pets. Do not store your Niacin supplement in the bathroom where there is an abundance of moisture. Dispose of any unused or expired Niacin in a safe manner as instructed by your physician or pharmacist.

Summary

Patients who have been diagnosed with elevated levels of blood cholesterol are facing several possible health issues unless they control these levels. One of the risks they face is heart disease and heart attacks, which are the result of cholesterol building up in the arteries and causing blockage. The other condition is pancreatitis, which is an inflammation of the pancreas that can be painful and debilitating. Fortunately, along with diet and exercise, Niacin supplements have been proven to help lower blood cholesterol to avoid major health problems.

A naturally occurring substance found in many foods, Niacin is one of the B-complex vitamins. Patients will benefit from a diet rich in Niacin that delivers at least 16 milligrams of the nutrient per day. Those who have built up high cholesterol, however, may not be able to help their levels even with diet improvements, making a diet supplement the best choice for many people.

Most adult patients over the age of 16 are safe taking Niacin supplements, with a few exceptions that are health related. Pregnant women and women who are nursing should not take Niacin supplements nor should children, especially those under two years old. Certain health conditions also prevent patients from taking Niacin therapy such as stomach ulcer, liver and kidney disease, heart disease and more.

If you are a candidate for Niacin supplement, you will typically be given from 500 to 2000 milligrams per day, typically split up into smaller doses one to three times per day as prescribed. You should not alter your doctor's prescription of Niacin for any reason. Additionally, do not take other vitamin therapies or supplements unless you have approved them with your physician.

Patients will have regular checks of their blood cholesterol, during which time any ill effects on their health will also be examined. Report signs and symptoms of liver problems, kidney problems, dangerous blood sugar levels or excessive dizziness to your physician immediately, do not wait for your scheduled appointment. Do not stop taking this medication without the permission and guidance of your doctor.

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Last Reviewed:
March 26, 2018
Last Updated:
April 23, 2018
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