A case for immediate-release niacin

Abstract Niacin is currently a favored drug for increasing high-density lipoprotein, especially in patients with ischemic heart disease or at high risk of developing it. In addition, niacin further decreases low-density lipoprotein in statin-treated patients and has been shown to reduce morbidity an...

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Bibliographic Details
Published inHeart & lung Vol. 41; no. 1; pp. 95 - 98
Main Author Bassan, Mayer, MD
Format Journal Article
LanguageEnglish
Published United States Mosby, Inc 2012
Elsevier Science Ltd
Subjects
Aged
Cardiology
Cardiovascular
Cholesterol, HDL - drug effects
Cholesterol, LDL - drug effects
Critical Care
Drug dosages
Drug therapy
HDL
Hepatotoxicity
Humans
Hyperlipidemias - drug therapy
Hypolipidemic Agents - administration & dosage
Hypolipidemic Agents - adverse effects
Hypolipidemic Agents - therapeutic use
Ischemia
Lipoproteins
Liver - drug effects
Liver - pathology
Male
Niacin
Niacin - administration & dosage
Niacin - adverse effects
Niacin - therapeutic use
Pulmonary/Respiratory
Risk Factors
Statins
Vitamin B Complex - administration & dosage
Vitamin B Complex - adverse effects
Vitamin B Complex - therapeutic use
HDL
Niacin
Hepatotoxicity
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Summary:Abstract Niacin is currently a favored drug for increasing high-density lipoprotein, especially in patients with ischemic heart disease or at high risk of developing it. In addition, niacin further decreases low-density lipoprotein in statin-treated patients and has been shown to reduce morbidity and mortality. Among the available niacin preparations, crystalline, immediate-release niacin is the most effective for increasing high-density lipoprotein and is relatively free of hepatic toxicity. We present the case of a patient who had an excellent clinical and laboratory response to 3 g daily of immediate-release niacin, but who later developed clinical hepatitis when he inadvertently switched to the same dose of slow-release niacin. We encourage the use of niacin in general, immediate-release niacin in particular, and caution that niacin is a drug and not a dietary supplement. We also present practical steps for starting niacin, including close patient contact and support, and beginning with a therapeutic dose of 2 g per day right from the start.
ISSN:0147-9563
1527-3288
DOI:10.1016/j.hrtlng.2010.07.019