Nicotinic Acid

Other Vitamins · Vitamin

Indications

Adjunct to statin in dyslipidaemia or used alone if statin not tolerated.

Dosage

Adults: 375 mg once daily at night (after a low-fat snack) for 1 wk, then 500 mg once daily at night for 1 wk then 750 mg once daily at night for 1 wk, then 1 gm once daily at night for 4 wk, increased if necessary in steps of 500 mg at intervals of at least 4 wk to max 2 gm daily; usual maintenance dose 1-2 gm once daily at night. Children: Not recommended.

Adverse Effects

Diarrhoea, nausea, vomiting, abdominal pain, dyspepsia, flushing, pruritus, rash, less commonly tachycardia, palpitation, shortness of breath, peripheral oedema, headache, dizziness, increase in uric acid, hypophosphataemia, prolonged prothrombin time and reduced platelet count, rarely hypotension, syncope, rhinitis, insomnia, reduced glucose anorexia, rhabdomyolysis, visual disturbance and jaundice reported.

Risk Factor (Pregnancy/Lactation)

Pregnancy: Risk cannot be ruled out. Lactation: Caution advised or effect undetermined. Contraindications: Arterial bleeding, active peptic ulcer disease. Precautions: Unstable angina, acute myocardial infarction, diabetes mellitus, gout, history of peptic ulceration.

Interactions

Adrenergic blocking agents.

Advice to Patient

Take with meals. Do not crush or chew sustained-release tablets, swallow whole. Contact prescriber if there is nausea, vomiting, heartburn, persistent gastrointestinal disturbance or changes in colour of urine or stool, worsening of condition. Avoid alcohol, spicy meals and hot drinks during treatment. Change position slowly from sitting or lying to standing. Give a gap of atleast 4-6 hours before or after taking bile acid binding resins such as cholestyramine or colestipol.

Pharmacokinetics

Absorption: Rapidly absorbed from the GI tract. Metabolism: Hepatic. Time to peak: 45 mins. Excretion: Urine.

Compiled by Healify Pharmacy from published drug references. How we compile it →

Always consult a pharmacist or doctor.