Niacin

Niacin (also called nicotinic acid) is vitamin B3. It is the ideal first choice to treat elevated cholesterol levels where eating modification and exercise have not produced the degree of results desired - it should not be used to continue an unhealthy lifestyle! Niacin is an especially good choice if the goal is to raise the HDL (good cholesterol). High levels (several grams per day) of niacin lowers cholesterol beautifully! Unfortunately niacin, at amounts as low as 50–100 mg., may cause flushing, headache, and stomachache in some people. Many people have trouble taking the higher doses (up to 2,000mg) needed to treat high cholesterol. Further, high doses of Niacin can cause liver toxicity, and these levels of niacin should only be taken under the supervision of your doctor who will follow your liver function tests.

To avoid the side effects of niacin, doctors of natural medicine use inositol hexaniacinate - often referred to as "no flush" niacin. The initial recommended dose of 500 mg is taken two times per day with meals. This dose is increased until the target dose of 2000 mg. per day is reached. This form of niacin lowers serum cholesterol, although it is not as potent as regular niacin, but it appears to have far fewer side effects, and the dose can be increased more quickly.

Please Note

bulletYour doctor will want to test your blood regularly to see if the medicine is lowering your cholesterol and/or triglyceride levels. Keep all your appointments for these tests.
bulletThis medicine may make you dizzy when you get up from sitting or lying down. Getting up slowly may help lessen this reaction.
bulletRegular niacin may cause flushing, tingling, or a sensation of warmth when you first start taking it. These effects usually stop with continued use. Taking the "no flush" variety of Niacin, or Niacitol, may prevent this. Taking a timed release form once daily may also help, especially if an aspirin tablet is taken about 30-60 minutes prior to the Niacin!
bulletFemales of childbearing age: If you are pregnant or breastfeeding an infant, do not take large dosages of niacin unless your doctor approves.
bulletDiabetics need to monitor their blood sugar levels more closely as the Niacin may make them harder to control initially.

Possible Side Effects

Some side effects may occur but usually diminish or stop as treatment continues. Please contact your doctor if any of the following get worse: flushing, tingling, feeling of warmth, headache, dizziness, stomach upset, nausea, vomiting. Also tell your doctor about any side effects that continue.

Special Instructions for taking regular release Niacin:

Start with 250mg. of the instant release formulation of Niacin at bedtime. Taking it at bedtime minimizes any side effects of flushing that could occur - you will be asleep! Increase the dose slowly as tolerated on a weekly basis per the chart below. Once you have been on Niacin for 1 month, and again at 2 months, lipid and liver function testing need to be done by your doctor.

If testing indicates room for improvement, you would continue to increase the dose until you get to the maximum therapeutic goal of 2000mg. a day. Remember that we need to follow your liver function labwork periodically; the next check will be two months after the first levels were checked, and 2 monthly until your 1 year anniversary has been reached.

 

Breakfast

Dinner

Bedtime
Week 1    

250mg.
Week 2

250mg.

  

250mg.
Week 3

250mg

250mg

250mg
Week 4

250mg

250mg

500mg.
Week 5

500mg.

250mg.

500mg.
Week 6

500mg.

500mg.

500mg.
Week 7

750mg.

500mg.

750mg.
Week 8

1000mg.

  

1000mg.

Proper Use

bulletTake the niacin with meals to lessen stomach upset.
bulletTake the niacin exactly as directed - do not take more of it as taking too much may increase the risk of side effects.
bulletAlways follow your low cholesterol diet your doctor recommended to control your manage your lipid levels – medication is not an excuse to eat as you please!
bulletRegular release Niacin capsules may be opened if you prefer and the powder mixed with soft food that can be swallowed without chewing.
bulletExtended release Niacin tablets and capsules must be swallowed whole to work properly - do not chew or crush them.

Other Names For Regular Niacin:

Nia-Bid, Niac, Niacels, Niacor, Nico-400. Nicobid, Nicobid Tempules, Nicolar, Nicotinex, Slo-Niacin, Niaspan, and others.

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