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What is niacin?
Niacin, also called nicotinic acid, is a B vitamin (vitamin B3). It occurs naturally in plants and animals, and is also added to many foods as a vitamin supplement. Niacin is also present in many multiple vitamins and nutritional supplements. Niacin is used to treat and prevent a lack of natural niacin in the body, and to lower cholesterol and triglycerides (types of fat) in the blood. It is also used to lower the risk of heart attack in people with high cholesterol who have already had a heart attack. Niacin is sometimes used to treat coronary artery disease (also called atherosclerosis).

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What is the price of this medication and similar alternatives?

This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.

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What are the possible side effects of niacin ?

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have any of these serious side effects:

• feeling light-headed, fainting;

• fast, pounding, or uneven heart beats;

• feeling short of breath;

• swelling;

• jaundice (yellowing of your skin or eyes); or

• muscle pain, tenderness, or weakness with fever or flu symptoms and dark colored urine.

If you are diabetic, tell your doctor about any changes in your blood sugar levels.

Less serious side effects of niacin include:

• mild dizziness;

• warmth, redness, or tingly feeling under your skin;

• itching, dry skin;

• sweating or chills;

• nausea, diarrhea, belching, gas;

• muscle pain, leg cramps; or

• sleep problems (insomnia).

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect.

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How should I take niacin ?
Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Follow the directions on your prescription label. Niacin is sometimes taken at bedtime with a low-fat snack. Follow your doctor's instructions. Niacin can cause certain side effects, such as flushing (warmth, itching, redness, or tingly feeling under your skin). These effects can be made worse if you drink alcohol or hot beverages shortly after you take niacin. These effects should disappear over time as you keep taking the medication.

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What is the most important information I should know about niacin?
Do not take this medication if you are allergic to niacin, or if you have severe liver disease, a stomach ulcer, or active bleeding. Niacin can cause certain side effects, such as flushing (warmth, itching, redness, or tingly feeling under your skin). These effects can be made worse if you drink alcohol or hot beverages shortly after you take niacin. These effects should disappear over time as you keep taking the medication. Avoid getting up too fast from a sitting or lying position, or you may feel dizzy. Get up slowly and steady yourself to prevent a fall.

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What happens if I miss a dose?
Take the missed dose as soon as you remember. Be sure to take the missed dose with food if you normally take your niacin dose with a meal or snack. If it is almost time for your next dose, skip the missed dose and take the medicine at your next regularly scheduled time. Do not take extra medicine to make up the missed dose.

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What other drugs will affect niacin ?
Tell your doctor about all other cholesterol-lowering drugs you are taking with niacin, especially atorvastatin (Lipitor), fluvastatin (Lescol), lovastatin (Mevacor), pravastatin (Pravachol), or simvastatin (Zocor). Before taking niacin, tell your doctor if you are also using any of the following drugs: a blood thinner such as warfarin (Coumadin); multivitamins or mineral supplements that contain niacin; blood pressure or heart medications such as amlodipine (Norvasc), diltiazem (Tiazac, Cartia, Cardizem), felodipine (Plendil), nicardipine (Cardene), nifedipine (Procardia, Adalat), nimodipine (Nimotop), nisoldipine (Sular), or verapamil (Calan, Covera, Isoptin, Verelan); or

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Can I take this if I am pregnant or trying to get pregnant or if I am breastfeeding?

Niacin has been assigned to pregnancy category C by the FDA when given in doses above the recommended daily allowance (RDA). There are no data from animal reproductive studies or controlled human pregnancy studies. The manufacturers of timed-release niacin do not recommend the use of this form of the drug for pregnant women. The manufacturer recommends that niacin be discontinued in women receiving the drug for primary hypercholesterolemia. If used for hypertriglyceridemia, niacin should be given during pregnancy when there are no alternatives and benefit outweighs risk.

Niacin is converted to niacinamide in vivo. Niacinamide is actively transported across the human placenta such that fetal blood levels of niacinamide are greater than corresponding maternal blood levels. There are no reports of adverse effects of niacin or niacinamide on the human fetus.

It is not known whether or not niacin is excreted into human milk. Some studies indicate that it may be excreted into milk in small amounts. The manufacturer recommends that due to the potential for serious adverse reactions in nursing infants, a decision should be made to discontinue nursing or discontinue the drug, taking into account the importance of the drug to the mother.

In one study of lactating women who were taking 2 to 60 mg of niacin per day, the average milk concentration ranged from 1.17 to 2.75 mcg/mL, and was directly proportional to dietary intake. The recommended daily allowance (RDA) for niacinamide during lactation is 18 to 20 mg. Dietary supplementation is only necessary in cases of poor nutritional intake.

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Who should NOT use this medication?

• Known hypersensitivity to niacin or any ingredient in the formulation.
• Active liver disease or unexplained persistent elevations of serum transaminases, active peptic ulcer disease, or arterial bleeding.
• Extended-release niacin in fixed combination with lovastatin (Advicor^®) contraindicated in pregnant or lactating women.

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What happens if I overdose?
Seek emergency medical attention if you think you have used too much of this medicine. Overdose symptoms may include nausea, dizziness, itching, vomiting, upset stomach, and flushing.

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What should I discuss with my healthcare provider before taking niacin ?
Do not take this medication if you are allergic to niacin, or if you have severe liver disease, a stomach ulcer, or active bleeding. Before taking niacin, tell your doctor if you are allergic to any drugs, or if you have: liver or kidney disease; heart disease or uncontrolled angina (chest pain); a stomach ulcer; diabetes; gout; or a muscle disorder such as myasthenia gravis. If you have any of these conditions, you may not be able to use niacin, or you may need dosage adjustments or special tests during treatment.

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Can I stop taking the medication if I feel better?
As a general rule, you should always take your medications exactly as prescribed and do not change the dosage or stop taking the medication without first discussing it with your healthcare provider.

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I am on so many medications; do I have to take them all?
This is called polypharmacy—many different medications being used at the same time by one person. Sometimes, being on multiple medications is acceptable and appropriate but at other times it may be problematic. If you are receiving your medications from multiple physicians you need to ensure that they all know what medications you are taking. The best way to do this is to make a list of all the medications you are currently using, including all nutritional supplements, homeopathic remedies, vitamins and over-the-counter drugs (if possible, also include all the diseases you have been diagnosed with). Give a copy to every doctor who takes care of you so they have it on file, this way they can avoid duplicating medications and perhaps even try to consolidate some. After every doctor's visit remember to update the list accordingly. Also, as much as you possibly can, try to use the same pharmacy to fill all your prescriptions, this way any potential drug interactions can be caught and averted.

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Where can I get more information?
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