Niacin, a B vitamin, improves lipid levels in your blood by lowering triglycerides and low-density lipoproteins, the "bad" form of cholesterol, while raising high-density lipoproteins, the "good" cholesterol. Niacin can reduce triglyceride levels by 30 to 70 percent and total and LDL cholesterol by 10 to 20 percent, Drugs.com states. Time-released forms of niacin come in several doses, including a 500 mg dose. The initial recommended dose for time-released niacin is 250 mg for the first few weeks, then increasing as needed, the Permanente Group recommends. Time-released niacin increases the risk of some side effects while decreasing others.
Flushing
Flushing, one of the biggest drawbacks of niacin treatment, affects 78 percent of patients overall but may occur less frequently if you take time-released niacin, Drugs.com states. Flushing usually occurs within 20 minutes of taking your pill and lasts 30 to 60 minutes. Taking a half or whole uncoated aspirin or a non-steroidal anti-inflammatory drug within 30 minutes of taking niacin if allowed by your doctor helps reduce flushing, the Permanente Medical Group reports. Avoiding hot drinks and alcohol can also reduce the risk of flushing. Itching often accompanies flushing, which can occur on the face as well as the whole body. Sweating and a sensation of burning on the skin as well as warmth can also occur with flushing. Flushing may decrease after taking the drug for a few weeks.
Liver Toxicity
Time-released forms of niacin may increase the risk of liver damage over immediate-release forms of the drug, Drugs.com warns. Between 2 and 3 percent of people taking time-released niacin preparations experience liver toxicity, Drugs.com warns. Stopping the drug usually reverses the damage within a week. Signs include jaundice, fatigue, a yellowing of the whites of the eye and skin, dark or tea-colored urine, loss of appetite or nausea. If you drink excessive amounts of alcohol, tell your doctor before taking this medication.
Stomach Upset
Slow-released niacin can cause stomach upset, including worsening of peptic ulcers, vomiting, diarrhea, gas, burping or stomach pain. Taking the drug with meals and not drinking alcohol, orange juice or hot drinks at the same time may decrease stomach upset, the Permanente Medical Group advises.
Sexual Dysfunction
Taking time-release niacin increased the risk of sexual dysfunction from 3 percent of men to 22 percent, Drugs.com reports.
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