Niacin is one of the B vitamins that most multivitamin supplements contain. You also can purchase niacin as a single-ingredient product. Doctors use niacin to treat high cholesterol or vitamin B3 deficiency. Niacin is available in various formulations such as immediate-release, sustained-release and extended-release. You may purchase it over- the-counter, or your doctor may prescribe a stronger version. Niacin favorably affects the good and bad cholesterol, as well as fat in the blood called triglycerides. However, its medical benefits are limited by how well you can tolerate its side effects.
Flushing
Flushing is the most common side effect among niacin users, according to the physician's prescribing information and the "Drug Information Handbook." With flushing, you may experience redness, a tingling sensation and feelings of warmth and itchiness. The "Cardiology Forum Report" states that flushing is more common with the immediate-release formulations of niacin. The sustained-release and extended-release forms cause less flushing because of their slower rates of absorption. Niaspan, an extended release formulation, is available by prescription, and has a low incidence of flushing associated with its use. Take aspirin or acetaminophen 30 minutes before niacin to reduce the severity and duration of a flushing episode. You may also try taking your dose at bedtime and avoiding hot drinks, spicy foods, and hot baths or showers too soon after your niacin dose.
Liver Damage
Niacin may be toxic to the liver or cause the death of liver cells. The sustained-release formulations are more likely to produce these adverse reactions, according to the "Cardiology Forum Report." The risk of liver damage also increases when niacin is combined with other potentially, liver- toxic cholesterol-lowering drugs, like the statins and fibric acid derivatives. While taking niacin, your doctor should periodically monitor the function of your liver. Also, don't drink alcohol while you are taking niacin. It increases your risk for liver damage and may exacerbate flushing.
Itching
Niacin may cause itching, with or without the presence of a rash, according to the physician's prescribing information. To avoid or treat these side effects, take an antihistamine, such as diphenhydramine, 30 minutes before your dose or at the onset of symptoms of itching.
Stomach Effects
Niacin may cause nausea, vomiting, diarrhea, indigestion and abdominal pain. Niaspan's abdominal side effects appeared to be dose-related, according to the results of the pre-marketing clinical trial submitted for FDA approval. The higher the dose of Niaspan, the higher the incidence of nausea, vomiting and diarrhea. To reduce the incidence of these adverse reactions, always use the lowest effective dose for your condition.
References
- Epocrates Online; Niaspan Monograph
- Abbott; Niaspan Tablets
- "Cardiology Forum Report"; Differentiating Niacin Formulations Used to Treat Lipid Disorders: Analysis of Efficacy, Safety, and Tolerability Profiles; Richard Karas, Abigail Zavod; March 2008
- "Drug Information Handbook"; Charles Lacy, Lora Armstrong, Morton Goldman, Leonard Lance; 2008
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