Niacin, also called nicotinic acid and vitamin B3, serves a variety of functions including extracting energy from foods, utilizing calcium and repair of DNA. Scientists have studied niacin extensively for its cardiovascular benefits, in particular its effects on regulating cholesterol levels. Recent research has revealed considerable benefits of a combination therapy of niacin and various prescription drugs for safe and effective cholesterol management.
Niacin and Simvastatin
Low-dose niacin together with the cholesterol drug simvastatin significantly reduced LDL cholesterol, in a study published in the October 2010 issue of "Minerva Cardioangiology." Participants in the study had elevated cholesterol levels that were not sufficiently controlled by statin therapy. Dosages of niacin started at 250 mg for two weeks, progressed to 500 mg for the next two weeks and then to 750 mg for four weeks. Patients also took 200 mg of aspirin before each dose. The researchers saw significant decreases in LDL, apolipoprotein B -- a constituent of LDL cholesterol -- triglycerides and total cholesterol. Also, HDL levels increased, as did apolipoprotein A-I -- a constituent of HDL cholesterol. The researchers concluded that the combination therapy was effective at lowering LDL without flushing or increased insulin resistance -- frequent side effects of high-dose niacin.
Extended Release
A study on innovative therapies for high cholesterol and other metabolic disorders reported that niacin effectively lowers LDL cholesterol and raises HDL cholesterol. Extended-release niacin, which keeps a steady supply of niacin in the bloodstream at lower levels, decreases niacin side effects while affording the same health benefits, as reported in the September 2005 "Revue Medicale de Bruxelles."
Combination Therapy Reduces Side Effects
A study published in the March 2002 "American Heart Journal" of combination therapy with very low-dose niacin and statins found that the approach increased HDL by an average of 2 mg/dL. Patients on statin therapy for three months took 50 mg of niacin twice per day for three months. Side effects of flushing occurred in 12 percent of participants; however no participants dropped out of the study because of side effects. The researchers concluded that low-dose niacin therapy was effective at increasing HDL cholesterol without significant side effects.
Niacin and Prevastatin
The "Annals of Pharmacotherapy" journal reported, in its June 1997 issue, on a study of low-dose niacin in diabetics with high cholesterol and found that a combination of 1.5 g of niacin per day, together with the statin drug prevastatin, significantly lowered LDL cholesterol, compared to the statin by itself. Patients took graduated doses of niacin up to a maximum of 500 mg three times per day for six weeks. Minor changes in blood sugar occurred in a small percentage of participants.
References
- "Minerva Cardioangiologiia"; Effects of Low-dose of Niacin Associated to Simvastatin in the Treatment of Mixed Dyslipidemia; B.J. Salgado et al.; October 2010
- "Revue Medicale de Bruxelles"; Innovative Therapies in Metabolic Diseases: Ezetimibe (Ezétrol), Nicotinic Acid (Niaspan), Acids Omega-3 (Omacor), Rimonabant (Acomplia); J. Ducobu et al.; September 2005
- "American Heart Journal"; Effect of Very-low-dose Niacin on High-density Lipoprotein in Patients Undergoing Long-term Statin Therapy; J. Wink et al.; March 2002
- "Annals of Pharmacotherapy"; Combination of Low-dose Niacin and Pravastatin Improves the Lipid Profile in Diabetic Patients Without Compromising Glycemic Control; S.F. Gardner et al.; June 1997
