High cholesterol is a major contributor to the development of heart disease. The American Heart Association reports that over 16 percent of the population has cholesterol levels over 240mg/dL. Vitamin B3, also known as niacin or nicotinic acid, may play an important role in raising good cholesterol, or HDL, and lowering bad cholesterol, or LDL. Niacin is available in both prescription and over-the-counter forms. As with all supplements, consult your health care provider before you start taking niacin.
Over-the-Counter Niacin
According to the Diet Channel, the recommended daily amount of niacin is 14mg for adults. When taken for cholesterol, however, daily doses may range from 1500mg to 3000mg. Niacin comes in several different over-the-counter forms, including tablets and capsules, in strengths ranging from 100mg to 1000mg. It is also found in smaller doses in combination with other B-complex vitamins or multivitamins. Over-the-counter niacin supplements often release the entire dose at once, which may increase the chance of experiencing side effects, such as flushing and headache. You should take niacin for cholesterol only under the supervision of your doctor.
Prescription Niacin
Several forms of niacin are available by prescription, including such brands as Slo-Niacin, Nicobid and Niaspan. Each prescription form of niacin is formulated to release slowly over time, usually 12 hours. These medications are available in strengths of 250mg, 500mg, 750mg and 1000mg. According to Drugs.com, manufacturers recommend a lower dose at the beginning, with a gradual increase over time to a larger dose so that the patient has time to adjust. The controlled-release formulation of prescription niacin may reduce the chance of developing side effects, such as flushing, sweating and headache, which you may experience more often with fast-release forms of niacin. Prescription products have also undergone clinical testing to prove purity and effectiveness, which supplements have not.
Combination Products
Niacin is also available in prescription form in combination with other cholesterol medications known as statins. Statins such as simvastatin and lovastatin work to reduce cholesterol by interfering with its production. Combining both types of medication may be more effective than taking either alone. Niacin with simvastatin is prescribed under the brand name Simcor, while lovastatin combined with niacin is prescribed as Advicor. At the does recommended by manufacturers, most patients will take 1000mg to 2000mg of niacin in the combination product, along with the statin medication. In addition to flushing and related side effects, these medications may cause additional adverse effects, such as muscle weakness.
Reducing Side Effects
When niacin is taken in doses recommended for high cholesterol, many patient experience side effects. Flushing is a common side effect of niacin therapy, and although controlled-release products may help to reduce this problem, it may still be bothersome. Niacin causes flushing by releasing prostaglandins, which cause the blood vessels of the skin, particularly the face and upper body, to become red and hot. Your doctor may recommend that you take 325mg of aspirin before your niacin dose to help reduce flushing by blocking the prostaglandins. Niacin may also cause blood sugar and liver function changes when taken in the amounts required for cholesterol. Your doctor may monitor your glucose and liver enzyme levels with blood tests while you are taking niacin.
