Nicotinic acid, also known as vitamin B3 or niacin, is water-soluble and can be used to lower cholesterol and triglycerides, as well as lower repeat heart attack risk for heart attack victims with high cholesterol. It is also used to prevent pellagra and as a treatment for atherosclerosis.
Side Effects
Nicotinic acid is given in fairly high doses (1.5 to 6 grams per day) to lower cholesterol and triglyceride levels. These higher doses can cause flushing, itching or dry skin, rashes, gout and occasionally indigestion or liver damage. Initial use may cause diarrhea, vomiting or stomach upset that ceases with continued use. Other reported side effects include hyperglycemia, cardiac arrhythmia, birth defects and orthostasis (dizziness/light headedness when standing up). Side effects are more severe at higher doses.
Rare Side Effects
Some other side effects have been reported but occur rarely. These include blood clotting, lactic acidosis, muscle cell damage, headache, tooth or gum pain, difficulty breathing, panic attacks, hypothyroidism, or eye problems such as swelling, blurred vision and toxic amblyopia.
Side Effect Relief
If flushing occurs you may need to start with a lower dose, or you may want to take aspirin or non-steroidal anti-inflammatory drugs 30 to 60 minutes before taking the niacin. Taking an antihistamine 15 minutes before taking niacin may help, as well, and it may also be beneficial to take niacin with food. Time-release niacin also seems to have less of a damaging effect on the liver. Avoid standing up too fast to prevent dizziness or light headedness and a possible loss of balance. Side effects may decrease over time. Alcohol or hot drinks can increase the side effects.
Considerations
Nicotinic acid should not be taken if you have severe liver disease, a stomach ulcer or active bleeding. You may not be able to take it if you have diabetes, gout, glaucoma, clotting disorders, alcoholism or oversensitivity to niacin. Extremely high doses can cause acute toxic reactions, especially in the liver, and eye problems that can lead to blindness, though it can be reversed if niacin treatment is stopped. Signs of liver damage include stomach pain, bloody stools and jaundice. Niacin taken in higher doses, such as that used to treat high cholesterol, should be supervised by a physician who can monitor liver function.
Types
Niacin is contained in foods such as eggs, meat, grains and dairy products. It is available as vitamin B3 or niacin as an over-the-counter supplement. As a cholesterol-lowering treatment, it is available in larger doses in such products as Niacor, Nicolar, Slo-Niacin, Advicor, Niaspan, Nicotinex and Nico-400, as well as in inositol hexaniacinate, extended-release niacin and time-release niacin.
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