Generic Name: niacin (NYE-a-sin)
Brand Name: Niacor

Niacin is used for:

Improving cholesterol levels, reducing the risk for a second heart attack, slowing or treating hardening of the arteries, and lowering very high serum triglyceride levels. It is used in combination with diet. It may be used alone or with other medicines. It may also be used for other conditions as determined by your doctor.

Niacin is an antihyperlipidemic. It works by reducing low-density lipoprotein ("bad") cholesterol and triglycerides and increasing high-density lipoprotein ("good") cholesterol.

Do NOT use niacin if:

  • you are allergic to any ingredient in niacin
  • you have severe or unexplained liver problems, an active peptic ulcer, or a history of arterial bleeding

Contact your doctor or health care provider right away if any of these apply to you.

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Before using niacin:

Some medical conditions may interact with niacin. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

  • if you are pregnant, planning to become pregnant, or are breast-feeding
  • if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
  • if you have allergies to medicines, foods, or other substances
  • if you have a history of chest pain, diabetes, gallbladder problems, glaucoma, gout, heart problems or a recent heart attack, kidney or liver problems, low blood pressure, low phosphate levels, muscle problems (eg, rhabdomyolysis), stomach problems (eg, peptic ulcers), or thyroid problems
  • if you have a history of bleeding problems or are taking anticoagulants (eg, warfarin)
  • if you consume large amounts of alcohol

Some MEDICINES MAY INTERACT with niacin. Tell your health care provider if you are taking any other medicines, especially any of the following:

  • Anticoagulants (eg, warfarin) because side effects such as bleeding may occur
  • Fibrates (eg, gemfibrozil, fenofibrate) or HMG-CoA reductase inhibitors ("statins") (eg, simvastatin) because side effects, such as serious muscle aches and weakness that may be a symptom of a serious medical condition called rhabdomyolysis, may occur
  • Medicine for high blood pressure (eg, diltiazem) or angina (eg, nitroglycerin) because side effects, such as dizziness upon standing and very low blood pressure, may be increased by niacin
  • Alcohol because toxic effects, such as delirium or lactic acidosis, may occur

This may not be a complete list of all interactions that may occur. Ask your health care provider if niacin may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use niacin:

Use niacin as directed by your doctor. Check the label on the medicine for exact dosing instructions.

  • To minimize flushing and upset stomach, take niacin at bedtime after a low-fat snack (eg, low-fat yogurt, banana, crackers with a glass of milk) unless your doctor directs otherwise. Do not take niacin with alcohol, a hot drink, or spicy foods.
  • Do not take bile acid sequestrants (eg, colestipol, cholestyramine) within 4 to 6 hours of taking niacin.
  • If you miss a dose of niacin, take it as soon as possible. If it is almost time for the next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use niacin.

Important safety information:

  • Niacin may cause dizziness or lightheadedness. These effects may be worse if you take it with alcohol or certain medicines. Use niacin with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.
  • Niacin may cause dizziness; alcohol, hot weather, exercise, or fever may increase this effect. To prevent it, sit up or stand slowly, especially in the morning. Sit or lie down at the first sign of this effect.
  • Do NOT take more than the recommended dose without checking with your doctor.
  • Niacin may reduce the number of clot-forming cells (platelets) in your blood. Avoid activities that may cause bruising or injury. Tell your doctor if you have unusual bruising or bleeding. Tell your doctor if you have dark, tarry, or bloody stools.
  • Do not substitute niacin for any other type of niacin without talking with your doctor. Severe liver damage can occur.
  • If you stop taking niacin for an extended period, contact your doctor before you start taking it again. Your dose may need to be adjusted.
  • Flushing occurs with niacin and may last for several hours. Talk with your doctor if flushing becomes bothersome.
  • Take niacin at bedtime so that flushing will occur during sleep. If you are awakened by flushing at night, get up slowly, especially if you feel dizzy or faint or if you are taking blood thinners. Take aspirin or a nonsteroidal anti-inflammatory drug (NSAID) (eg, ibuprofen) 30 minutes before taking niacin to lessen flushing.
  • Diabetes patients - Niacin may cause the results of some tests for urine glucose to be wrong. Ask your doctor before you change your diet or the dose of your diabetes medicine.
  • Do not take large doses of vitamins while you use niacin unless your doctor tells you to.
  • Report any unexplained muscle pain, tenderness, or weakness to your doctor right away, especially if you also have a fever or general body discomfort.
  • Niacin may interfere with certain lab tests, including plasma or urinary catecholamine tests or urine glucose tests. Be sure your doctor and lab personnel know you are taking niacin.
  • Lab tests, including liver function tests, blood glucose, and serum creatine kinase tests, may be performed while you use niacin. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.
  • Niacin should be used with extreme caution in CHILDREN; safety and effectiveness in children have not been confirmed.
  • PREGNANCY and BREAST-FEEDING: If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using niacin while you are pregnant. It is not known if niacin is found in breast milk. Do not breast-feed while taking niacin.

Possible side effects of niacin:

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Diarrhea; dizziness; headache; heartburn; increased cough, indigestion, or upset stomach; nausea; temporary skin redness, itching, tingling, or feelings of warmth (flushing); vomiting.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue; unusual hoarseness); black, tarry, or bloody stools; changes in vision (eg, cloudy or blurred vision); decrease in urine or dark-colored urine; fainting; fast or irregular heartbeat; flu-like symptoms (eg, chills, fever, persistent sore throat); increased sweating; loss of appetite; muscle pain, tenderness, swelling, or weakness (with or without fever and fatigue); numbness or persistent tingling of the skin; severe dizziness or headache; severe or persistent diarrhea, nausea, or vomiting; shortness of breath; stomach pain; swelling of the hands, legs, or feet; unusual bruising or bleeding; vomit that looks like coffee grounds; yellowing of the skin or eyes.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately. Symptoms may include flushing.

Proper storage of niacin:

Store niacin at room temperature, between 59 and 86 degrees F (15 and 30 degrees C). Store away from heat, moisture, and light. Do not store in the bathroom. Keep niacin out of the reach of children and away from pets.

General information:

  • If you have any questions about niacin, please talk with your doctor, pharmacist, or other health care provider.
  • Niacin is to be used only by the patient for whom it is prescribed. Do not share it with other people.
  • If your symptoms do not improve or if they become worse, check with your doctor.
  • Check with your pharmacist about how to dispose of unused medicine.

This information should not be used to decide whether or not to take niacin or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about niacin. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to niacin. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using niacin.

Issue Date: September 3, 2014
Database Edition 14.3.1.003
Copyright © 2014 Wolters Kluwer Health, Inc.

Disclaimer: This information should not be used to decide whether or not to take this medicine or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this medicine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using this medicine.

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