Niacin Disease Interactions
There are 6 disease interactions with niacin:
The Coronary Drug Project (1975) reported a significant increase in cardiac arrhythmias associated with the use of niacin at lipid-lowering dosages. Treatment using pharmacologic dosages of niacin and niacinamide (nicotinamide) should be administered cautiously in patients with coronary heart disease or arrhythmias. Particular caution is advised in the presence of unstable angina or in the acute phase of myocardial infarction, especially if the patient is also receiving vasoactive drugs such as nitrates, calcium channel blockers, or adrenergic blocking agents.
The use of nicotinic acid and its derivatives at dosages substantially exceeding those for physiologic requirements is contraindicated in patients with active liver disease or unexplained, persistent elevations of serum transaminases. Hepatotoxicity, including biochemical abnormalities of liver function, cholestatic jaundice, increased prothrombin time, and fulminant hepatic necrosis and failure, has been reported during therapy with niacin and niacinamide (nicotinamide), particularly in patients who have substituted sustained-release nicotinic acid products for immediate-release preparations at equivalent dosages. Treatment using pharmacologic dosages (e.g., lipid-lowering dosages) of these agents should be administered cautiously in patients with gallbladder disease or a history of jaundice, liver disease and/or heavy alcohol use. Liver transaminase levels should be evaluated prior to initiation of therapy, every 6 to 12 weeks for the first year, and periodically thereafter (e.g., semiannually). Patients who develop elevated ALT or AST levels during therapy should be monitored until abnormalities resolve. If an increase above 3 times the upper limit of normal persists, therapy should be withdrawn. Liver biopsy should be considered in patients with elevations that persist beyond cessation of therapy.
The use of niacin and niacinamide (nicotinamide) is contraindicated in patients with severe hypotension. These agents have peripheral vasodilating effects and may commonly cause flushing at dosages substantially exceeding those for physiologic requirements (e.g., lipid-lowering dosages).
The use of niacin and niacinamide (nicotinamide) at dosages substantially exceeding those for physiologic requirements is contraindicated in patients with active peptic ulcer disease. These agents have been reported to activate peptic ulcer. Treatment using pharmacologic dosages (e.g., lipid-lowering dosages) should be administered cautiously in patients with a history of peptic ulcer disease.
Elevated fasting blood sugars and decreased glucose tolerance have been reported during niacin and niacinamide (nicotinamide) therapy at dosages substantially exceeding those for physiologic requirements. Patients with diabetes mellitus should be monitored more closely during therapy with these agents, and adjustments made accordingly in their antidiabetic regimen.
Large doses of niacin and niacinamide (nicotinamide) can compete with uric acid for excretion by the kidney. Hyperuricemia and precipitation of gout have been reported during long-term therapy. Treatment using pharmacologic dosages (e.g., lipid-lowering dosages) of these agents should be administered cautiously in patients with or predisposed to gout.
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niacin drug Interactions
There are 148 drug interactions with niacin
niacin alcohol/food Interactions
There are 2 alcohol/food interactions with niacin
Drug Interaction Classification
The classifications below are a general guideline only. It is difficult to determine the relevance of a particular drug interaction to any individual given the large number of variables.
|Major||Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.|
|Moderate||Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.|
|Minor||Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.|
Do not stop taking any medications without consulting your healthcare provider.
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