Drug Interaction Report

Niacin may reduce the uricosuric effect of sulfinpyrazone. The mechanism is not entirely clear, but probably involves reduction of the inhibitory effect of sulfinpyrazone on renal tubular reabsorption of uric acid. Since hyperuricemia is a potential side effect of niacin, an alternative antihyperlipidemia agent should be used.

GENERALLY AVOID: Ethanol can exacerbate the cutaneous flushing that is a common side effect of niacin. At least one case of delirium and lactic acidosis has been reported with coadministration of these drugs, although data are limited.

MANAGEMENT: Coadministration should probably be discouraged, particularly since chronic consumption of large amounts of alcohol is associated with hyperlipidemia.

A single case has been reported in which cutaneous flushing and tremors were noted in a woman who was taking niacin while wearing a nicotine patch. The mechanism is suspected to be synergistic cutaneous vasodilatory effects. The clinical significance of this possible interaction is not known.