Niacin

What is this medication?

NIACIN (NYE a sin) prevents and treats low niacin levels in your body. Niacin (vitamin B3) plays an important role in maintaining the health of your heart, blood vessels, and metabolism. It may also be used with other medications to decrease bad cholesterol and fats (such as LDL, triglycerides) and increase good cholesterol (HDL) in your blood.

This medicine may be used for other purposes; ask your health care provider or pharmacist if you have questions.

COMMON BRAND NAME(S): ENDUR-ACIN, Niacor

What should I tell my care team before I take this medication?

They need to know if you have any of these conditions:

• Bleeding problems
• Frequently drink alcohol
• Liver disease
• Ulcers of intestine or stomach
• An unusual or allergic reaction to niacin, other supplements, medications, foods, dyes, or preservatives
• Pregnant or trying or get pregnant
• Breast-feeding

How should I use this medication?

Take this supplement by mouth with water. Take it as directed on the label at the same time every day. Take it with a low-fat meal or snack.

Talk to your care team about the use of this supplement in children. Special care may be needed.

Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.

NOTE: This medicine is only for you. Do not share this medicine with others.

What if I miss a dose?

If you miss a dose, take it as soon as you can. If it is almost time for your next dose, take only that dose. Do not take double or extra doses.

What may interact with this medication?

• Aspirin
• Medications for blood pressure, chest pain, or heart disease
• Medications for cholesterol or triglycerides
• Nitroglycerin
• Nutritional supplements that contain niacin or nicotinamide

This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also, tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

What should I watch for while using this medication?

Visit your care team for regular checks on your progress. Tell your care team if your symptoms do not start to get better or if they get worse. You may need blood work while you are taking this supplement.

This supplement may affect your coordination, reaction time, or judgment. Do not drive or operate machinery until you know how this supplement affects you. Sit up or stand slowly to reduce the risk of dizzy or fainting spells. Drinking alcohol with this supplement can increase the risk of these side effects.

Do not drink hot drinks or alcohol at the same time you take this supplement. Hot drinks and alcohol can increase the flushing caused by this supplement, which can be uncomfortable. Alcohol can also increase possible dizziness. Taking aspirin or an NSAID, such as ibuprofen, 30 minutes before this supplement may help reduce flushing.

Taking this supplement is only part of a total heart-healthy program. Ask your care team if there are other changes you can make to improve your overall health.

If you are a person with diabetes, close regulation and monitoring of your blood sugars can help control your blood fat levels. This supplement may change the way your diabetic medication works, and will sometimes require that your dosages be adjusted. Check with your care team.

What side effects may I notice from receiving this medication?

Side effects that you should report to your care team as soon as possible:

• Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
• High blood sugar (hyperglycemia)—increased thirst or amount of urine, unusual weakness or fatigue, blurry vision
• Liver injury—right upper belly pain, loss of appetite, nausea, light-colored stool, dark yellow or brown urine, yellowing skin or eyes, unusual weakness or fatigue

Side effects that usually do not require medical attention (report to your care team if they continue or are bothersome):

• Bloating
• Burping
• Facial flushing, redness
• Gas

This list may not describe all possible side effects. Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Where should I keep my medication?

Keep out of the reach of children and pets.

Store between 15 and 30 degrees C (59 and 86 degrees F). Keep the container tightly closed. Get rid of any unused supplement after the expiration date.

To get rid of medications that are no longer needed or have expired:

• Take the medication to a medication take-back program. Check with your pharmacy or law enforcement to find a location.
• If you cannot return the medication, check the label or package insert to see if the medication should be thrown out in the garbage or flushed down the toilet. If you are not sure, ask your care team. If it is safe to put it in the trash, empty the medication out of the container. Mix the medication with cat litter, dirt, coffee grounds, or other unwanted substance. Seal the mixture in a bag or container. Put it in the trash.

NOTE: This sheet is a summary. It may not cover all possible information. If you have questions about this medicine, talk to your doctor, pharmacist, or health care provider.

How much niacin should I take per day?​

With extended-release tablets, your healthcare provider will likely start you with 500 milligrams (mg) per day for the first month. Then, they may slowly increase the dose to 1,000 mg, 1,500 mg or 2,000 mg per day.

If you’re not taking the extended-release tablets, you may need to take them two or three times a day. And you may start with 250 mg and slowly increase it. You should not take more than 6,000 mg a day.

How long does niacin flush last?​

The burning or tingling feeling in your chest and face can last 20 to 30 minutes. Flushing episodes can happen for days or weeks. But over time, they occur less often and become less severe.

Why should I take niacin at bedtime?

Taking it at bedtime with a snack can help reduce side effects that can happen. Also, you may be asleep when flushing happens.

Does niacin help with blood pressure and cholesterol?

Niacin isn’t a blood pressure medicine. Niacin can lower LDL (“bad”) cholesterol and raise HDL (“good”) cholesterol. But too much niacin can promote inflammation that leads to stroke and heart attacks.

In studies, niacin didn’t show cardiovascular benefit when added to statins. Current guidelines don’t recommend niacin as a first- or second-line treatment.