In this episode, I discuss a medication known as niacin (Niaspan, Niacor, Niacinol, Nicotinex).
Everybody welcome back to another episode of drug talk as always i’m your host garrett campbell hearing me discussing a medication known as niacin its brand name is nice span before i talk about the medication itself just keep in mind that this channel is for information purposes only and not to be used as a source for recommendations for your personal healthcare
So niacin or nicotinic acid is a b-complex vitamin that has anti hyperlipidemia effects the exact mechanism of action is still not completely understood although it may involve actions such as esterification of hepatic triglycerides decreased release of free fatty acids from adipose tissue and increased activity of lipoprotein lipase which enhances the removal
Of chylomicron triglycerides from the plasma iesson has the ability to increase hdl or high density lipoprotein decrease triglycerides decrease ldo as well as decreasing total cholesterol so there are a couple different specific indications for niacin the most common ones would be for dis lipedema azur hyperlipidemia it can be used in combination with a bile
Acid binding resin to treat coronary atherosclerosis it can be used to treat primary hypercholesterolemia niacin can treat severe cases of hypertriglyceridemia finally can also be used prophylactically in patients who have previously suffered from a myocardial infarction and also have dis lavinius before somebody was to use niacin or niacinamide precautions and
Warnings that they should be made aware of is contraindicated in patients who have active liver disease or unexplained persistent elevations in their liver transaminases it’s also contraindicated in patients who have an active peptic ulcer patients who have arterial bleeding can also not use doxepin and the final contraindication would be for any individual that
Has a hypersensitivity to niacin moving on now to precautions it should be used cautiously and in the have unstable angina or in individuals or in that acute phase post myocardial infarction would have to be even more careful if they’re using niacin in these situations with other vasoactive drugs patients may notice an increase in fasting glucose some patients
Would require monitoring of this especially if they’re elderly or predisposed to diabetes some patients may experience an increase in uric acid so it should be as cautiously in patients who have a history of goat reduction in phosphorus levels may occur so for patients in whom this would be an issue they would require more close monitoring care professionals
Should be cautious when prescribing this medication to individuals who have a history of a peptic ulcer an increase in prothrombin time may occur in some patients they’ll be more at risk for this if they use other anticoagulants these patients may also notice a decrease in their platelet count they must also be used cautiously in patients who have a history of a
Patou by larry disease or jaundice some patients may experience an increase in their liver tests some when they’re testing for those liver enzymes rhabdomyolysis has been reported with niacin in patients who are also using statins patients who have diabetes renal failure or uncontrolled hypothyroidism would be at a greater risk of this and finally it should also
Be used cautiously in patients who have renal impairment and when somebody is cleared of the contraindications and made aware of the precautions and warnings and they start using niacin they can expect to take it in tablet form when somebody is using niacin to treat coronary atherosclerosis in combination with a bile acid binding resin they can use 500 milligrams
Daily to start it would then increase this dose by about 500 milligrams every four weeks to a maximum dose of 2,000 milligrams daily usual maintenance dose would be somewhere in between 1,000 and 2,000 milligrams daily it’s also important to note that with these doses i’m talking about the extended-release tablet when somebody is using niacin to treat their mixed
Disappears they can use the immediate release version of the tablet typically they would start off using 205 milligrams daily it would then increase the dose every four or seven days until reaching the dose of 1.5 grams or 2 grams daily this dose would typically be broken up throughout the day after two months of using this therapy the patient still doesn’t reach
Their disability and goals they can then increase the dose in intervals of every 2 or 4 weeks up to 3 grams daily maximum dose in this situation would be 6 grams in one day individuals with hyperlipidemias who are using this medication after a heart attack they would usually use 500 milligrams daily typically take their dose at bedtime and if needed they would
Increase their dose every 4 weeks or so until reaching a maximum dose of 2,000 milligrams a day in this situation they would usually be using the extended-release tablet now there are some side effects or adverse reactions that may happen to some patients when they’re using niacin or niacinamide effect would definitely be flushing this happens 88% of the time
Four to nine percent of patients experience nausea and 2 to 9% experience vomiting some serious but rare side effects would be hepatic necrosis padow toxicity or rhabdomyolysis it’s all we’re gonna talk about today with niacin or nice and as always i’m thankful that you took the time to come by and watch one of my videos if you found the information valuable
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Transcribed from video
NIACIN (NIASPAN) – PHARMACIST REVIEW – #66 By Drug Talk
