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Niacor (Niacin) - Summary

 
 



NIACOR SUMMARY

Niacin or nicotinic acid, a water-soluble B-complex vitamin and antihyperlipidemic agent, is 3-pyridinecarboxylic acid. It is a white, crystalline powder, sparingly soluble in water.

Niacor is indicated for the following:

I. Therapy with lipid-altering agents should be only one component of multiple risk factor intervention in those individuals at significantly increased risk for atherosclerotic vascular disease due to hypercholesterolemia. Nicotinic acid, alone or in combination with a bile-acid binding resin, is indicated as an adjunct to diet for the reduction of elevated total and LDL cholesterol levels in patients with primary hypercholesterolemia (Types IIa and IIb)†, when the response to a diet restricted in saturated fat and cholesterol and other nonpharmacologic measures alone has been inadequate (see also the NCEP treatment guidelines6). Prior to initiating therapy with nicotinic acid, secondary causes for hypercholesterolemia (e.g., poorly controlled diabetes mellitus, hypothyroidism, nephrotic syndrome, dysproteinemias, obstructive liver disease, other drug therapy, alcoholism) should be excluded, and a lipid profile performed to measure total cholesterol, HDL cholesterol, and triglycerides.

II. Nicotinic acid is also indicated as adjunctive therapy for the treatment of adult patients with very high serum triglyceride levels (Types IV and V hyperlipidemia)† who present a risk of pancreatitis and who do not respond adequately to a determined dietary effort to control them. Such patients typically have serum triglyceride levels over 2000 mg/dL and have elevations of VLDL cholesterol as well as fasting chylomicrons (Type V hyperlipidemia)†. Subjects who consistently have total serum or plasma triglycerides below 1000 mg/dL are unlikely to develop pancreatitis. Therapy with nicotinic acid may be considered for those subjects with triglyceride elevations between 1000 and 2000 mg/dL who have a history of pancreatitis or of recurrent abdominal pain typical of pancreatitis. Some Type IV patients with triglycerides under 1000 mg/dL may, through dietary or alcoholic indiscretion, convert to a Type V pattern with massive triglyceride elevations accompanying fasting chylomicronemia, but the influence of nicotinic acid therapy on the risk of pancreatitis in such situations has not been adequately studied. Drug therapy is not indicated for patients with Type I hyperlipoproteinemia, who have elevations of chylomicrons and plasma triglycerides, but who have normal levels of VLDL. Inspection of plasma refrigerated for 14 hours is helpful in distinguishing Types I, IV, and V hyperlipoproteinemia7.


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NEWS HIGHLIGHTS

Published Studies Related to Niacor (Niacin)

Changes in lipoprotein particle number with ezetimibe/simvastatin coadministered with extended-release niacin in hyperlipidemic patients. [2013]
CONCLUSIONS: These results suggest that E/S+N improves lipoprotein particle

MRI-measured regression of carotid atherosclerosis induced by statins with and without niacin in a randomised controlled trial: the NIA plaque study. [2013]
plaque regression among older individuals with established atherosclerosis... CONCLUSIONS: Treatment with statin therapy to presently recommended LDL levels,

Extended-release niacin acutely suppresses postprandial triglyceridemia. [2012]
triglycerides are related to free fatty acid restriction... CONCLUSIONS: Given right before a fat meal, even a single dose of

Effect of niacin on erectile function in men suffering erectile dysfunction and dyslipidemia. [2011.10]
INTRODUCTION: Dyslipidemia is closely related to erectile dysfunction (ED). Evidence has shown that the lipid-lowering agent, 3-hydroxy-3-methylglutaryl-coenzyme A reductase inhibitor (statins), can improve erectile function. However, information about the potential role of another class of lipid-lowering agent, niacin, is unknown. AIM: To assess the effect of niacin alone on erectile function in patients suffering from both ED and dyslipidemia... CONCLUSIONS: Niacin alone can improve the erectile function in patients suffering from moderate to severe ED and dyslipidemia. (c) 2011 International Society for Sexual Medicine.

Extended-release niacin/laropiprant lowers serum phosphorus concentrations in patients with type 2 diabetes. [2011.07]
BACKGROUND: Niacin compounds lower serum phosphorus concentrations in patients with end-stage renal disease. METHODOLOGY: We evaluated the impact of extended release niacin, given in fixed-dose combination with laropiprant, a specific inhibitor of prostaglandin-mediated, niacin-induced flushing, versus placebo, on serum phosphorus concentrations measured serially (at weeks 0, 4, 8, 12, 18, 24, 30, and 36) during a 36-week randomized, controlled trial...

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Clinical Trials Related to Niacor (Niacin)

Niacin on Immune Activation : a Proof-of-concept Study [Active, not recruiting]
There are a number of powerful anti-HIV drugs, which keep the virus at undetectable levels and enable HIV-infected individuals to live longer. However, some participants taking anti-HIV drugs do not achieve an adequate CD4 recovery and remain at risk for developing AIDS and non-AIDS-related complications. ER niacin (PrNiaspanFCT) is an extended-released form of niacin, also known as vitamin B3. Niacin is effective in reducing cholesterol levels in the blood. This drug has been known for a long-time to treat dyslipidemia and it is used to improve favourably all the lipoprotein risk factors for artherosclerotic disease, particularly in HIV-infected patients. Recent scientific research shows that regular consumption of niacin-rich foods may also provide protection against Alzheimer's disease and age-related cognitive decline. The purpose of this study is to find out: 1. If ER niacin combined with anti-HIV drugs, compared with anti-HIV drugs alone, could reduce T cell immune activation and enhance CD4 recovery; 2. If ER niacin can improve your quality of life and your neurocognitive functions

Biosynthesis of PGD2 in Vivo [Completed]
We would like to see if aspirin could block niacin-induced flushing by analyzing blood and urine after taking aspirin. Phase I: 5 days of 81 mg aspirin/placebo followed by 600 mg Niacin, 2 week washout and 5 days taking the alternate. The order in which this is given will be randomized or assigned by chance. Phase II: One study week consisting of 5 days of taking 81 mg Aspirin, taken once daily, followed by a single dose of 600 mg Niacin on day 6. Phase III: 5 days taking 81 mg Aspirin/placebo, 10 day washout in between. Phase IV: Use of extended release niacin instead of instant release. Phase V: A Celebrex study is necessary to explore the contribution of Cox-2 to niacin induced flushing.

Nicotinamide Versus Sevelamer Hydrochloride on Phosphatemia Control on Chronic Hemodialysed Patients [Recruiting]
The comparison between nicotinamide and sevelamer aims to demonstrate, in chronic hemodialysed patients, the non-inferiority of nicotinamide in terms of control of the phosphatemia. Secondary objectives is to compare the two treatments in terms of efficiency in other biological parameters, vascular calcification and bone mass loss and on the clinical and biological tolerance and finally to explore the roles of metabolites of nicotinamide.

Effect of Niacin on Transport of HDL and Relationship to Atherogenic Lipoproteins and Lipolysis [Completed]
This study looks at whether niacin improves reverse cholesterol transport (RCT) in healthy volunteers. 3H-Cholesterol will be used to measure RCT by analyzing changes in the tracer activity in total plasma, lipoproteins, red blood cells (RBCs) and stool. The hypothesis is that niacin augments reverse cholesterol transport.

Short-term Effect of Extended-release Niacin on Endothelial Function. [Completed]
Individuals with reduced plasma concentration of high-density lipoprotein (HDL) cholesterol are more susceptible to oxidative stress and often present reduced endothelial function, which has been mainly related to this susceptibility. Studies in animal and cell models have demonstrated that niacin activates both GPR-109A in leukocytes and heme oxygenase-1 (HO-1) pathway promoting strong anti-inflammatory and anti-oxidative effects. . In this context, the aim of this study was to investigate the short-term effect of niacin on endothelial function and verify the existence of interaction of PGD2 receptor antagonist, i. e.

laropiprant (LRPT), in subjects with low HDL-cholesterol (HDL - C).

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PATIENT REVIEWS / RATINGS / COMMENTS

Based on a total of 2 ratings/reviews, Niacor has an overall score of 6.50. The effectiveness score is 6 and the side effect score is 6. The scores are on ten point scale: 10 - best, 1 - worst.
 

Niacor review by 63 year old male patient

  Rating
Overall rating:  
Effectiveness:   Highly Effective
Side effects:   Mild Side Effects
  
Treatment Info
Condition / reason:   hypercholesterolemia w/ low LDL
Dosage & duration:   1,000mg taken 1x - 2x / day for the period of 6 mos
Other conditions:   CAD, hypertension
Other drugs taken:   Lipitor, Toporol, Plavix, HCTZ, Asprin, Omega 3 supplement, CoQ10
  
Reported Results
Benefits:   Very effective increase of HDL
Side effects:   Flushing in the beginning.
Comments:   I added supplements after statins were not effective at raising HDL to "good" levels. Although excellent at reducing LDL. The most dramatic effect was the addition of Niacin. I've added other anti-oxidants and supplements since, but the measurable results from Nicin therapy were dramatic.

 

Niacor review by 54 year old female patient

  Rating
Overall rating:  
Effectiveness:   Ineffective
Side effects:   Severe Side Effects
  
Treatment Info
Condition / reason:   high cholesterol
Dosage & duration:   100 mg gradually increasing to 400 mg taken three times a day for the period of 4 days
Other conditions:   osteoporosis
Other drugs taken:   fosamax
  
Reported Results
Benefits:   I was not willing to deal with the effects of the drug three times a day and so I discontinued use.
Side effects:   There were no side effects -- but the expected effects were very intense -- a hot flush that moved from my face to my legs, and itching on my arms, legs, back, and torso.
Comments:   Niacin taken in such a large dose opens the capillaries. This increases the blood flow close to the skin and releases histamines. The resulting hot flush and itching lasts for about 15 minutes. It is an interesting experience, but three times a day is a bit much, especially during my at work dose. The red face was alarming my customers and the itching was a bit too distracting.

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Page last updated: 2014-11-30

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