This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on ISI (46)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Topic Collections  • Review  • Lipids and Lipid Disorders  • Alert me on articles by topic

James McKenney, PharmD

Arch Intern Med. 2004;164:697-705.

Therapy with niacin (nicotinic acid) is unique in that it improves all lipoprotein abnormalities. It significantly reduces low-density lipoprotein cholesterol, triglyceride, and lipoprotein(a) levels, while increasing high-density lipoprotein cholesterol levels. This makes niacin ideal for treating a wide variety of lipid disorders, including the metabolic syndrome, diabetes mellitus, isolated low high-density lipoprotein cholesterol, and hypertriglyceridemia. Niacin-induced changes in serum lipid levels produce significant improvements in both coronary artery disease and clinical outcomes. Niacin is currently available in 3 formulations (immediate release, extended release, and long acting), which differ significantly with respect to their safety and efficacy profiles. Immediate-release niacin is generally taken 3 times a day and is associated with adverse flushing, gastrointestinal symptoms, and elevations in blood glucose levels. Long-acting niacin can be taken once daily and is associated with significantly reduced flushing, but its metabolism increases the risk of hepatotoxic effects. Extended-release niacin, also given once daily, has an absorption rate intermediate between the other formulations and is associated with fewer flushing and gastrointestinal symptoms without increasing hepatotoxic risk.

From National Clinical Research and Virginia Commonwealth University, Richmond. Dr McKenney has served as a consultant for AstraZeneca and Pfizer; received speaking honoraria from AstraZeneca, Kos Pharmaceuticals, Merck, and Pfizer; and received research grants from AstraZeneca, BMS, GSK, Kos Pharmaceuticals, Merck, Pfizer, Sanyko, and Schering Plough.

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Lipoprotein Metabolism and Lipid Management in Chronic Kidney Disease
Kwan et al.
J. Am. Soc. Nephrol. 2007;18:1246-1261.
FULL TEXT  

Transcriptome of the subcutaneous adipose tissue in response to oral supplementation of type 2 Leprdb obese diabetic mice with niacin-bound chromium
Rink et al.
Physiol. Genomics 2006;27:370-379.
ABSTRACT | FULL TEXT  

Dissolution profiles of nonprescription extended-release niacin and inositol niacinate products.
Poon et al.
Am J Health Syst Pharm 2006;63:2128-2134.
ABSTRACT | FULL TEXT  

HDL and the progression of atherosclerosis: new insights
Sirtori
Eur Heart J Suppl 2006;8:F4-F9.
ABSTRACT | FULL TEXT  

Functionally Defective High-Density Lipoprotein: A New Therapeutic Target at the Crossroads of Dyslipidemia, Inflammation, and Atherosclerosis
Kontush and Chapman
Pharmacol. Rev. 2006;58:342-374.
ABSTRACT | FULL TEXT  

Adherence and Persistence with Single-Dosage Form Extended-Release Niacin/Lovastatin Compared with Statins Alone or in Combination with Extended-Release Niacin
LaFleur et al.
The Annals of Pharmacotherapy 2006;40:1274-1279.
ABSTRACT | FULL TEXT  

Hypertriglyceridemia.
Pejic and Lee
J Am Board Fam Med 2006;19:310-316.
ABSTRACT | FULL TEXT  

Description of the torcetrapib series of cholesteryl ester transfer protein inhibitors, including mechanism of action
Clark et al.
J. Lipid Res. 2006;47:537-552.
ABSTRACT | FULL TEXT  

Stopping Statins
Stone
Circulation 2004;110:2280-2282.
FULL TEXT