Niacin (Nicotinic acid)

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Author:
mpgcuenca
ID:
119741
Filename:
Niacin (Nicotinic acid)
Updated:
2011-11-29 23:54:17
Tags:
Anti hyperlipidemic Drugs
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Niacin (Nicotinic acid)
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  1. Niacin available drugs
    • Niacin (generic and sustained-release generic)
    • Niaspan (extended release niacin)
  2. Indication & Role
    • Best to increase HDLs 30-40%
    • Lowers LDLs 20-30%
    • Lowers triglycerides 35-45%
    • Only drug that reduces LPa by 40%
    • Reduces Cardiovascular events
  3. MoA
    • Inhibits adipose cells triglycerides (TGCs) lipolysis, decreasing hepatic glyceride synthesis.
    • May inhibit rate limiting enzyme in TGCs synthesis
    • In liver inhibits synthesis & esterification of FAs.
    • Decreases clearance of apoAI in HDL increasing HDLs
  4. RoA
    Orally in short acting or sustained release preps.
  5. 1. Absorption
    2. Distribution
    3. Metabolism
    4. Elimination
    • 1. Well absorbed orally
    • 2. Peak [plasma] (PPC) 30-60 min.
    • 3. 1/2 life 60 min.
    • 4. Taken up by liver, excess excreted in urine
  6. Common SEs
    • Hepatotoxicity indicated by >50% reduction in LDLs
    • Cutaneous effects flushing and pruritis of the face
    • Upper trunk
    • Skin rashes
    • Acanthosis nigricans
    • Flushing and associated pruritis are prostaglandin mediated thus concomitant aspirin usage may alleviate it.
    • Dyspepsia
    • Rarely nausea, vomiting, and diarrhea (N/V/D)
    • DM pts niacin can induce insulin resistance with resultant hyperglycemia.
  7. Clinical Use
    • Pts that don't tolerate statins.
    • Increase dose slowly.
    • Monitor w/in a few weeks for signs of hepatic toxicity or hyperglycemia.

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