How do niacin drugs affect cholesterol?

Dr. Darria Long Gillespie, MD
Emergency Medicine
Niacin (vitamin B3) limits the production of LDL cholesterol in the liver. It can lower LDL, increase HDL, and lower triglycerides. Niacin is available as a single drug (Niacor, Niaspan) or combined with a statin (Advicor, Simcor).

Current US cholesterol management guidelines state that non-statin drugs, including niacin, are not first-line therapy, but can be added to statins for the following people: those age 75 or younger who have had a heart attack or stroke; those age 40 to 75 with diabetes; and those with untreated LDL 190 mg/dL or above. 

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Ozgen Dogan
Cardiology (Cardiovascular Disease)
Niacin, a type of vitamin B, can be very useful if you need to increase your good cholesterol (high-density lipoprotein [HDL]). It has been shown to increase HDL by 10 to 30%. Your doctor will prescribe a dose that is much higher than the amount found in multivitamins. Side effects can include temporary flushing of the skin (which can be counteracted by aspirin) and/or upset stomach.
Niacin has diverse actions affecting cholesterol formation. A primary effect appears to be that it decreases the production of triglycerides in the body, which might be the mechanism that allows this drug to decrease low-density lipoprotein (LDL) or "bad" cholesterol levels. Nicotinic acid also raises high-density lipoprotein (HDL) or "good" cholesterol levels via mechanisms not yet understood.

Some of the most common side effects of niacin drugs are flushing, hot flashes, itching, and headache. People who take niacin for a prolonged period of time, especially at high doses, should have periodic liver function tests.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.