Niaspan

Generic name: Niacin

What is Niaspan?

Niaspan is a medication that is used along with diet and exercise to improve cholesterol levels. Niaspan increases "good" HDL cholesterol in your body and also lowers the "bad" LDL cholesterol and triglycerides in your body. Niaspan is for people whose cholesterol has not come down enough with exercise and a low-fat diet alone.

Niaspan is also prescribed to combat clogged arteries, heart disease, and lower the chance of repeated heart attacks. Niaspan is often taken along with another drug called a bile acid binding resin. It can also be prescribed with statins. Niaspan is also used to reduce very high levels of the blood fats known as triglycerides, a condition that can cause inflammation of the pancreas.

What is the most important information I should know about Niaspan?

Taking Niaspan is not a substitute for following a healthy low-fat and low-cholesterol diet and exercising to lower your cholesterol.

Niaspan preparations should not be substituted for equivalent doses of immediate-release niacin. If you make such a substitution in your medications, it may lead to very severe liver problems. If you are switching from immediate-release niacin to Niaspan, which is delayed-release, therapy with Niaspan should start with low doses and the Niaspan dose should then be titrated to get the desired response. Your doctor will perform liver tests on you while you are taking Niaspan.

Use Niaspan with caution in patients who consume substantial quantities of alcohol and/or have a past history of liver disease due to the possible side effects that may occur.

If you are currently on both a HMG-CoA reductase inhibitor (also known as a "statin") and Niaspan, you should carefully monitor for any signs and symptoms of muscle pain, tenderness, or weakness, particularly during the initial months of therapy and when the dose of either drug is being increased. The potential benefits and risks should be weighed carefully before combining these medicines.

Do not drive or perform other possibly unsafe tasks until you know how you react to Niaspan; this drug may cause dizziness or lightheadedness. These effects may be worse if you take it with alcohol or certain medicines.

Niaspan may cause dizziness; alcohol, hot weather, exercise, or fever may increase this effect. To prevent it, sit up or stand slowly, especially in the morning. Sit or lie down at the first sign of this effect.

If you stop taking Niaspan for an extended period, contact your doctor before you start taking it again. Your dose may need to be adjusted.

Flushing occurs with Niaspan and may last for several hours. Talk with your doctor if flushing becomes bothersome. Take Niaspan at bedtime so that flushing will occur during sleep. If you are awakened by flushing at night, get up slowly, especially if you feel dizzy or faint or if you are taking blood thinners. Take aspirin or a nonsteroidal anti-inflammatory drug (NSAID) (such as ibuprofen) 30 minutes before taking Niaspan to lessen flushing.

Niaspan may cause the results of some tests for urine glucose to be wrong. Ask your doctor before you change your diet or the dose of your diabetes medicine.

Do not take large doses of vitamins while you use Niaspan unless your doctor tells you to.

Who should not take Niaspan?

Do not take Niaspan if you are allergic to the medication or any of its ingredients. Also, do not take Niaspan if you have liver disease, active peptic ulcer disease, or a history of arterial bleeding.

What should I tell my doctor before I take the first dose of Niaspan?

Tell your doctor about all prescription, over-the-counter, and herbal medication you are taking before beginning treatment with Niaspan. Also, talk to your doctor about your complete medical history, especially if you have heart, kidney, or liver problems. Tell your doctor if you have diabetes; muscle pain or disease; gallbladder problems; history of bleeding; consume large amounts of alcohol; have severe low blood pressure, gout, or a history of jaundice (yellowing of your skin or eyes related to liver problems).

What is the usual dosage?

The information below is based on the dosage guidelines your doctor uses. Depending on your condition and medical history, your doctor may prescribe a different regimen. Do not change the dosage or stop taking your medication without your doctor's approval.

Adults 21 and older: The usual starting dose is 500 milligrams (mg) taken 1 time each day at bed time. Every 4 weeks, your doctor may increase your dosage by no more than 500 mg. The recommended maintenance dose is 1000 mg (two 500 mg tablets or one 1000 mg tablet) to a maximum of 2000 mg (two 1000 mg or four 500 mg tablets) daily. Women may respond to lower doses than men.

If Niaspan is discontinued for an extended period of time, the drug should be reintroduced with small increases in dose made over a period of time.

How should I take Niaspan?

Take each dose of Niaspan with a full glass of water at bedtime, after a low-fat snack (such as low-fat yogurt, banana, or crackers with a glass of milk). It is not recommended to take Niaspan on an empty stomach. Swallow Niaspan whole. Do not crush, chew, or break the tablets. To lessen the chance of side effects such as flushing, avoid alcohol, hot beverages, and spicy foods near the time you take Niaspan. Flushing is when your face, neck, chest, and back become red, warm, itchy, or if you feel a tingling sensation on any of these areas of your body. Your doctor may also tell you to take aspirin or a nonsteroidal anti-inflammatory drug 30 minutes before taking Niaspan in order to help prevent flushing.

If you are taking Niaspan with bile acid-binding resins, you should wait 4 to 6 hours, or as much time as possible, between the time when you take the bile acid-binding resins and the time when you take Niaspan.

What should I avoid while taking Niaspan?

Avoid hot or alcoholic beverages and do not eat spicy foods around the time when you take Niaspan. Do not break, crush, or chew Niaspan caplets.

Do not drive or perform other possibly unsafe tasks until you know how you react to Niaspan; this drug may cause dizziness or lightheadedness.

Avoid sitting or standing up too quickly when you are taking Niaspan, especially in the morning or in the middle of the night. Sit or lie down at the first sign of dizziness, a side effect of Niaspan.

Do not take large doses of vitamins while you use Niaspan unless your doctor tells you to.

What are possible food and drug interactions associated with Niaspan?

If Niaspan is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining Niaspan with the following: alcohol or hot drinks, anticoagulants such as warfarin, antihypertensive therapy, aspirin, cholesterol-lowering drugs known as bile acid sequestrants, fibrates such as gemfibrozil, HMG-CoA reductase inhibitors such as lovastatin, or vitamins or other nutritional supplements containing large doses of niacin.

What are the possible side effects of Niaspan?

Side effects cannot be anticipated. If any develop or change in intensity, tell your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking this drug.

Taking multivitamins containing large doses of niacin and related compounds may increase the chance of side effects from Niaspan.

Side effects may include: abdominal pain, chills, diarrhea, dizziness, fainting, flushing, headache, indigestion, itching, nasal inflammation, nausea, pain, rapid heartbeat, rash, shortness of breath, skipped beat during heartbeat, sweating, swelling, vomiting

In rare cases, it may be possible for people who take Niaspan along with cholesterol-lowering medications called statins, like lovastatin, to develop muscle aches and pains, muscle disintegration, or muscle disease. Tell your doctor if you experience any muscle pain, tenderness, or weakness.

Flushing occurs with Niaspan and may last for several hours. Talk with your doctor if flushing becomes bothersome. Take Niaspan at bedtime so that flushing will occur during sleep. If you are awakened by flushing at night, get up slowly, especially if you feel dizzy or faint or if you are taking blood thinners. Take aspirin or a nonsteroidal anti-inflammatory drug (NSAID) (such as ibuprofen) 30 minutes before taking Niaspan to lessen flushing.

Can I receive Niaspan if I am pregnant or breastfeeding?

The effects of Niaspan during pregnancy are unknown. Tell your doctor immediately if you are pregnant or plan to become pregnant. Talk to your doctor if you are breastfeeding; Niaspan is found in breast milk and may cause harm to your baby.

What should I do if I miss a dose of Niaspan?

If you miss a dose of Niaspan and you are taking 1 dose daily at bedtime, skip the missed dose. Do not take the dose in the morning or 2 doses at once. Continue your regular dosing regimen after the missed dose.

How should I store Niaspan?

Store Niaspan at room temperature. Store away from heat, moisture, and light. Do not store in the bathroom. Keep Niaspan out of the reach of children.