How Does Niacin Work and How Should I Take It?

Niacin may be taken alone or with another cholesterol lowering medication, such as a statin drug, in order to reduce cholesterol levels. Over-the-counter and prescription formulations (like Niaspan® and Nicolar®) may include other vitamins or minerals.

Although niacin has been found to lower triglyceride and low density lipoprotein (LDL) levels and raise high density lipoprotein (HDL)levels, the degree in which this drug works varies from patient to patient. That is, niacin may significantly reduce triglycerides and LDL level in one patient, but may be ineffective in another patient. The mechanism by which niacin works is not completely known.

Niacin is typically administered in dosages from 500 mg up to 2000 mg. Higher doses are reserved for individuals who have high levels of cholesterol and can be usually obtained through a prescription.

Here are some tips on how to take niacin:

• Since the dosages vary between different brands of niacin, it is important to follow the manufacturer instructions concerning dosage.
• Gradually introduce niacin to your system instead of taking the recommended niacin dose on Day 1.

  For instance, if you want to take a total of 500 mg of regular or timed-release niacin and you have 250 mg tablets, try taking just 250 mg for about a week. This will minimize symptoms associated with niacin therapy. If you do this, do not cut timed-release pills, as this will cause the pills to no longer be timed-release.

• Take it at bedtime.
• Take niacin on a full stomach.

***Most importantly, as with any other type of medication, consult your health care practitioner to make sure niacin will not interfere with any other conditions you may have or other medications you are taking.

Common Side Effects Associated With Niacin

There are many side effects associated with niacin that vary in degree from each individual. These side effects seem to correlate with dosage strength and may be reduced if you are taking a time-released form of niacin. Symptoms typically disappear over a week or so, as your body is adjusting to the medication. They include, but are not limited to:

• flushing (redness, itching, warmth, redness)
• night sweats
• palpitations, cardiac fibrillations, or other arrhythmias
• decreased glucose tolerance
• migraines
• skin hyperpigmentation