Document Detail


Nicotinic acid: clinical considerations.
MedLine Citation:
PMID:  22564238     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: Nicotinic acid (NA), the oldest hypolipidemic drug, possesses unique broad-spectrum beneficial effects on lipid profiles. Specifically, NA reduces both triglycerides and low-density lipoprotein cholesterol levels, while significantly increasing high-density lipoprotein cholesterol levels. However, NA is often avoided in the clinical setting, or prematurely discontinued by the provider or patient, due to side effects that could possibly be prevented (flushing, gastrointestinal disorders) or that are feared out of proportion to their true incidence rate (hyperglycemia, hyperuricemia).
AREAS COVERED: This article reviews NA's side effects, along with a number of old and new strategies to reduce their incidence, especially flushing. The aim of this paper is to provide a useful clinical guide to the administration of NA in dyslipidemic patients.
EXPERT OPINION: An important number of side effects affects compliance and restricts NA's clinical use. NA-induced flushing is the most restricting side effect, accounting for the majority of NA therapy discontinuations. In addition, gastrointestinal side effects, hyperuricemia, deterioration of glycemic profile, or even new-onset diabetes discourage therapy consecution. Aspirin pretreatment, considered selection and proper counseling of patients, and regular monitoring of liver aminotransferases, creatine kinase, serum uric acid levels, and glycemic profiles can reduce NA's side effect rate and improve compliance.
Authors:
Anastazia Kei; Moses S Elisaf
Publication Detail:
Type:  Journal Article; Review     Date:  2012-05-07
Journal Detail:
Title:  Expert opinion on drug safety     Volume:  11     ISSN:  1744-764X     ISO Abbreviation:  Expert Opin Drug Saf     Publication Date:  2012 Jul 
Date Detail:
Created Date:  2012-06-25     Completed Date:  2012-10-30     Revised Date:  2013-11-06    
Medline Journal Info:
Nlm Unique ID:  101163027     Medline TA:  Expert Opin Drug Saf     Country:  England    
Other Details:
Languages:  eng     Pagination:  551-64     Citation Subset:  IM    
Affiliation:
University of Ioannina, School of Medicine, Department of Internal Medicine, Ioannina, Greece.
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MeSH Terms
Descriptor/Qualifier:
Cardiovascular Diseases / chemically induced
Gastrointestinal Diseases / chemically induced
Glucose / metabolism
Homeostasis / drug effects
Humans
Hypotension / chemically induced
Lipids / blood
Liver / drug effects
Muscle, Skeletal / drug effects
Niacin / adverse effects*
Skin / drug effects
Chemical
Reg. No./Substance:
0/Lipids; 50-99-7/Glucose; 59-67-6/Niacin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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