Document Detail

Prolonged-release nicotinic acid: a review of its use in the treatment of dyslipidaemia.
MedLine Citation:
PMID:  16392885     Owner:  NLM     Status:  MEDLINE    
Prolonged-release (PR) nicotinic acid (niacin) [Niaspan] is an oral, once-daily formulation of the lipid-modifying drug designed to produce less vasodilatory flushing than crystalline immediate-release (IR) nicotinic acid and less hepatotoxicity than previous sustained-release formulations of nicotinic acid.PR nicotinic acid appears to retain the same level of efficacy as crystalline IR nicotinic acid and be better tolerated than older nicotinic acid formulations. Nicotinic acid has beneficial effects on all traditional blood lipid and lipoprotein fractions and is the most effective agent for increasing high-density lipoprotein (HDL)-cholesterol (HDL-C) and reducing lipoprotein(a). The effects of PR nicotinic acid are often additive when used in combination with HMG-CoA reductase inhibitors (statins), making it a useful addition when lipid goals are not achieved with the usual statin monotherapy or when additional correction of a specific lipid abnormality is required. PR nicotinic acid also slows atherosclerotic progression and even appears to produce regression of atherosclerosis in patients on stable statin therapy. PR nicotinic acid is a logical drug choice for treating atherogenic dyslipidaemia commonly associated with type 2 diabetes mellitus and the metabolic syndrome, and has been shown to be effective in patients with diabetes without adversely affecting glycaemic control in the majority of patients. The incidence of vasodilatory flushing with PR nicotinic acid is lower than with IR nicotinic acid and it decreases substantially over time as tolerance develops. To date, there has been no clinically significant hepatotoxicity observed with PR nicotinic acid. Therefore, once-daily PR nicotinic acid appears to maximise the potential benefits of nicotinic acid, while minimising any historical tolerability or safety concerns.
Paul L McCormack; Gillian M Keating
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Drugs     Volume:  65     ISSN:  0012-6667     ISO Abbreviation:  Drugs     Publication Date:  2005  
Date Detail:
Created Date:  2006-01-05     Completed Date:  2006-04-14     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  7600076     Medline TA:  Drugs     Country:  New Zealand    
Other Details:
Languages:  eng     Pagination:  2719-40     Citation Subset:  IM    
Adis International Limited, Auckland, New Zealand.
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MeSH Terms
Antilipemic Agents / administration & dosage,  pharmacokinetics,  therapeutic use*
Delayed-Action Preparations
Dose-Response Relationship, Drug
Drug Therapy, Combination
Dyslipidemias / drug therapy*
Niacin / administration & dosage,  pharmacokinetics,  therapeutic use*
Randomized Controlled Trials as Topic
Reg. No./Substance:
0/Antilipemic Agents; 0/Delayed-Action Preparations; 59-67-6/Niacin

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

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