Your records indicate that you’ve been prescribed niacin (also called nicotinic acid, or vitamin B3) to help control your cholesterol. This sheet tells you about cholesterol, how niacin can help you improve your health, and how you can get the most benefit from your medication plan. Keep in mind that medications are only one part of your treatment plan. Diet and exercise also play key roles in improving your health.

Understanding Cholesterol

Cholesterol is a soft, waxy substance that is carried in the blood. Some cholesterol is produced by the liver. And some cholesterol is absorbed by the body from the foods you eat. There are two main types of cholesterol: LDL (bad cholesterol) and HDL (good cholesterol). When levels are healthy, cholesterol helps the body function properly. But if cholesterol levels are unhealthy, a material called plaque can build up in the arteries. Plaque damages arteries and reduces blood flow. This raises the risk of heart attack and stroke. It can also lead to problems in the eyes, kidneys, and blood vessels in the legs.

How Does Niacin Treat Cholesterol?

Along with diet and exercise, niacin helps improve cholesterol levels in the body. This makes the arteries less likely to become clogged. So blood flow is less likely to be reduced. Niacin does the following:

• Reduces production of LDL (“bad”) cholesterol.

• Increases the production of HDL (“good”) cholesterol. HDL helps remove LDL cholesterol from the blood.

• Lowers the level of triglycerides (fat) in the blood.

How to Use Niacin

• Niacin is taken in capsule or tablet (immediate- or extended-release) form. It can also be taken as a drinkable solution. Follow the detailed instructions that came with your medication.

• Take this medication every day on schedule. Most people who take cholesterol medications do so every day for the rest of their lives. Develop a routine for taking your medication so that you don’t forget.

• If you miss a dose of this medication, take it as soon as you remember. But if it’s almost time for your next dose, skip the missed dose and go back to your regular schedule. (Talk with your healthcare provider about what “almost time” means.) Do not take a double dose.

• Once you’ve started this medication, do not stop taking it without first speaking with your healthcare provider. Stopping can make your condition worse. If your healthcare provider recommends stopping, follow his or her instructions carefully.

• Refill your prescription while you still have a little medication left, so you don’t run out. Ask your healthcare provider to write an “extra” prescription in case of an emergency. If you use mail order, be sure to place your order with enough time for the medication to arrive while you still have some left.

• When you travel, make sure you have enough medication to last for your entire trip. When traveling by air, keep your medications with you, not packed in your luggage. Carry your prescription labels with you (either the original packaging or a photocopy). For more information about traveling with your medications, visit the Transportation Security Administration website: www.tsa.gov.

• Along with daily niacin use, follow any diet and exercise plan your healthcare provider prescribes. This will help limit the amount of cholesterol that can enter and build up in your body. It will also help niacin work as well as possible.

What to Know About Niacin for Cholesterol Treatment

• Over time, your healthcare provider may raise or lower the dosage of your niacin. The goal is to find the amount of medication to keep your cholesterol under control without taking more than is needed. Do not take more or less of this medication than your healthcare provider has prescribed.

• The usual prescribed dosage of niacin rarely causes serious side effects. Possible side effects include abdominal pain, diarrhea, dizziness, or flushing (reddening of the skin). In any case, talk to your healthcare provider about side effects that are bothersome. He or she may be able to adjust the dosage or medication you are taking. In the meantime, do not stop taking your niacin. Doing so can make your condition worse.

• Do the following to help limit side effects:

  • If you take immediate-release niacin, NEVER substitute it with extended-release niacin. Doing so could cause liver failure.

  • If you take extended-release capsules, swallow them whole. Do not break up or chew capsules before taking them.

  • If you take extended-release tablets, take them before going to bed, following a low-fat snack. The tablets should be swallowed whole. Do not break up or chew tablets before swallowing them. And to lower the effects of flushing, take aspirin or ibuprofen 30 minutes before taking your medication. Also, to reduce the risk of flushing, do not drink alcoholic or hot beverages around scheduled dose times.

  • If you take statins, talk to your healthcare provider before taking niacin. You may be at increased risk for muscle problems when these two medications are taken together.

• If you think you might be pregnant, call your healthcare provider right away. Niacin may harm an unborn child.