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Clinical pharmacy 2024/2025 Level 3 Pharm D Pharmacology 1 (PO 502)

4- Niacin

 Niacin is a vitamin, the quantity of ingested in food does not

have effect on serum lipids. The action on lipids requires the
administration of several grams of niacin each day.
 strongly inhibits lipolysis in adipose tissue, thereby reducing
Mechanism of production of free fatty acids.

action  The liver normally uses circulating free fatty acids as a major
precursor for TG synthesis. Reduced liver TG levels
decrease hepatic VLDL production, which in turn reduces

LDL-C plasma concentrations.
 Niacin reduces the catabolic rate of HDL→ ↑HDL
(the most effective agent for increasing HDL-C)

Effect: decrease TGs by 20-50%

Dose Started at low dose and titrated to maximum 2 g daily

➢ flushing (especially with extended and sustained release

preparations), hyperglycemia, hyperuricemia, gastrointestinal
Adverse effects distress elevated transaminases (require LFTs monitoring)
 Flushing is minimized by aspirin or ibuprofen before

niacin or administer niacin at bedtime

Contraindications: liver disease, severe gout, active peptic ulcer

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