Niaspan
The following drug information is obtained from various newswires, published
medical journal articles, and medical conference presentations.
Treatment for increasing HDL cholesterol ("good cholesterol") in patients with dyslipidemia
General Information
Niaspan is one of only two products in the United States
approved for increasing HDL levels. Low HDL cholesterol levels have
been shown to be of the highest risk factors contributing to
coronary heart disease(CHD) and other dangerous cardiac
conditions.
Possible causes of low HDL cholesterol include:
- Obesity
- Low total, high polyunsaturated fat diet
- Cigarette smoking
- Thiazide diuretics
- Some beta-blockers
- Probucol
- Anabolic steroids
- Liver or kidney failure
- Hyperthyroidism
- Some forms of diabetes
- Acute inflammation/injury/stress
- Genetic defects in proteins which influence serum HDL
concentrations.
Most drugs for treating cholesterol problems are designed to
reduce LDL ("bad cholesterol") levels. Niaspan's
active ingredient, niacin, on the other hand, is most effective in
elevating HDL ("good cholesterol") levels. This increase
in HDL has been shown to significantly reduce chances of CHD.
Niaspan's Once-At-Night dosing minimizes side effects, such
as flushing and liver enzyme elevations, associated with older
niacin preparations.
In addition to increasing HDL cholesterol, Niaspan also
lowers LDL cholesterol, triglycerides, and
lipoprotein.
Clinical Results
In clinical studies, Niaspan increased HDL levels by 14% to 32%.
(at doses of 1,000 mg to 2,000 mg per day). Furthermore, a
seven-year study published in "The New England Journal of
Medicine," indicated that a mere 6% increase in HDL
cholesterol yielded greater than 20% reductions in cardiac events
and stroke among 2,500 CHD patients whose only lipid abnormality at
baseline was low HDL cholesterol.
Kos Pharmaceuticals reports that studies showed that
changes in lipid concentrations (efficacy) are greater for
women than for men.
Side Effects
The most common side effect of Niaspan is flushing, which is
characterized by redness, tingling, or itching that typically
occurs on the face, neck, chest, and back. In most cases, the
flushing sensation lasts for one hour, approximately two to four
hours after taking the dose. To minimize flushing, avoid drinking
alcohol or hot drinks close to taking the dose, and avoid taking
Niaspan with spicy foods.
Other less frequent side effects include upset stomach and
rash.
Do NOT take Niaspan if:
- You have active liver disease
- You have peptic ulcer disease
- You have arterial bleeding
- You are allergic to any of the ingredients of the
drug
Use with caution if you consume substantial amounts of alcohol,
or if you have a past history of liver or kidney disease.
Mechanism of Action
Niacin, the main ingredient of Niaspan, raises the high-density
lipoprotein (HDL) fraction of cholesterol. HDL carries cholesterol
out of your circulation.
Literature References
Lipoprotein metabolism
Havel RJ and Kand JP (1989) "Structure and function of plasma
lipoproteins" In: "The metabolic basis of inherited
disease" (6th Edition). {Scriver CR, Beaudet Al, Sly WS, Valle
D eds} New York: McGraw-Hilll pp 1129-38.
Structure and function HDL
Eisenberg S (1984) "High density lipoprotein metabolism".
J Lipid Res 25:1017-58
Structure, function and metabolism of HDL
Carlson LA (ed). (1990) "Disorders of HDL" Smith-Gordon
Publishers, London
Additional Information