Nicotinic Acid (Niacin)

Registered South African indications:

• Pellagra

Contraindications

• Hypersensitivity to the active ingredient or any of its excipients

Cautions

• Pregnancy
• Breastfeeding
• Renal impairment
• Mild to moderate hepatic impairment
• Diabetes mellitus
• Gout
• Unstable angina
• Acute myocardial infarction
• Alcohol abuse

Forms avail. in SA and covered in this monograph: tab

Dyslipidaemia

• Oral (tab): Initial: 250mg, dly; Titrate at intervals of 4-7 days; Maintenance: 1.5-2g/day, in 2-3 divided doses; If needed can titrate at intervals of 2-4 weeks to 3g/day, in 3 divided doses; Max: 6g/24hrs

Pellagra

• Oral (tab): 300-500mg/day, in divided doses; Max: 500mg/24hrs

Paed. forms avail. in SA and covered in this monograph: tab

Pellagra

• Oral (tab): 50-100mg, 8hrly

Pregnancy

• FDA Pregnancy Category C

Breastfeeding

• Caution; not recommended

Renal Impairment

• Caution; no information available

Hepatic Impairment

• Mild to moderate: Caution; no information available 
• Severe: Contraindicated

Elderly

• No dose adjustment recommended

Porphyria Information

• Not porphyrinogenic (NP)

Cardiovascular Disorders

• Vasodilation
• Flushing
• Dizziness

Gastrointestinal Disorders

• Gastrointestinal disturbances

Endocrine and Metabolic Disorders

• Poor glucose control

Musculoskeletal Disorders

• Myopathy

• Alcohol
• Antidiabetic agents
• Bile acid sequestrants
• Statins

• Hepatic function

Specific cases require

• Blood glucose
• Creatine phosphokinase
• Uric acid

The mechanism by which nicotinic acid exerts its lipid-lowering effects is not fully understood but it has been shown to have a variety of favourable effects on lipid metabolism. These include inhibition of hepatic production of very-low-density lipoprotein (VLDL), reduction of cholesterol transfer from high-density lipoprotein (HDL) to VLDL thus increasing HDL concentrations, reduction in HDL clearance and a reduction in serum apolipoprotein B-100 levels.

Capsule 20mg

• HWM nicotinamide (HWM)

Tablet 25mg

• Nicotinamide (Adminicle)
• Nicotinamide (Portfolio)

Tablet 50mg

• Nicotinamide (Adminicle)

Tablet 100mg

• Nicotinamide (Adminicle)
• Nicotinamide (Pecolo)