After triple by-pass in 1996 I tried diet and exercise for a year. My cholesterol numbers improved but not enough for a person with 4 risk factors. In late 1997 I went on Niaspan working up from 500mg to 2000mg in 500mg increments.My results have been really great and if anything seem to be getting better. I just got my latest report yesterday.

Total C--------172
LDL-------------86
HDL-------------77
Tri-------------46
Lp{a}----------7.1

That brings out the smiles.

bob

please tell me, what is niaspan? i cant tolerate tricor that i was put on, am taking niacin hexaniacinate, 600-900 mgs. is it similar, does it work? thanks

msulayla,

Niaspan is the only FDA approved form of niacin. Standard niacin will indeed lower Triglycerides, Lp[a] and LDL. It will also raise HDL. However, it takes 1500-2000mg to be really effective for most people. That quanity of niacin causes severe flushing for most people. Also, it can cause liver damage. Niaspan is an extended release form of niacin which reduces the flushing and possibility of liver damage. When using any form of niacin your doctor should run periodic tests for liver function. I have blood tests every 6 mo. which measures the lipid profile as well as liver function, sugar and many other items. Immediate release niacin must be taken three times a day while Niaspan is taken only once a day at bedtime. A aspirin taken 1/2 hour before the Niaspan helps to reduce the flushing. Niaspan must be increased slowly to minimize the flushing. I started with 500mg and worked up to 2000mg in 500mg increments. I had flushing in the beginning but it went away after time. I have been on Niaspan since late 1997 with no side effects except the flushing which as I said went away after time. I probably sound like a commercial but my results have been so good I tell all my family and friends who may have a need for Niaspan. I had triple bypass in 1996 and would like to prevent my family and friends from going through that. Best of luck to you.

bob

Do you mean that you take 2,000mg Niaspan all at once? Why? Why can't you take it in divided doses over the course of the day? That is an awfully large dose to take all at once.

Actually, with the inositol hexanicotinate, the dosage recommendations are between 2,000-3,000mg per day, to be taken in divided doses.

Arizona,

Niaspan is designed for once a day dossage. If you have flushing it is at night while sleeping. Immeadiate release niacin doesn't stay in your system very long which means you have to take it frequently. Niaspan is formulated for 24 hour retention. Unlike a other niacin products Niaspan is FDA approved. That means they went through phase 1, 11 and 111 trails for safety and efficacy.

For years doctors knew that niacin would improve the lipid profile. The side effects prevented widespread acceptance by doctors. Niaspan reduces the side effects to a tolerable level. In my case I know this is true because I have been on Niaspan for 6 years.

best

bob

Sixers,

I'm just trying to understand the rational of taking a large dose(2,000mg)of Niaspan all at the same time. Now, twenty four hours is a long time. It stands to reason that in that period of time the pills may actually pass through the body. Normally, a time-release pill will dissolve within 6 hours, which is a reasonable amount of time. But twenty four hours? I don't know. Suppose you were to take it in divided doses, say 500mg at breakfast, another 500mg at lunch, 500mg after dinner, and finally 500mg before bedtime? Wouldn't that work just as well, or better, instead of dosing yourself with 2,000mg all in one shot? Or doesn't it matter.

Arizona,

The following is taken from one of the Niaspan patents. This is a quote.

SUMMARY OF THE INVENTION

In brief, the present invention alleviates and overcomes certain of the above-identified problems and shortcomings of the present state of nicotinic acid therapy through the discovery of novel nicotinic acid formulations and methods of treatment.

Generally speaking, novel nicotinic acid formulations have been discovered that optimize blood levels of nicotinic acid over a period of about 5 to about 9 hours when administered as a single oral dose for achieving a balanced lipid alteration in individuals at a time when the rate of serum lipids, lipoproteins, cholesterol and cholesterol precursor biosynthesis is believed to be at its highest. In other words, the novel nicotinic acid formulations have been uniquely formulated for administration as a single dose, preferably during the evening or at night when the nicotinic acid levels subsequently achieved are effective for substantially lowering the levels of total cholesterol, LDL cholesterol, triglycerides and/or Lp(a) as well as raising the levels of HDL particles, all of which are primary nocturnally synthesized. Preferably, the nicotinic acid formulations are administered at or after an evening meal or low fat snack but before bedtime, i.e., between about 6 pm and 12 am, preferably between about 8 pm and 12 am, and most preferably between about 8pm and 10 pm.

The amount of nicotinic acid that is administered is effective to substantially lower at least one serum lipid, such as total cholesterol, LDL cholesterol, triglycerides, and/or Lp(a) and elevated HDL,, without causing drug-induced hepatotoxicity to levels which would require the therapy to be discontinued. In other words, a single 1 to 3 gram dose of a nicotinic acid formulation of the present invention administered between about 6 pm and 12 am is believed to be as effective as an equal or higher daily dosage of nicotinic acid administered in two to four divided doses between, e.g., 8 am and 8 pm.

Furthermore, because at least the majority of the nicotinic acid is released and metabolized in vivo during a limited predetermined period of time of about 5 to about 9 hours, the liver is not being exposed to constant levels of nicotinic acid which results during the administration of long-term, spaced daily doses of SR nicotinic acid. Thus, it is believed that the nicotinic acid formulations of the present invention are unlikely to cause individuals to develop dose-limiting hepatotoxicity when used as a single daily dose administered in a therapeutic amount.

The nicotinic acid formulations in accordance with the present invention have been uniquely designed as intermediate release formulations which can be characterized by one or more of the following biopharmaceutic characteristics: (1) an in vivo stair-stepped or sigmoidal-shaped absorption profile when the plasma nicotinic acid or NUA data is deconvoluted using the Wagner-Nelson method; (2) an in vitro dissolution profile; (3) a fit factor F.sub.2 ; (4) urine metabolite recovery; (5) AUC; (6) Cmax; and/or (7) Tmax. By the term "intermediate release," it is used herein to characterize the nicotinic acid formulations of the present invention which release their medication in vitro or in vivo over a period of time which is greater than about 1 to 2 hours, i.e., slower that IR niacin, but less than about 10 to 24 hours, i.e., faster than SR niacin.

It is therefore, an object of the present invention to provide a composition of nicotinic acid or any compound which is metabolized by the body to form nicotinic acid for treating hyperlipidemia.

It is another object of the present invention to provide a composition as above, which as a time release sustaining characteristic.

It is yet another object of the present invention to provide a method for employing a composition as above, for treating hyperlipidemia, which results in little or no liver damage.


Arizona, here is some useful background information.

BACKGROUND

Nicotinic acid, 3-pyridinecarboxylic acid or niacin, is an antilipidemic agent that is marketed under, for example, the trade names Nicolar.RTM., SloNiacin.RTM., Nicobid.RTM. and Time Release Niacin.RTM.. Nicotinic acid has been used for many years in the treatment of lipidemic disorders such as hyperlipidemia, hypercholesterolemia and atherosclerosis. This compound has long been known to exhibit the beneficial effects of reducing total cholesterol, low density lipoproteins or "LDL cholesterol," triglycerides and apolipoprotein a (Lp(a)) in the human body, while increasing desirable high density lipoproteins or "HDL cholesterol".

Typical doses range from about 1 gram to about 3 grams daily. Nicotinic acid is normally administered two to four times per day after meals, depending upon the dosage form selected. Nicotinic acid is currently commercially available in two dosage forms. One dosage form is an immediate or rapid release tablet which should be administered three or four times per day. immediate release ("IR") nicotinic acid formulations generally release nearly all of their nicotinic acid within about 30 to 60 minutes following ingestion, as illustrated in FIG. 1. The other dosage form is a sustained release form which is suitable for administration two to four times per day. See, however, U.S. Pat. No. 5,126,145 issued to O'Neill. In contrast to IR formulations, sustained release ("SR") nicotinic acid formulations are designed to release significant quantities of drug for absorption into the blood stream over specific timed intervals, also as shown in FIG. 1. If the release occurs at appropriate times, therapeutic levels will be maintained by SR nicotinic acid formulations over an extended period such as 12 or 24 hours after ingestion.

The dosing regimen of IR nicotinic acid is known to provide a very beneficial effect on blood lipids as discussed in Knopp et al.; "Contrasting Effects of Unmodified and Time-Release Forms of Niacin on Lipoproteins in Hyperlipidemic Subjects: Clues to Mechanism of Action of Niacin"; Metabolism 34/7, 1985, page 647. The chief advantage of this profile is the ability of IR nicotinic acid to decrease total cholesterol, LDL cholesterol, triglycerides and Lp(a) while increasing "HDL" particles. In fact, IR nicotinic acid has been well regarded as an effective drug in the treatment of high cholesterol since about the early 1960s. Unfortunately, IR nicotinic acid has never really become widely used because of the high incidence of flush that often occurs when an IR dose is taken. That means an individual may develop a visible, uncomfortable, hot or flushed feeling three or four times a day for about one hour following each IR dose.

In order to avoid or reduce the cutaneous flushing, a number of materials have been suggested for administration with an effective antihyperlipidemic amount of immediate release nicotinic acid, including guar gum in U.S. Pat. No. 4,956,252, and mineral salts as disclosed in U.S. Pat. No. 5,023,245; or inorganic magnesium salts as reported in U.S. Pat. No. 4,911,917. These materials have been reported to avoid or reduce the cutaneous flushing side effect commonly associated with nicotinic acid treatment.

Another method of avoiding or reducing the side effects associated with immediate release nicotinic acid is the use of SR nicotinic acid formulations. SR nicotinic acid formulations are designed to slowly release the compound from the tablet or capsule. The slow drug release reduces and prolongs blood levels of drug in an attempt to lower peak nicotinic acid concentrations with the goal of reducing or eliminating nicotinic acid induced flush. Examples of currently marketed SR formulations of nicotinic acid include Nicobid.RTM. capsules (Rhone-Poulenc Rorer), Enduracin.RTM. (Innovative Corporation) and SloNiacin.RTM. (Upsher-Smith Laboratories, Inc., U.S. Pat. No. 5,126,145, which describes a sustained release niacin formulation containing two different types of hydroxypropyl methylcellulose and a hydrophobic component).

Studies in hyperlipidemic patients have been conducted with a number of SR nicotinic acid products. These studies have demonstrated that the sustained release products do not have the same advantageous lipid altering effects as IR nicotinic acid, and in fact often have a worse side effect profile compared to the IR products. The major disadvantage of the SR formulations, as can be seen in Knopp et al., in 1985, is the significantly lower reduction in triglycerides (-2% for the sustained versus -38% for the immediate release) and lower increase in HDL cholesterol, represented as HDL2 particles which are known by the art to be most beneficial, (-5% for the sustained release versus +37/% for the immediate release).

Additionally, SR nicotinic acid formulations have been noted as causing greater incidences of liver toxicity as described in Henken et al.: Am J Med, 91:1991 (1991) and Dalton et al.: Am J Med, 93:102 (1992). There is also great concern regarding the potential of these formulations in disrupting glucose metabolism and uric acid levels.

In a recent edition of the Journal of the American Medical Association, an article appeared which presented research results investigating the liver toxicity problems associated with an SR form of nicotinic acid. See McKenney et al.: A Comparison of the Efficacy and Toxic Effects of Sustained- vs. Immediate-Release Niacin in Hypercholesterolemic Patients, JAMA, (271)9: 672 (Mar. 2, 1994). This McKenney et al. article presented a study of twenty-three patients. Of that number, 18 or 78 percent were forced to withdraw because liver function tests (FTs) increased indicating potential liver damage. The conclusion of the authors of that article was that the SR form of nicotinic acid "should be restricted from use."

A similar conclusion was reached in an article authored by representatives of the Food and Drug Administration. See Radar, et al.: Hepatic Toxicity of Unmodified and Time-Release Preparations of Niacin, JAMA, 92:77 (January 1992). Because of these studies and similar conclusions drawn by other health care professionals, the sustained release forms of nicotinic acid have experienced limited utilization.


Here is the link for the entire patent.


http://www.healthboards.com/cgi/postings.cgi?action=reply&forum=High+Cholesterol&number=65&topic=001254.cgi&TopicSubject=Niaspan+makes+me+smile

bob

Sorry,

I pasted the wrong link. Try this.
http://patft.uspto.gov/netacgi/nph-Parser?Sect1=PTO2&Sect2=HITOFF&p=1&u=/netahtml/search-bool.html&r=4&f=G&l=50&co1=AND&d=ptxt&s1=nIASPAN&OS=nIASPAN&RS=nIASPAN

bob

sixers,

Thanks for that info especially:

Studies in hyperlipidemic patients have been conducted with a number of SR nicotinic acid products. These studies have demonstrated that the sustained release products do not have the same advantageous lipid altering effects as IR nicotinic acid, and in fact often have a worse side effect profile compared to the IR products. The major disadvantage of the SR formulations, as can be seen in Knopp et al., in 1985, is the significantly lower reduction in triglycerides (-2% for the sustained versus -38% for the immediate release) and lower increase in HDL cholesterol, represented as HDL2 particles which are known by the art to be most beneficial, (-5% for the sustained release versus +37/% for the immediate release).

That HDL response difference is most astounding. Imagine taking mega doses of medication to LOWER HDL levels!!!



[This message has been edited by zip2play (edited 10-01-2003).]

For Niaspan fans:
FDA GIVES TENTATIVE OK TO BARR'S GENERIC NIASPAN


Barr has won tentative approval to market the first generic version of Kos Pharmaceutical's cholesterol drug Niaspan (niacin) 1000-mg extended-release tablets, the generic firm said this week.

In November 2001, Barr applied to the FDA challenging patents on the drug that had annual sales of about $70 million. Kos has sued Barr for patent infringement, and a trial is scheduled for December 2004 in federal court.

Perhaps that will make Niaspan dosing more $$$ friendly in the future (currently $2-$4 a day.)

ps....Can anyone explain to me the difference between "extended release" and "sustained release"....they seem the same to me???

zip2play,

As I understand it this 4-9 hour time release is the difference. I am trying to understand exactly how it works and that learning process is not complete. But, for me I am sure that it does work to improve all lipid fractions including Lp{a}. Check out this quote from the patent.


Generally speaking, novel nicotinic acid formulations have been discovered that optimize blood levels of nicotinic acid over a period of about 5 to about 9 hours when administered as a single oral dose for achieving a balanced lipid alteration in individuals at a time when the rate of serum lipids, lipoproteins, cholesterol and cholesterol precursor biosynthesis is believed to be at its highest. In other words, the novel nicotinic acid formulations have been uniquely formulated for administration as a single dose, preferably during the evening or at night when the nicotinic acid levels subsequently achieved are effective for substantially lowering the levels of total cholesterol, LDL cholesterol, triglycerides and/or Lp(a) as well as raising the levels of HDL particles, all of which are primary nocturnally synthesized. Preferably, the nicotinic acid formulations are administered at or after an evening meal or low fat snack but before bedtime, i.e., between about 6 pm and 12 am, preferably between about 8 pm and 12 am, and most preferably between about 8pm and 10 pm.

The amount of nicotinic acid that is administered is effective to substantially lower at least one serum lipid, such as total cholesterol, LDL cholesterol, triglycerides, and/or Lp(a) and elevated HDL,, without causing drug-induced hepatotoxicity to levels which would require the therapy to be discontinued. In other words, a single 1 to 3 gram dose of a nicotinic acid formulation of the present invention administered between about 6 pm and 12 am is believed to be as effective as an equal or higher daily dosage of nicotinic acid administered in two to four divided doses between, e.g., 8 am and 8 pm.

Furthermore, because at least the majority of the nicotinic acid is released and metabolized in vivo during a limited predetermined period of time of about 5 to about 9 hours, the liver is not being exposed to constant levels of nicotinic acid which results during the administration of long-term, spaced daily doses of SR nicotinic acid. Thus, it is believed that the nicotinic acid formulations of the present invention are unlikely to cause individuals to develop dose-limiting hepatotoxicity when used as a single daily dose administered in a therapeutic amount.

bob

Sixers,

Thanks for the information on Niaspan. Actually, I'm rather dumfounded that so much emphasis is placed on statins such as Zocor, Lipitor, and Pravachol via television, radio, newspaper, and magazine advertisements. Maybe I've missed them, but I have yet to see an advertisement for Niaspan. Overall, I believe that nicotinic acid is a superior alternative to statins, and much safer as well. By the way, do you recall what your numbers were like prior to taking Niaspan?

Arizona,

I have a copy of all of my tests since my triple bypass in 1996. I had three tests before I started Niaspan. During this period I tried diet and exercise.

10/02/96 4/15/97 10/14/97
HDL-----------39----------45-----------44
LDL----------105---------119-----------98
Tri----------140---------169----------228
Total--------172---------198----------188


During the last 5 years after I titrated up to 2000mg Niaspan I have had 10 blood tests. The LDL range has been 86 to 55 with an average of 71. The HDL range has been 77 to 52 with an average of 67. Triglycerides have been 137 to 46 with an average of 89. Total has been 174 to 132 with an average of 156.

bob

Sixers,

So it would appear that you have significantly lowered your LDL and triglyceride level, while dramatically increasing HDL! My congratulations to you! Keep up the good work. You are obviously doing very well.

I have personally been taking niacin(over the counter)for close to twenty years. I take about 1,000mg per day in 4 divided doses. Although my total cholesterol is 234, my HDL is 107, and my triglycerides are only 65. I really do feel that niacin has helped me in this respect. It is a great supplement to take for overall cardiovascular health.

Arizona,

No, you haven't seen any commercials for Niaspan. The company who makes Niaspan is small. They have been loosing money until the last three quarters. Now that they are making money they are increasing their sales force. They hope to be up to 600 by the end of the year. This is still very small compared to Pfizer or the other big boys.

bob

Sixers,

I don't know about you, but the truth is, I'm actually getting pretty sick and tired of looking at all these drug commercials on television anyway. As soon as it is suggested that the drug companies should lower their prices, they immediately cry poverty, claiming that the costs are justified in order to recoup the cost of all their research and development. Yet, by the same token, they spend more in a single year on advertising than they do on research and development. I can remember when such advertising was not only unheard of, but prohibited. A trained medical doctor should know how to diagnose a patient and prescribe the appropriate medication. He should not be relying on what a patient may have heard on some television commercial. All you hear is "ask your doctor whether this or that is right for you." Not only is it silly, but I can't help but think that there is something unethical about this as well.

There are several active boards about the various forms of niacin available. I believe there is a lot of useful information here which will help clarify the issue.

bob

I have just been switched from Zocor is Niaspan as my Tri level is 772. Hope this works.

mrsstats,

772 that is really high. You will probably have to titrate up to the maximun dose of 2000mg. Also, try substituting Splenda for sugar. I find the taste about as good as sugar. Unlike Aspartame I have not heard of any side effects. It costs quite a bit more than sugar but I think it is worth it. I just bought a package which has the equivalent sweetness of 5 lbs of sugar for $6.30 at Walmart. Diet Rite caffeine free cola is made with Splenda. Try to cut down on other carbs. Alcohol is bad. Good luck.

bob

Sorry, but I don't inderstand all this love for nyaspar :confused: . The inositol niacinate is a very good form of vitamine b3 (niacin etc.) without flushing :D . To work better it's necessary only to adjust dosage.
The following was find at an internet site:
:rolleyes: :rolleyes:
Vitamin B-3 Inositol Hexanicotinate 625mg 60 cp
Price: $11.95
Flush-Free Cholesterol Control
Inositol hexanicotinate (IHN), also known as inositol niacinate, is a flush-free form of niacin without the binders or fillers found in other flush-free, niacin products. Niacin, when taken in high doses, has been medically proven to lower cholesterol. Each capsule supplies 500 mg of niacin and 125 mg of inositol. Recommended dosage: one to four capsules per day, depending upon individual need and response.
:rolleyes: :rolleyes:

The following excerpts are from an article on niacin in the U. S. Pharmacist.

<<SR niacin was developed to reduce flushing; however, some SR niacin formulations have been linked with hepatotoxicity and even liver failure.13,15 These adverse effects are directly related to niacin metabolism, which occurs via two pathways (FIGURE 2).11 The nonconjugated pathway is a high-affinity, low-capacity system involving metabolites associated with hepatotoxicity. The conjugated pathway is a low-affinity, high-capacity system involving metabolites associated with flushing and is only used when the other pathway is saturated. IR niacin rapidly saturates the nonconjugated system, shunting a large amount of niacin to be metabolized by the conjugative system and resulting in a high rate of flushing. Since SR niacin is absorbed more slowly, it is metabolized mostly by the nonconjugative pathway and is therefore associated with hepatotoxicity.11




In one study, up to 53% of patients treated with IR niacin reported flushing, compared with 22% in the SR niacin group; four of the 23 IR-treated patients (17%) withdrew because of flushing. However, 67% of patients discontinued SR niacin therapy because of liver enzyme elevations (three times the upper limit of normal), and 52% of patients developed hepatotoxic symptoms; however, no patients treated with IR niacin developed significant changes in liver enzymes.13 SR niacin was more effective in reducing LDL-C at dosages of 1,500 mg/d and above; however, IR niacin increased HDL-C to a greater extent at all dosages. The researchers found no differences in triglyceride reductions.

Adverse effects on hepatic function vary among SR niacin products11,16 and have been especially noted with switches from IR niacin to equal doses of SR formulations.17 Furthermore, SR niacin is approved by the FDA as a dietary supplement and not for the treatment of dyslipidemia. Although several brands are available OTC, differences among brands, and even batches, coupled with increased hepatic risk make it advisable to select another treatment option.


Niacin and Combination Therapy
In combination, niacin has been shown to offer improvements across the lipid profile, reduce progression and increase regression of atherosclerotic plaques, and reduce cardiovascular risk. There has been increasing use of combination therapy for the treatment of dyslipidemia, due to the additive efficacy of combining products. Niacin/fibrate therapy may be used for treatment of atherogenic dyslipidemia and for hypertriglyceridemia.10 This combination has been associated with a significant reduction in coronary events29; however, clinical data are limited. Niacin/bile acid sequestrant (BAS) therapy has been shown to improve the lipid profile, slow angiographic progression, and decrease cardiovascular events, which provides a good treatment option for patients who need to lower their LDL-C but are refractory to or intolerant of statins.30-32 Many patients, however, are unable to tolerate BAS therapy due to a high rate of adverse gastrointestinal effects.

The statins used in statin/niacin therapy lower LDL-C, and the niacin raises HDL-C and lowers triglyceride levels. Numerous studies have shown the efficacy and safety of this combination in improving lipid profiles, reducing progression and promoting regression of atherosclerosis, and reducing coronary events.3,33,34 ER niacin/lovastatin (Advicor) is the first combination lipid-modifying product approved by the FDA. After 52 weeks of therapy, ER niacin/lovastatin reduced LDL-C by 45% and triglycerides by 42% and increased HDL-C by 41%.3 Flushing caused 10% of patients to withdraw, and no confirmed myopathy was observed. The incidence of liver transaminase enzymes greater than three times the ULN has been shown to be less than 1%.3,35,36 In the recently published Advicor Versus Other Cholesterol-Modulating Agents Trial Evaluation (ADVOCATE),35 treatment with ER niacin/lovastatin 1,000/40 mg resulted in LDL-C lowering comparable to atorvastatin 10 mg (38%, for both) and greater than simvastatin 20 mg (42% vs 35%; P = .05). In addition, the combination had significantly greater HDL-C*raising effects than did either of the statin monotherapy regimens. Therefore, combination therapy such as ER niacin/lovastatin offers increased therapeutic benefits across the lipid spectrum.>>


Here is the link to the entire article.

http://www.uspharmacist.com/index.asp?show=article&page=8_1157.htm

bob

However, 67% of patients discontinued SR niacin therapy because of liver enzyme elevations (three times the upper limit of normal), and 52% of patients developed hepatotoxic symptoms;

That is perhaps the most frightening result of any drug safety testing I have ever seen :eek: . What does it take for the FDA to pull a product from the shelf, 100% mortality?

It's also the main reason my skepticism of Niaspan must continue, after all it's just a somewhat faster SR niacin product.

Maglioned,

To the best of your knowledge, is inositol hexanicotinate commonly used in Italy, and if so, have there been any reported problems with its use? The reason I ask is because this form of niacin has been used more extensively in European countries throughout the years. In fact, I believe some of the studies were carried out in Italy. Here in the United States, most people remain pretty much in the dark regarding inositol hexanicotinate.

Sorry, but I don't inderstand all this love for nyaspar :confused: . The inositol niacinate is a very good form of vitamine b3 (niacin etc.) without flushing :D . To work better it's necessary only to adjust dosage.
The following was find at an internet site:
:rolleyes: :rolleyes:
Vitamin B-3 Inositol Hexanicotinate 625mg 60 cp
Price: $11.95
Flush-Free Cholesterol Control
Inositol hexanicotinate (IHN), also known as inositol niacinate, is a flush-free form of niacin without the binders or fillers found in other flush-free, niacin products. Niacin, when taken in high doses, has been medically proven to lower cholesterol. Each capsule supplies 500 mg of niacin and 125 mg of inositol. Recommended dosage: one to four capsules per day, depending upon individual need and response.
:rolleyes: :rolleyes:
It is not a love for Niaspan, it is a reasonable demand for data supporting the use of generic, sustained release niacin. No one is saying Niaspan is inherently better, only that at least Niaspan does have peer reviewed clinical data to support its bias. Where is the clinical data supporting the bias for IH?


All due respect, this is simply an advertisement for a product. The vendor cannot be looked upon as a reliable source of information without offering citations for thier "recommendations". It is just sales speak if it is void of supportive data.