Hi all, I am 32 year old female, had a Berkely heart profile last year which revealed high Lp(a)-42, high homocystiene, my LDL was 130, HDL=100 however the good wasn't the great kind so I started Niaspan 500mg 9/09 and increased it to 1g around Nov/09 and have had minimal flushing problems on occasion. Around 2/13 I broke out with a rash, started on my back, upper chest, stomach and it was SEVERE itching. Stopped Niaspan about 4 days later however rash persisted for another 10 days then resolved. Saw the doctor who did not suggest doing any safety labs and said it looked like "hot tub rash" to her. I have not started back on the Niaspan however I think I am going to try going back on 500mg (while at work, I work in a medical office) as I'm afraid this was an allergic reaction and I'm quite scared of taking it again and having an even worse allergic reaction. I really am not ready to start a statin, even though my doctor wanted me initially on Crestor and after my research I objected and wanted to try niaspan first which brought my LDL down to 100, TRGs down to 45, and Lp (a) to 15, it was around 42 prior to niaspan. I'm just wondering if anyone else has had a persistent rash (not just flushing) but a rash that lasted this long with Niaspan, sorry for the long post.
Niacin is the safest and most effective class of cholesterol lowering medications. It seems to improve the entire lipid panel like no other medication currently available. The other added benefits are a decrease in CRP (Inflammation levels), increased blood blow and blood pressure lowering due to the vasodilation. Side effects can include dry skin, slight glucose increase, mild stomach issues and skin irritations or a temporary rash. They most often subside.
This may or may not help you, but I thought I'd mention it.
I had to stop taking Niaspan ER 500 mg after taking it every other day for a month due to severe stomach problems. The first time I tried it, I had itchiness and bad flushing, even when taking an aspitin an hour before the pill.
The second time I tried it, a few months later, I had read that if you take 500 mg of Vitamin C at the same time you take the drug, it can reduce or eliminate the itching.
I tried it, and it worked for me in full. I didn't even have mild itching or flushing, even though I still had accelerated heartbeats like the first time. Still, the gastro problems were so bad that I had to stop.
like Ace, I am a big fan of niacin. However, one should keep in mind that statins are the best at lowering LDL. (statins have a bad rap, and a lot of the myalgias can be avoided if vitamin D levels are checked prior to therapy)
Occacionally, rash with niacin is severe and can limit therapy. It seems to affect people who normally have "sensitive" skin, are fair skinned, or get frequent dermatoses. Most can reinitiate therapy and only go up to a dose 250 mg less than that which produced the rash. If targeting HDL increase, 750mg daily of an ER/SR niacin should have a great benefit. It usually takes higher doses for LDL and TG reduction.
With regard to nausea or GI intolerance, (assuming you are taking with meals or a full glass of water) you should try a different form. Both Niaspan (FDA approved, prescription only) and Slo-Niacin (OTC extended release niacin) use a poly methyl cellulose base for the delayed release mechanism, and is prone to significant variability in its release. Endur-acin is another OTC extended release preparation that uses a vegetable wax matrix for its release mechanism, and is touted for a very consistent release profile. Slo-Niacin and Endur-acin have significant published clinical data to support their use. Beyond these it is not recommended to use OTC sustained release niacin that don't have supporting data. Do not switch brands without communication/approval from your physician. Regardless of preparation, liver function tests need to be performed (same for statins).