Indications |
Oral Treatment and prophylaxis of nicotinic acid deficiency Adult: Up to 500 mg daily in divided doses. May also be given by IM or slow IV inj. Oral Hyperlipidaemias Adult: As immediate-release preparation: Initially, 600 mg daily in 3 divided doses, gradually increased over 2-4 wk to max 6 g daily (usual dose 1-2 g bid-tid). As modified-release preparation: Initially, 375 or 500 mg at night gradually increased by no more that 500 mg in 4 wk according to patient's response. Maintenance: 1-2 g at bedtime. Oral Vasodilation Adult: As immediate-release preparation: 100-150 mg 3-5 times daily. As extended release preparation: 300-400 mg 12 hrly. |
Contraindications |
Liver disease; active peptic ulcer; severe hypotension; arterial bleeding. |
Warnings / Precautions |
Gout; cases of severe hepatic toxicity, including fulminant hepatic necrosis have occurred in patients who have substituted SR nicotinic acid products for immediate-release nicotinic acid at equivalent doses. Monitor LFT. DM, diabetic patients may experience a dose-related rise in glucose intolerance. Children, adolescents. Pregnancy, lactation (contraindicated at high doses). |
Adverse Reactions |
Vomiting, diarrhoea, peptic ulceration, jaundice, abnormal LFTs, decreased glucose-tolerance, hyperuricaemia, gout, toxic amblyopia, flushing, pruritus, hyperpigmentation, dry skin and headache, atrial fibrillation, orthostasis, cystoid macular oedema. |
Drug Interactions |
Potentiates the effects of ganglionic blocking agents and vasoactive drugs resulting in postural hypotension. Increased risk of rhabdomyolysis with concomitant admin of HMG-CoA reductase inhibitors. Alcohol or hot drinks may increase the side effects of flushing and pruritus and should be avoided at the time of drug ingestion. See Below for More nicotinic acid Drug Interactions |
Lab Interactions |
False-positive results in urine glucose determination e.g. Benedict's test. False elevations in some fluorometric determinations of urinary catecholamines due to production of fluorescent substances in the urine. |
Mechanism of Actions |
Nicotinic acid is a derivative of vitamin B<209>3<190 and is incorporated into coenzymes nicotinamide adenine dinucleotide (nad) phosphate (nadp), which are involved in multiple cellular metabolic pathways. nicotinic acid also reduces total serum cholesterol, ldl, vldl, triglycerides, increases hdl cholesterol. it appears to decrease hepatic synthesis of however, the exact mechanisms acid's antilipemic effects unknown unrelated its role as a vitamin. Absorption: Readily absorbed from the GI tract (oral). Distribution: Widely in body tissues; enters breast milk. Metabolism: Converted to N-methylnicotinamide, 2-pyridine and 4-pyridine derivatives. Excretion: Urine (small amounts as unchanged drug). |
Administration |
Nicotinic acid: Should be taken with food. (Take at bedtime after a low-fat snack.) |
ATC Classification |
C04AC01 - nicotinic acid ; Belongs to the class of nicotinic acid agents. Used as peripheral vasodilators. C10AD02 - nicotinic acid ; Belongs to the class of nicotinic acid and derivatives. Used in the treatment of hyperlipidemia. |
Available As |
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Nicotinic Acid
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Nicotinic Acid Containing Brands
Nicotinic Acid is used in following diseases
Drug - Drug Interactions of Nicotinic Acid
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