Nicotinic Acid

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.
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.
Adult: As immediate-release preparation: 100-150 mg 3-5 times daily. As extended release preparation: 300-400 mg 12 hrly.
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).
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
  • Nicotinic Acid 12 mg
  • Nicotinic Acid 125 mg
  • Nicotinic Acid 15 mg
  • Nicotinic Acid 24 mg
  • Nicotinic Acid 25 mg
  • Nicotinic Acid 250 mg
  • Nicotinic Acid 325 mg
  • Nicotinic Acid 375 mg
  • Nicotinic Acid 5 mg
  • Nicotinic Acid 50 mg
  • Nicotinic Acid 500 mg
  • Nicotinic Acid 6 mg
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