niacin

If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch up. If you stop taking this for one week or more, consult your doctor or pharmacist before taking it again.

See also Drug Interactions section. Take this medication by mouth with food, usually once or twice a day or as directed by your doctor. Taking niacin on an empty stomach increases side effects (e.g., flushing, upset stomach). Follow all directions on the product package. If you are uncertain about any of the information, consult your doctor or pharmacist. Niacin is available in different formulations (e.g., immediate, extended-release). If your doctor has prescribed niacin, do not switch strengths, brands, or forms because doing so may increase the risk of severe liver problems. Swallow extended-release capsules whole. Do not crush or chew extended-release capsules or tablets. Doing so can release all of the drug at once, increasing the risk of side effects. Also, do not split extended-release tablets unless they have a score line and your doctor or pharmacist tells you to do so. Swallow the whole or split tablet without crushing or chewing. To prevent flushing, do not take this medication with alcohol or hot drinks. Taking a plain (non-enteric-coated, 325-milligram) aspirin or a nonsteroidal anti-inflammatory drug (e.g., ibuprofen) 30 minutes before taking niacin may help prevent flushing. Consult your doctor or pharmacist for specific directions on aspirin/NSAID use before starting your niacin treatment to make sure it is right for you, especially if you are also using "blood thinners" (anticoagulants such as warfarin or heparins). If you also take certain other drugs to lower blood fats (bile acid-binding resins such as cholestyramine or colestipol), take niacin at least 6 hours before or after taking these medications. These products interact with niacin, preventing its full absorption. Continue to take other medications to lower your cholesterol as directed by your doctor. Dosage is based on your medical condition and response to therapy. Follow the directions on the label or your doctor's instructions carefully. If you are taking this for lipid problems, your doctor will start you at a low dose and gradually increase your dose in order to minimize side effects. Your dose will need to be increased slowly even if you are already taking niacin and are being switched from another niacin product to this product. Use this medication regularly in order to get the most benefit from it. To help you remember, take it at the same times each day. If this medication has been prescribed by your doctor, do not stop taking it unless your doctor tells you to do so. If your doctor tells you to stop taking niacin, do not start taking it again until your doctor has given you instructions on how to restart it. Your dose may need to be gradually increased to the dose you were on. It is very important to continue to follow your doctor's advice about diet and exercise. If your condition persists or worsens, or if you think you may have a serious medical problem, seek immediate medical attention.

If you are taking this medication under your doctor's direction, your healthcare professionals (e.g., doctor or pharmacist) may already be aware of any possible drug interactions and may be monitoring you for it. Do not start, stop or change the dosage of any prescribed medicine before checking with them first. Before using this product, tell your doctor of any prescription and nonprescription/herbal products you may use, especially: "blood thinners" (e.g., warfarin, heparins), drugs that affect your blood pressure (e.g., calcium channel blockers such as diltiazem, alpha blockers such as prazosin), drugs for diabetes (e.g., insulin, glipizide, metformin), other drugs that cause flushing (e.g., nitrates), vitamins/dietary supplements/products that also contain niacin or nicotinamide. Serious muscle injury (e.g., myopathy, rhabdomyolysis) may infrequently occur if the following drugs are combined with niacin (1 gram per day or more): fibrates (e.g., gemfibrozil, fenofibrate), "statins" (e.g., lovastatin, atorvastatin). Seek immediate medical attention if you experience any muscle pain, weakness or tenderness. Limit alcoholic beverages. Alcohol can increase the side effects of this medication. This product can affect the results of certain lab tests (e.g., urine or blood catecholamines, copper-based urine glucose tests). Make sure laboratory personnel and all your doctors know you use this drug. This document does not contain all possible interactions. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist.

If you are taking this for high cholesterol, for best results, it should be used along with doctor-approved plans for low-fat/low-cholesterol diet, exercise, and weight control. Talk to your doctor or pharmacist about lifestyle changes that might benefit you. Niacin is common in foods such as beans, milk products, eggs, chicken, and beef. Eat more of these foods to increase the amount of niacin in your diet if you have a niacin deficiency. Ask your doctor about dietary changes that may help your condition. There are many niacin products available. Some can be purchased without a prescription. Consult your doctor or pharmacist about the best product for you. Laboratory tests (e.g., blood lipids, blood sugar, liver function tests) may be performed (especially if prescribed for cholesterol/triglyceride control) to monitor for effectiveness and possible side effects. Consult your doctor for more details. Do not share this medication with others.

If overdose is suspected, contact your local poison control center or emergency room immediately. US residents can call the US national poison hotline at 1-800-222-1222. Canadian residents should call their local poison control center directly.

Before taking niacin, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details. This product should not be used if you have certain medical problems. Before using this product, consult your doctor or pharmacist if you have: very low blood pressure, current liver disease, increase in liver enzymes, current ulcer, current bleeding. If you have any of the following health problems, consult your doctor or pharmacist before starting this product: alcohol use, history of bleeding problems (e.g., low platelets), diabetes, gallbladder disease, glaucoma, gout, heart disease (e.g., recent heart attack, unstable angina), kidney disease, history of liver disease, untreated mineral imbalance (low phosphate levels), history of stomach/intestinal ulcers, underactive thyroid (hypothyroidism). This drug may make you dizzy. Do not drive, use machinery, or do any activity that requires alertness until you are sure you can perform such activities safely. Limit alcoholic beverages. To minimize dizziness and lightheadedness, get up slowly when rising from a sitting or lying position. This is very important if you are also taking medication to lower your blood pressure. Before having surgery, tell your doctor or dentist that you are taking this medication. If you have diabetes, this drug may increase your blood sugar levels. Check your blood sugar levels regularly as directed by your doctor. Tell your doctor immediately if you have symptoms of high blood sugar such as increased thirst and urination. Your anti-diabetic medication or diet may need to be adjusted. Ask your doctor. This medication should be used only when clearly needed during pregnancy. Discuss the risks and benefits with your doctor. This medication passes into breast milk. Consult your doctor before breast-feeding.

This product is usually stored at room temperature between 59-86 degrees F (15-30 degrees C) away from moisture and light. Do not store in the bathroom. Refer to storage information printed on the package. If you have any questions about storage, ask your pharmacist. Keep all products away from children and pets. Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company for more details about how to safely discard your product.

Flushing/warmth in the face and neck, headache, itching, burning, sweating, chills, or tingling may occur within 20 minutes to 4 hours of taking this medication. Flushing may persist for a few hours. These effects should improve or go away as your body adjusts to the medication. Stomach upset, heartburn, nausea, vomiting, and diarrhea may also occur. If any of these effects persist or worsen, contact your doctor or pharmacist promptly. If your doctor has prescribed this medication, remember that he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects. Tell your doctor immediately if any of these unlikely but serious side effects occur: severe dizziness/fainting, fast/irregular heartbeat, severe headache (migraine), unusual joint pain, swelling of legs/arms, vision problems. Tell your doctor immediately if any of these rare but very serious side effects occur: severe stomach/abdominal pain, black/tarry stools, easy bruising/bleeding, unexplained muscle pain/tenderness/weakness, persistent nausea/vomiting, change in the amount of urine, dark urine, vomit that looks like coffee grounds, yellowing eyes/skin. A very serious allergic reaction to this drug is unlikely, but seek immediate medical attention if it occurs. Symptoms of a serious allergic reaction may include: rash, persistent itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing. This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist. In the US - Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088. In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

This section contains uses of this drug that are not listed in the approved professional labeling for the drug, but may be prescribed by your health care professional. Use this drug for a condition that is listed in this section only if it has been so prescribed by your health care professional. Niacin may also be used to improve cholesterol and lower fat levels (triglycerides) in the blood under the care of your doctor. It is generally used after non-drug treatments have not been fully successful at lowering cholesterol (e.g., diet change, increase in exercise, weight loss if overweight). Doses for treating these blood fat problems are usually much higher than for dietary problems.