Nicolar

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.

Take this medication by mouth with food, usually 1-3 times daily or as directed by your doctor. If you take this medicine once daily, take it with your evening meal. Taking niacin on an empty stomach increases side effects (e.g., flushing, upset stomach). Niacin is available in different formulations (e.g., immediate and sustained release). Do not switch other strengths, brands, or forms of niacin with this product. Severe liver problems may occur. Dosage is based on your medical condition and response to therapy. Generally, 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 (e.g., extended-release) to this product. Follow your doctor's instructions carefully. If you also take certain other drugs to lower your cholesterol (bile acid-binding resins such as cholestyramine or colestipol), take niacin at least 4-6 hours before or after taking these medications. These products can react with niacin, preventing its full absorption. Continue to take other medications to lower your cholesterol as directed by your doctor. To lessen the chance of side effects such as flushing, avoid alcohol and hot beverages near the time you take niacin. Taking a plain (non-enteric coated, 325 milligram) aspirin or a nonsteroidal anti-inflammatory drug (e.g., ibuprofen, 200 milligrams) 30 minutes before taking niacin may help prevent flushing. Ask your doctor if this treatment is right for you. Use this medication regularly in order to get the most benefit from it. Remember to take it at the same time each day. It is important to continue taking this medication even if you feel well. Most people with high cholesterol do not feel sick. Do not stop taking this medicine unless instructed by your doctor. If niacin is stopped, you may need to return to your original dose and gradually increase it again. Consult your doctor or pharmacist for instructions on restarting your dose if you have not taken your medication for several days. It is very important to continue to follow your doctor's advice about diet and exercise.

See also the How to Use section. 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 medicine before checking with them first. Before using this medication, tell your doctor or pharmacist of all prescription and nonprescription/herbal products you may use, especially of: "blood thinners" (e.g., warfarin), drugs that affect your blood pressure (e.g., calcium channel blockers such as diltiazem, alpha blockers such as prazosin), 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.

Do not share this medication with others. Laboratory tests (e.g., blood lipids, blood sugar, liver function tests) should be performed periodically to monitor your progress or check for side effects. Consult your doctor for more details. For best results, this medication 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.

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 medication should not be used if you have certain medical conditions. Before using this medicine, consult your doctor or pharmacist if you have: very low blood pressure, current liver disease, increase in liver enzymes, current ulcer, current bleeding. Before using this medication, tell your doctor or pharmacist your medical history, especially of: alcohol use, bleeding problems (e.g., low platelets), diabetes, gallbladder disease, glaucoma, gout, heart disease (e.g., recent heart attack, unstable angina), kidney disease, 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 glucose 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. 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.

Store at room temperature between 59-86 degrees F (15-30 degrees C) away from light and moisture. Do not store in the bathroom. Keep all medicines 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 of the face and neck along with warmth, headache, itching, burning, sweating, chills, or tingling may occur within 20 minutes of taking this medication. Flushing may persist for a few hours after use. These effects should improve or go away as your body adjusts to the medication. Dizziness, stomach upset, heartburn, nausea, vomiting, and diarrhea may also occur. If these effects persist or worsen, notify your doctor promptly. Remember that your doctor has prescribed this medication because 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.