Niaspan ER and sustained release

IR is tricky with 3 doses a day,.. STAY AWAY FROM DIETARY SUPPLEMENT NIACIN !!! Unless,.. you are an expert identifying the safe, from the toxic, from he 'placebo'. YES.. most of the $20-35 a month NO FLUSH have NO BENEFIT. Do NOT work. Safe??.. yes! Work??,.. NO! Preventative Cardiology Norris RB, et al Jan 2006. the cardiologist wrote Rx ER niacin & pateint switched to NO FLUSH,.. no HDL changes, no further LDL drop, No trig drop,.. NOTHING !! Card didn`t know. Grilled patient. patient confesswed. Labs do NOT lie. HDL, especially HDL2 AND Lp(a) hardly move for 9 months, BUT continue to respoind for 3 years. Allen Taylor, MD, Colonel - Walter Reed & Moti Kashyap, VA/Los Angeles-Long Beach. ONLY niacin & estrogen increase HDL2. Fibrates LOWER HDL2. 1000 mg or 1g increase HDL2 11% & at 2000 mg or 2g it increases 189%. Absolutely unique. By he time the flushing quits occuring : 1) small dense pattern B LDL. even with a total LDL of 85, pattern B will eventually get you
2) LOW HDL2; Often far below 10 in males & < 15 in females
Niacin is THE MOST POTENT AGENT to fully correct BOTH these defects.
Manage triglycerides up to 800 mg/dL with ONLY 10 caps fish oil and 1 gm or more of RX niacin: No need for fibrates until pancreatiis is a threat @ ~>800-1000..

BEWARE the SR, CR, LA aka 'LOW' FLUSH niacins. Poor efficacy and other poor tolerability issues: GI, etc. Again, unregulated, not even OTC. DANGEROUS to play with. Several gov't studies, on Sustained release / SR at the VA, there were reports of confirmed hepatotoxicity: "...fulminant hepatic failure.." long residence times in the liver are not a good idea.
DO NOT PLAY DOCTOR!! Find a Dr. who has A LOT of experience Rx-ing ER niacin. If he doesn`t CURRENTLY have 50-100 successfully managed niacin patients, ask IM's, ENDO's & Cards until you find someone who does have clinical experience. 100 new starts a year,.. minimum. OR.. call a lipid clinic. They know. USE HE WEB: Find a lipid expert in your zip code: Lipid.org aka National Lipid Association

Take care,..
...be well...!! ;-)
Steve the Lipid Guy

The hard truth about sustained release niacin ( NIASPAN) The Drug Niaspan will raise your HDL, but the prescribing physician won't tell you that this drug has one of the highest drop out rates. The reason? The side effects are unbearable for most people.

The posting below states that "Niaspan WILL save your life" Not true! The niaspan website fully admits that Niaspan is not to be taken to prevent a heart attack if you have never had one. So far there is no proof that Niaspan will prevent a cardiac event. But there is proof it will alter your blood lipids.

Niaspan can damage your liver. That is why liver function tests are routinly done for those taking the drug. It is toxic doses of Vitamin B3 which results in the horror stories you read in this.
Niaspan can damage your muscles. Taking this and other cholesterol lowering drugs only add to your health risks.

Be smart. Eat right and exercise. Its the best thing you can do for your health.

Good luck.