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Vitamin B3 / lipid-modifying agent

Nicotinic acid

Brand names: Niaspan

Nicotinic acid (niacin) is a lipid-modifying agent that lowers triglycerides and LDL-cholesterol and raises HDL-cholesterol, used for dyslipidaemia when statins are insufficient or unsuitable.

Dosing — no UK product information found

We found no UK product information (SmPC) for this medicine or presentation on the eMC or MHRA Products (checked October 2026). It may be unlicensed in the UK, imported, a medical device, or no longer marketed. ClinCalc Pro shows only doses it can trace to official product information, so none is shown — follow your specialist service or local guideline.

Clinical monograph

How it works

It inhibits hepatic synthesis and secretion of very-low-density lipoprotein, reducing circulating LDL-cholesterol and triglycerides while increasing HDL-cholesterol, in part through effects on adipose tissue lipolysis.

Prescribing in practice

  • Cutaneous flushing is very common and dose-limiting, and large outcome trials have not shown that adding nicotinic acid to statin therapy reduces cardiovascular events while it may increase certain adverse effects, so its routine use is limited.
  • It can worsen glycaemic control, raise uric acid and precipitate gout, and may cause hepatotoxicity, particularly with modified-release formulations.
  • Caution is needed in active peptic ulcer disease and hepatic impairment; consult the SPC for full cautions.

Monitoring

Monitor lipid profile, liver function, blood glucose and uric acid during treatment.

Counselling the patient

  • Warn the patient that flushing, warmth and itching of the skin are common, often shortly after a dose.
  • Explain that taking it with food and avoiding alcohol and hot drinks around dosing can reduce flushing.

Evidence & guidelines

Outcome trials (including AIM-HIGH and HPS2-THRIVE) did not show added cardiovascular benefit of nicotinic acid on top of statin therapy; refer to current prescribing references.

Reference: NICE CG181; HPS2-THRIVE; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

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