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Niaspan: Flushing
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The most common side effect of Niaspan is flushing, which is characterized by redness, tingling, or itching that typically occurs on the face, neck, chest, and back. In most cases, the flushing sensation lasts for one hour, approximately two to four hours after taking the dose. To minimize flushing, avoid drinking alcohol or hot drinks close to taking the dose, and avoid taking Niaspan with spicy foods.
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Niaspan and simvastatin are two widely prescribed medications for treating cholesterol. Niaspan is used to raise HDL "good" cholesterol levels, and simvastatin is effective in reducing LDL "bad" cholesterol levels. This combination is being submitted for FDA approval to address LDL, HDL and triglycerides in a single pill, which may lead to improved patient convenience and outcomes.
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Niaspan sales potential increased with the approval of several healthcare services extending coverage for the product. By the end of 1999 eight of the ten largest health maintenance organizations and nine of the ten largest pharmacy benefits managers provided reimbursement for Niaspan prescriptions. Niaspan won approval for reimbursement by state Medicaid agencies in California and Tennessee, where standards were the most stringent. Thus coverage was automatically extended to Medicaid agencies in all 50 states. In January 2000 the U.S. Veterans Affairs Department extended coverage to Niaspan, adding it to the national formulary at 170 hospitals serving more than 3.5 million military veterans.
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Niaspan and gemfibrozil increased the mean levels of aspartate aminotransferase by 15% to 16% but did not affect the level of alanine aminotransferase (Table 3). No patient in the study had an aminotransferase level greater than 3 times the upper limit of normal. Effects of Niaspan on glucose, uric acid, amylase, phosphorus, and creatinine levels were consistent with previous experience.9-10 Small but statistically significant increases in phosphorus and urea nitrogen, and decreases in uric acid and creatinine, were observed in the gemfibrozil group. Table 4 shows the changes in hematologic variables, the most substantial of which were a 11.6% increase in platelet count with gemfibrozil and a 12.8% decrease in platelet count with Niaspan. The changes in platelet count were not accompanied by clinical episodes of altered hemostasis.
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Niaspan should be used with caution if you have diabetes, a heart condition, or problems with gout. If you have diabetes, tell your doctor if you have a change in blood sugar levels while taking Niaspan. Also use Niaspan with caution if you have kidney problems.
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Niaspan is contraindicated in patients with allergies to any of its ingredients, active peptic ulcer disease, significant or unexplained persistent liver dysfunction, or arterial bleeding. Niaspan should not be substituted for equivalent doses of immediate-release niacin. The most common side effect with Niaspan is flushing of the skin. Other commonly reported side effects include indigestion, headache, pain, abdominal pain, nausea, itching, diarrhea, runny nose, vomiting and rash.
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