Nicotinic acid

1. Nicotinic acid, or niacin, decreases the synthesis of LDL cholesterol. This agent increases the HDL level by 15 to 35 percent, reduces total and LDL cholesterol levels by 10 to 25 percent, and decreases the triglyceride level by 20 to 50 percent.

2. Side effects of nicotinic acid include flushing, pruritus, gastrointestinal discomfort, hyperuricemia, gout, elevated liver function tests and glucose intolerance. Taking 325 mg of aspirin 30 minutes before the drug is ingested may minimize flushing. Therapy should be avoided in diabetes mellitus because it tends to worsen glycemic control.

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