Niacin: A lipid polypill?

Kostner, Karam and Gupta, Sonell (2008) Niacin: A lipid polypill?. Expert Opinion on Pharmacotherapy, 9 16: 2911-2920. doi:10.1517/14656566.9.16.2911


Author Kostner, Karam
Gupta, Sonell
Title Niacin: A lipid polypill?
Journal name Expert Opinion on Pharmacotherapy   Check publisher's open access policy
ISSN 1465-6566
1744-7666
Publication date 2008-01-01
Year available 2008
Sub-type Article (original research)
DOI 10.1517/14656566.9.16.2911
Volume 9
Issue 16
Start page 2911
End page 2920
Total pages 10
Place of publication London, United Kingdom
Publisher Informa Healthcare
Language eng
Subject 2736 Pharmacology (medical)
3004 Pharmacology
Abstract Niacin is one of the oldest yet also most diverse lipid lowering agents. As it not only lowers low-density-lipoprotein (LDL) cholesterol, triglycerides (TG) and lipoprotein(a) [Lp(a)] but also increases high-density-lipoprotein (HDL) cholesterol, it is useful for treating a wide variety of lipid disorders including mixed hyperlipidaemia, hypertriglyceridaemia and isolated low HDL cholesterol, as well as elevated Lp(a). Niacin, which exists in several different formulations, such as immediate release (IR), extended release (ER) and slow release (SR) niacin, has several modes of action: it modulates liver TG synthesis, which leads to increased intracellular apolipoprotein (apo) B degradation and increases TG lipolysis in adipose tissue. Recently, a specific niacin receptor has also been discovered. Several clinical outcome trials have demonstrated that niacin reduces coronary artery disease risk in combination with statins and two large mortality trials are currently underway looking at hard end-point reduction with niacin and statin compared to statin alone. Niacin's major adverse event (AE) is flushing, and this prevents many patients from either taking it or reaching target doses of this drug. Flushing incidence and intensity is reduced with ER-niacin and by co-administration of aspirin and a selective or non-selective prostaglandin inhibitor.
Keyword Extended-release niacin
Flushing
Lipoproteins
Mechanisms
Niacin
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Medicine Publications
 
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