Nicotinic Acid (Niacin) for High Cholesterol

Covers nicotinic acid medicine to treat high cholesterol. Includes generic and brand names such as niacin (Niacor and Niaspan). Looks at why it is used and how well it works. Includes possible side effects.

Nicotinic Acid (Niacin) for High Cholesterol


These medicines contain the nicotinic acid form of niacin.

Immediate-release form

Generic Name Brand Name
niacin Niacor

Sustained-release form

Generic Name Brand Name
niacin Slo-Niacin

Extended-release form

Generic Name Brand Name
niacin Niaspan

How It Works

Nicotinic acid reduces the production of
triglycerides and VLDL (very low-density lipoprotein,
which is converted to
LDL in the blood). This leads to decreased LDL ("bad")
cholesterol, increased
HDL ("good") cholesterol, and lowered triglycerides.
Nicotinic acid raises HDL cholesterol more than other lipid-lowering

Why It Is Used

Nicotinic acid is used to lower cholesterol and triglycerides. Niacin may not be appropriate for some
people who have:

  • Gout.
  • Active stomach
  • Oversensitivity to niacin.
  • Glaucoma.
  • Type 2 diabetes
    and do not have their blood sugar levels controlled.
  • Clotting
    disorders, such as hemophilia.
  • Active liver
  • Alcoholism.

How Well It Works

Nicotinic acid can improve cholesterol levels, but it has not been proved to lower the risk of a heart attack or a stroke.

Side Effects

All medicines have side effects. But many people don't feel the side effects, or they are able to deal with them. Ask your pharmacist about the side effects of each medicine you take. Side effects are also listed in the information that comes with your medicine.

Here are some important things to think about:

  • Usually the benefits of the medicine are more important than any minor side effects.
  • Side effects may go away after you take the medicine for a while.
  • If side effects still bother you and you wonder if you should keep taking the medicine, call your doctor. He or she may be able to lower your dose or change your medicine. Do not suddenly quit taking your medicine unless your doctor tells you to.

Call 911 or other emergency services right away if you have:

  • Trouble breathing.
  • Swelling of your face, lips, tongue, or throat.

Call your doctor if you have:

  • Hives.
  • Severe stomach pain.
  • Loss of appetite.
  • Yellow eyes or skin (symptoms of jaundice).

Common side effects of this medicine include:

  • Flushing or redness of skin on face and neck.
  • Itching.
  • Headache.
  • Dizziness or lightheadedness.
  • Diarrhea.

These side effects are more severe when higher doses are

See Drug Reference for a full list of side effects. (Drug
Reference is not available in all systems.)

What To Think About

Flushing side effect

Facial flushing and
itching gradually diminish over time for most people. Starting with a low dose
and gradually increasing the dose may reduce the flushing and itching. If you need to relieve flushing, talk with your doctor to find a method that works for you.

Over-the-counter niacin

Talk to your doctor before you start taking
over-the-counter (nonprescription) niacin. If you choose to take it, ask your
doctor to help you know which medicine to buy and how much to take.

acid is a B vitamin that is available without a prescription as a vitamin
supplement (niacin). The nicotinic acid form of niacin lowers cholesterol, but
other forms of niacin do not. These other forms that do not lower cholesterol
include nicotinamide and inositol nicotinate (also called no-flush niacin).

Ask your doctor how much niacin you should take. You want to take a dose that will work. But you do not want
to take more niacin than you need. Larger doses of niacin can be dangerous,
because they can damage your liver.

Activity and diet

A heart-healthy lifestyle is important for lowering your risk whether you take medicine or not. This includes eating healthy foods, being active, staying at a healthy weight, and not smoking.

Taking medicine

Medicine is one of the many tools your doctor has to treat a health problem. Taking medicine as your doctor suggests will improve your health and may prevent future problems. If you don't take your medicines properly, you may be putting your health (and perhaps your life) at risk.

Advice for women

If you are pregnant, breastfeeding, or trying to get pregnant, do not use any medicines unless your doctor tells you to. Some medicines can harm your baby. This includes prescription and over-the-counter medicines, vitamins, herbs, and supplements. And make sure that all your doctors know that you are pregnant, breastfeeding, or planning to get pregnant.


If you take niacin as a prescription or over-the-counter medicine, your doctor will likely have you get regular blood tests to check for liver problems.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

Complete the new medication information form (PDF) ( What is a PDF document? ) to help you understand this medication.


ByHealthwise StaffPrimary Medical Reviewer Kathleen Romito, MD - Family Medicine Martin J. Gabica, MD - Family Medicine Specialist Medical Reviewer Adam Husney, MD - Family Medicine

Current as ofOctober 5, 2017