Date - 10 January 2005

Source- Drugs in Context 2004; 1A(9): Niaspan - Lipid disorders p341

Author - Anna Palmer

Niaspan^® is an extended-release formulation of nicotinic acid, or niacin, developed in order to provide the same lipid-lowering effects of the original nicotinic acid, but with an improved tolerability and safety profile. Nicotinic acid itself, as an immediate-release formulation, has been shown in clinical trials to slow the progression of cardiovascular disease and to reduce low density lipoprotein cholesterol (LDL-C), triglycerides, lipoprotein (a), and to increase high density lipoprotein cholesterol (HDL-C). However, its widespread use in clinical practice has been restricted by its poor tolerability profile, particularly the high prevalence of the so-called ‘niacin flush’, which involves a flushing, burning and itching sensation in the face and neck. Niaspan is absorbed into the bloodstream over an 8-12 hour period which alters the way the drug is metabolised and thus changes the profile of adverse events experienced by the patient. As a consequence, Niaspan has a reduced incidence of the niacin flush. Niaspan has been shown to possess equivalent efficacy to nicotinic acid in terms of its lipid-lowering effects and provides consistent reductions in triglycerides and lipoprotein (a) and increases in HDL-C. The LDL-C lowering effects of Niaspan appear to be more pronounced in hyperlipidaemic individuals than in those with normal baseline LDL-C levels. In addition, an additive effect upon LDL-C levels has been demonstrated for the combination of lovastatin with Niaspan. Many of the safety concerns relating to niacin (such as hepatic dysfunction, myopathy and hyperglycaemia) have not been observed in any of the Niaspan clinical trials. Thus, this new extended-release formulation of nicotinic acid represents a highly effective and well-tolerated agent for the control of plasma lipids in hyperlipidaemic individuals.

Keywords: Niaspan, Lipid disorders.