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The study involved 208 people who had, or were at high risk of developing, coronary artery disease and were being treated with a statin drug (primarily simvastatin [Zocor] or atorvastatin [Lipitor]). Participants were randomly assigned to receive niacin or a second cholesterol-lowering drug (ezetimibe; brand name Zetia) for an average of 14 months. Niacin was taken in the form of extended-release tablets at bedtime. The initial dose was 500 mg, which was increased as tolerated to a maximum of 2,000 mg each night.
In this study, niacin was well tolerated by most participants. However, niacin frequently causes a skin flush, which some people find intolerable, and 18% of the participants taking niacin discontinued it because of side effects.
On rare occasions, niacin in large doses (particularly extended-release forms of niacin) has caused liver damage. It is therefore important for anyone taking a large amount of niacin (such as more than 500 mg per day) to be monitored by a doctor. Despite these potential adverse effects, niacin has been shown to be an important weapon in the battle against cardiovascular disease.
Niacinamide, a form of vitamin B3 that is similar to niacin, does not cause a skin flush and does not lower serum cholesterol levels. Inositol hexanicotinate (sometimes called “no-flush niacin”) is another form that usually does not cause a skin flush. However, its effect on serum cholesterol levels appears to be minimal.
Suggested Use: As a dietary supplement, take 1 tablet daily with any meal for maximum results or as directed by your healthcare provider. Do not exceed recommended dosage.