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Varying cost and free nicotinic acid content in over-the-counter niacin preparations for dyslipidemia.
Ann Intern Med. 2003 Dec 16; 139(12):996-1002.AIM

Abstract

BACKGROUND

Nicotinic acid is an effective treatment for dyslipidemia, but the content of over-the-counter niacin is not federally regulated. As a result, patients may use preparations of over-the-counter niacin that do not contain free nicotinic acid.

OBJECTIVE

To characterize the types, costs, and free nicotinic acid content of over-the-counter niacin preparations and to review literature on the use of over-the-counter niacin for dyslipidemia.

DATA SOURCES

Commonly used over-the-counter niacin preparations (500-mg tablets or capsules) from the 3 categories of immediate-release, sustained-release, and no-flush were purchased at health food stores and pharmacies and from Internet-based vitamin companies. Pertinent literature on the use of over-the-counter niacin was obtained by searching PubMed.

MEASUREMENTS

For each preparation studied, the monthly cost of therapy (at 2000 mg/d) and the free nicotinic acid content (quantified by high-performance liquid chromatography) were reported.

DATA SYNTHESIS

On average, immediate-release niacin preparations cost 7.10 dollars per month, sustained-release preparations cost 9.75 dollars per month, and no-flush preparations cost 21.70 dollars per month. The average content of free nicotinic acid was 520.4 mg for immediate-release niacin, 502.6 mg for sustained-release niacin, and 0 for no-flush niacin.

CONCLUSIONS

No-flush preparations of over-the-counter niacin contain no free nicotinic acid and should not be used to treat dyslipidemia. Over-the-counter sustained-release niacin contains free nicotinic acid, but some brands are hepatotoxic. Immediate-release niacin contains free nicotinic acid and is the least expensive form of over-the-counter niacin.

Authors+Show Affiliations

Meyers CD
University of Washington School of Medicine, Seattle, Washington, USA. daniel.meyers@med.va.gov
Carr MC
No affiliation info available
Park S
No affiliation info available
Brunzell JD
No affiliation info available

MeSH

Chromatography, High Pressure LiquidDosage FormsFees, PharmaceuticalHumansHyperlipidemiasNiacinNonprescription Drugs

Pub Type(s)

Journal Article
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

14678919

Citation

Meyers, C Daniel, et al. "Varying Cost and Free Nicotinic Acid Content in Over-the-counter Niacin Preparations for Dyslipidemia." Annals of Internal Medicine, vol. 139, no. 12, 2003, pp. 996-1002.
Meyers CD, Carr MC, Park S, et al. Varying cost and free nicotinic acid content in over-the-counter niacin preparations for dyslipidemia. Ann Intern Med. 2003;139(12):996-1002.
Meyers, C. D., Carr, M. C., Park, S., & Brunzell, J. D. (2003). Varying cost and free nicotinic acid content in over-the-counter niacin preparations for dyslipidemia. Annals of Internal Medicine, 139(12), 996-1002.
Meyers CD, et al. Varying Cost and Free Nicotinic Acid Content in Over-the-counter Niacin Preparations for Dyslipidemia. Ann Intern Med. 2003 Dec 16;139(12):996-1002. PubMed PMID: 14678919.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Varying cost and free nicotinic acid content in over-the-counter niacin preparations for dyslipidemia. AU - Meyers,C Daniel, AU - Carr,Molly C, AU - Park,Sang, AU - Brunzell,John D, PY - 2003/12/18/pubmed PY - 2003/12/20/medline PY - 2003/12/18/entrez SP - 996 EP - 1002 JF - Annals of internal medicine JO - Ann Intern Med VL - 139 IS - 12 N2 - BACKGROUND: Nicotinic acid is an effective treatment for dyslipidemia, but the content of over-the-counter niacin is not federally regulated. As a result, patients may use preparations of over-the-counter niacin that do not contain free nicotinic acid. OBJECTIVE: To characterize the types, costs, and free nicotinic acid content of over-the-counter niacin preparations and to review literature on the use of over-the-counter niacin for dyslipidemia. DATA SOURCES: Commonly used over-the-counter niacin preparations (500-mg tablets or capsules) from the 3 categories of immediate-release, sustained-release, and no-flush were purchased at health food stores and pharmacies and from Internet-based vitamin companies. Pertinent literature on the use of over-the-counter niacin was obtained by searching PubMed. MEASUREMENTS: For each preparation studied, the monthly cost of therapy (at 2000 mg/d) and the free nicotinic acid content (quantified by high-performance liquid chromatography) were reported. DATA SYNTHESIS: On average, immediate-release niacin preparations cost 7.10 dollars per month, sustained-release preparations cost 9.75 dollars per month, and no-flush preparations cost 21.70 dollars per month. The average content of free nicotinic acid was 520.4 mg for immediate-release niacin, 502.6 mg for sustained-release niacin, and 0 for no-flush niacin. CONCLUSIONS: No-flush preparations of over-the-counter niacin contain no free nicotinic acid and should not be used to treat dyslipidemia. Over-the-counter sustained-release niacin contains free nicotinic acid, but some brands are hepatotoxic. Immediate-release niacin contains free nicotinic acid and is the least expensive form of over-the-counter niacin. SN - 1539-3704 UR - https://www.unboundmedicine.com/medline/citation/14678919/Varying_cost_and_free_nicotinic_acid_content_in_over_the_counter_niacin_preparations_for_dyslipidemia_ DB - PRIME DP - Unbound Medicine ER -