Medications for Lowering Your Cholesterol
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Nicotinic acid

What is it?
      Nicotinic acid or niacin, the water-soluble B vitamin, improves all lipoproteins when given in doses well above the vitamin requirement. Nicotinic acid lowers total cholesterol, LDL-cholesterol and trygylceride levels, while raising HDL-cholesterol (the “good” cholesterol) levels. There are two types: immediate release and timed release. Most experts recommend starting with the immediate-release form.

How should it be used?
      Nicotinic acid is inexpensive and is available without a prescription, but your doctor must monitor you because of potential side effects. Because the dose needed is about 100 times more than the Recommended Dietary Allowance for niacin and can be potentially toxic, the drug must always be taken under a doctor’s care and never self-prescribed.

Does it work well?
      Nicotinic acid reduces LDL-cholesterol levels by 10 to 20 percent, triglycerides by 20 to 50 percent, and raises HDL-cholesterol by 15 to 35 percent.

What are side effects?
      A common and troublesome side effect of nicotinic acid is flushing or hot flashes, which are the result of the widening of blood vessels. Most patients develop a tolerance to flushing.

What about nicotinic acid and blood pressure medications?
       If you are taking high blood pressure medication, it is important to set up a blood pressure monitoring system while you are getting used to your new niacin regimen. If you notice a change in your blood pressure, call your doctor.

     A variety of gastrointestinal symptoms including nausea, indigestion, gas, vomiting, diarrhea, and the activation of peptic ulcers have been seen with the use of nicotinic acid. Three other major adverse effects include liver problems, gout, and high blood sugar. Risk of the latter three increases as the dose of nicotinic acid is increased. Your doctor will probably not prescribe this medication for you if you have diabetes, because of the effects on your blood sugar.

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