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Niacin must be taken in 2-3 gram doses or it is ineffective. However, even at low doses patients can get a red face and experience itching due to prostaglandin E1 release, which is a vasodilator. To minimize this the pt can take an aspirin one hour before taking the niacin because aspirin blocks prostaglandin synthesis. Niacin causes heartburn and other side effects as well. It acts on the liver. If pt is on niacin, it is usually a slow release mechanism to minimize effects on the liver. Uric acid production also increases (as is seen with the thiazide diuretics… this would be a good test question!!! Remember: uric acid excess leads to gouty arthritis).
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Pharmacology Notes
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