title: Niacin, an old drug with new perspectives for the management of dyslipidaemia.
abstract: Niacin has been used for decades to treat dyslipidaemic disorders. Niacin is the most effective agent currently available for increasing levels of high-density lipoprotein. Moreover, significant improvements in cardiovascular outcomes in niacin treated patients have been demonstrated. However, tolerability concerns, particularly flushing, have limited its use in the past. Therefore, ER niacin, a prolonged-release formulation of niacin, has been developed with similar efficacy but a superior tolerability profile compared to the immediate-release formulations. Recent insights on niacin mechanisms of action have led to the development of a new agent called laropiprant. Laropiprant selectively blocks the binding of prostaglandin D2 to its receptor (DP1) in dermal capillaries, which mediates niacin-induced vasodilation. When co-administered with ER niacin, a marked reduction in ER niacin induced flushing is seen.The clinical use of niacin and the novel flush-reducing co-medication, will be discussed.
authors.affiliation: Dienst Endocrinologie, Universitair Ziekenhuis Gasthuisberg, Herestraat 49, 3000 Leuven, België.
authors.forename: K
authors.initials: K
authors.lastname: Benhalima
authors.forename: E
authors.initials: E
authors.lastname: Muls
mesh_terms: D004338:Drug Combinations; D004347:Drug Interactions; D050171:Dyslipidemias / Q000188:drug therapy*; D005483:Flushing / Q000139:chemically induced / Q000517:prevention & control; D006801:Humans; D000960:Hypolipidemic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D007211:Indoles / Q000627:therapeutic use; D009525:Niacin / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*
chemical_list: D004338:Drug Combinations; D000960:Hypolipidemic Agents; D007211:Indoles; C518174:MK-0524; D009525:Niacin