title: Lipid and transaminase concentrations after formulary conversion of Niaspan to Slo-Niacin.
abstract: OBJECTIVE
  Lipid and transaminase levels after conversion from immediate-release niacin to extended-release niacin were evaluated.
  
  
  METHODS
  All patients who had their medications converted from Niaspan to Slo-Niacin between March 2008 and January 2009 were considered for evaluation. Subjects who took =2000 mg of Niaspan were automatically converted to Slo-Niacin in a 1:1 dosing ratio conversion. Mean aspartate transaminase (AST) and alanine transaminase (ALT) levels and lipid values (low-density-lipoprotein [LDL] cholesterol, high-density-lipoprotein [HDL] cholesterol, and triglyceride levels) during Niaspan therapy were compared with the means of these values obtained after at least 90 days of Slo-Niacin therapy. Data were analyzed using the Wilcoxon rank-order test and frequency distributions.
  
  
  RESULTS
  Of the 1172 patients who were identified as having had their Niaspan switched to Slo-Niacin after formulary conversion, 142 met the inclusion criteria for this study. The majority of the patients had a decrease or no change in AST (72.5%) and ALT (69%) levels after at least 90 days of Slo-Niacin therapy. None of the patients had transaminase levels greater than three times the upper limit of normal during Slo-Niacin therapy. Differences in AST, ALT, triglyceride, and LDL cholesterol levels were not statistically significant between Niaspan and Slo-Niacin. On the other hand, patients' mean HDL cholesterol level was significantly greater with Slo-Niacin therapy than with Niaspan (42 mg/dL versus 40 mg/dL, respectively; p < 0.05).
  
  
  CONCLUSIONS
  Formulary conversion from Niaspan to Slo-Niacin resulted in a small but significant increase in HDL cholesterol concentration and no significant change in ALT or AST level.
authors.affiliation: James A. Haley Veterans Affairs Hospital, 13000 Bruce B. Downs Boulevard 119, Tampa, FL 33612, USA. cristina.byrd@va.gov
authors.forename: Cristina
authors.initials: C
authors.lastname: Byrd
authors.forename: Kim A
authors.initials: KA
authors.lastname: Mowrey
mesh_terms: D000410:Alanine Transaminase / Q000097:blood / Q000187:drug effects; D001219:Aspartate Aminotransferases / Q000097:blood / Q000187:drug effects; D008076:Cholesterol, HDL / Q000097:blood / Q000187:drug effects; D008078:Cholesterol, LDL / Q000097:blood / Q000187:drug effects; D003692:Delayed-Action Preparations; D050171:Dyslipidemias / Q000188:drug therapy*; D005572:Formularies, Hospital as Topic; D006801:Humans; D000960:Hypolipidemic Agents / Q000008:administration & dosage / Q000494:pharmacology*; D009525:Niacin / Q000008:administration & dosage / Q000494:pharmacology*; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D013997:Time Factors; D014280:Triglycerides / Q000097:blood
chemical_list: D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D003692:Delayed-Action Preparations; D000960:Hypolipidemic Agents; D014280:Triglycerides; D009525:Niacin; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase