Enthusiasm for niacin waned, now waxes.

Enthusiasm for niacin waned, now waxes

Niacin, first prescribed as a treatment for high blood cholesterol in 1955, is the granddaddy of today's commonly used cholesterol-lowering agents. However, side effects arising from therapeutically potent doses of this water-soluble vitamin have greatly restricted its use, notes Joseph M. Keenan, a family physician at the University of Minnesota in Minneapolis. Keenan cites studies showing that up to 40 percent of patients prescribed standard niacin quit taking it because of the side effects -- primarily upset stomach and a whole-body flushing of the skin -- as did 16 to 40 percent of patients treated with alternative, timed-release niacin formulations.

Keenan and his co-workers have now tested yet another timed-release version, with the niacin embedded in a wax matrix. In their 16-week, double-blind, placebo-controlled study of 201 men and women with elevated LDL levels, the new formulation achieved niacin's typical cholesterol reductions -- with almost no ill effects.

Side effects o ccur when large quantities of niacin enter the bloodstream, but the formulation tested by Keenan's group features a nondigestible wax that slowly parcels out the drug as it passes through the gut.

The findings suggest that 1,500 milligrams of niacin daily will achieve the same cholesterol-lowering effects seen with some controlled-release formulations containing 3,000 mg. Most impressive, however, was the patients' low dropout rate of only 3.4 percent, Keenan says. This "really is a breakthrough formulation," he told SCIENCE NEWS, adding that it may help revive interest in an effective and "dirt cheap" drug.