CKS is no longer commissioned by the National Institute for Health and Clinical Excellence (NICE). NICE remains committed to providing a replacement service for CKS and is currently reviewing its options. In the meantime, although CKS content is now not being maintained, it still remains relevant and will continue to be made available. CKS content was generated under a programme of topic creation and update. To check if the topic you are viewing is current or out of date, please refer to the topic publication details by clicking on the 'How up-to-date is this topic?' link in the left hand menu on individual topic pages.
Lipid modification - primary and secondary CVD prevention - Management
What are the drug interactions associated with nicotinic acid?
- There are case reports that nicotinic acid may increase the risk of muscle toxicity (e.g. rhabdomyolysis) in people taking a statin [Baxter, 2008].
- People on this combination should be warned to seek urgent medical advice if they experience any unexplained muscular adverse effects.
- The manufacturer of Niaspan® advises that concomitant alcohol or hot drinks may increase undesirable flushing and pruritus and should be avoided around the time of Niaspan® ingestion.
- The manufacturer warns that Niaspan® has been associated with small dose-related reductions in platelet count (mean of –11% with 2000 mg) and small increases in prothrombin time (mean of approximately +4%).
- The clinical significance of this is uncertain.
- For people on anticoagulants (e.g. warfarin), the manufacturer of Niaspan® advises that prothrombin time and platelet counts should be monitored closely.
[ABPI Medicines Compendium, 2006a]
© NHS Institute for Innovation and Improvement