Clinical update on the use of niacin for the treatment of dyslipidemia

PURPOSE: To provide nurse practitioners (NPs) with clinical and practical information about the use of niacin in the treatment of dyslipidemia. DATA SOURCES: Research-based and review articles in the medical literature and National Cholesterol Education Program guidelines. CONCLUSIONS: Niacin provides beneficial effects on all major lipid fractions, particularly high-density lipoprotein cholesterol and triglycerides. Niacin also reduces low-density lipoprotein (LDL) cholesterol; lipoprotein (a); and the number of highly atherogenic small, dense LDL particles. Niacin promotes angiographic regression when used in combination with other drugs that lower LDL cholesterol and can reduce cardiovascular risk in patients with coronary heart disease. Several niacin formulations are available, but the safety (i.e., from hepatotoxicity) and tolerability (i.e., severity of flushing) of these niacin formulations may differ. IMPLICATIONS FOR PRACTICE: Niacin therapy is appropriate for many types of lipid abnormalities, including complex dyslipidemias. NPs can take several steps to minimize potential side effects of niacin therapy and to ensure that patients adhere to this important intervention.