What Do I Need to Know About Nicotinic Acid to Lower Cholesterol?

Nicotinic acid is one type, or class, of medicine used to lower cholesterol. It is pronounced nick-oh-TIN-ick AS-sid. It is a form of vitamin B3, or niacin. It has been used safely for decades to lower cholesterol.

When Is Nicotonic Acid Prescribed?

Nicotinic acid is especially helpful for people with moderately elevated LDL and triglycerides and low HDL. Doctors suggest it along with diet changes and exercise for people whose levels aren't improving with these methods alone. Your doctor may suggest it if any of these is true.

  • You have heart disease.
  • You have borderline-high LDL - the bad cholesterol. And you also have low HDL - the good cholesterol.

  • You are at high risk for heart disease and have low HDL cholesterol.

Sometimes doctors suggest nicotinic acid along with other medicines that lower cholesterol. These may include bile acid resins, some statins, and some fibrates.

Common Names of Nicotinic Acid

Don't confuse nicotinic acid with nicotinamide, which is a different form of vitamin B3. The following table shows some of the most common brand and generic names for this type of medicine.

brand generic
Niacor crystalline nicotinic acid
Niaspan sustained-release nicotinic acid
Nicotinic Acid sustained-release nicotinic acid

How to Take Nicotinic Acid

Some forms of crystalline nicotinic acid are available only with a prescription. Your doctor may prefer a prescription form since these go through a more careful analysis than over-the-counter types. However, your doctor may recommend an over-the-counter form for use as a vitamin supplement. Even over-the-counter forms can cause serious side effects if your doctor is not monitoring your condition carefully. So you should not take nicotinic acid to lower your cholesterol on your own. Take this drug only if your doctor tells you to and monitors your condition.

Most people take nicotinic acid as a tablet or capsule one to three times a day, along with or after meals. A typical dose is 1,500 mg and 3,000 mg per day. Your doctor will likely start you at a very low dose. Then he or she will increase your dose gradually over 6 weeks or so until you reach the dosage that works for you. Follow your doctor's guidance about when and how to take your medicine and how much to take.

How Nicotinic Acid Works

Nicotinic acid works by affecting enzymes in your liver. It also affects enzymes in the fatty tissue stored in your body. In your liver, nicotinic acid reduces the production of very-low-density lipoproteins, called VLDL. Normally some VLDL particles are converted into LDL cholesterol. Reducing VLDL lowers LDL levels - and that means you've lowered the bad type of cholesterol.

Nicotinic acid also changes the way your body breaks down fat. By doing this, it may help reduce your triglyceride level. It may lower LDL cholesterol by 5% to 25%. It may lower triglycerides by 20% to 50%. It may also raise HDL cholesterol - the good type - by 15% to 35%.