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Overview :
Large doses of niacin can result in clinical and laboratory
findings that may necessitate discontinuation. Adverse effects usually reverse
on discontinuation of high doses.
A high daily dose of niacin (nicotinin acid) is around 3
grams per day.
Clinical findings:
(1)
vasodilatation and flushing (secondary to histamine release and reduced by
premedication with aspirin)
(2)
pruritis or urticaria
(3)
blistering and hyperpigmentation of the skin
(4) nausea
and vomiting, stomache
(5)
headache
(6)
diarrhea or constipation
(7) cardiac
arrhythmias
Laboratory findings:
(1) decreased triglycerides
(2) increased HDL cholesterol
(3) elevation of liver function tests (transaminases,
alkaline phosphatase)
(4) elevated serum uric acid levels
(5) hyperglycemia in diabetics (secondary to insulin
resistance)
High doses should be avoided or used with caution in patients
with:
(1) unstable angina
(2) predisposition to gout
(3) diabetes mellitus
(4) liver disease
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