Hypocholesterolemic action, nicotinic acid

Nicotinic acid (niacin) was first shown to lower serum cholesterol levels over 40 years ago (1955). This activity is not related to its vitamin functions (nicotinamide does not share its action). At daily doses of 3 g niacin s hypocholesterolemic effects are about equivalent to clofibrate. In addition to lowering triglycerides, it can also raise HDL levels. Unfortunately, at these high doses nicotinic acid can produce intense flushes and itching, resulting in poor patient compliance. Circumventing the problem with potential pro-drugs such as nicotinyl alcohol, fructose tetranicotinate, and others were not very successful. 

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