Alex Yampolsky, PharmD, is a clinical pharmacist at Elizabeth Seton Children’s Center, a pediatric long-term care facility in Yonkers, New York.
Niacor (niacin ) is an orally administered prescription medication that is used to lower the levels of low-density lipoprotein (LDL), known as "bad cholesterol", in the blood along with triglycerides (a type of fat in the blood) by restricting the build-up of lipids (fat cells). Niacor works by blocking how your liver makes cholesterol, as cholesterol can stick to the walls of your arteries and narrow or block them.
Niacor also increases levels of high-density lipoprotein (HDL), also known as "good" cholesterol in the blood, and ultimately decreases your risk of heart disease, including heart attack.
Moreover, it increases the activity of lipoprotein lipase, an enzyme that converts triglycerides back into cholesterol.
Niacor is categorized as a B vitamin. B vitamins are organic compounds that help the body convert food into energy (the metabolism), create new blood cells, and maintain healthy skin cells, brain cells, and other body tissues. While there are many formulations of Niacor, a common prescribed dosage is 500 milligrams of nicotinic acid/niacin.
Niacor is available in various oral formulations, including tablets and capsules.
Brand Name(s): Niacor
Dosage Form(s): Tablet, capsule, extended release capsule, extended release tablet
The Food and Drug Administration (FDA) has approved Niacor to be used alone or with other medicines to treat hyperlipidemia (high cholesterol). This may help prevent the development of pancreatitis (inflammation of the pancreas) and other problems caused by high levels of cholesterol and triglycerides in the blood.
Niacin is also used to help lower the risk of a heart attack in people with a history of heart disease. Additionally, Niacor is used as a treatment for dyslipidemia in specific refractory cases.
Take your niacin product as directed on the label. Do not take more than recommended.
Use this medicine exactly as directed by your healthcare provider. Follow all the directions on your prescription label. Ask your pharmacist for any clarification you may need.
Take Niacor two to three times a day. Your healthcare provider may start you with a one-half tablet as a single daily dose after dinner. Then increase your dose every four to seven days until the desired cholesterol and/or triglyceride level is reached. Generally, your dose should not exceed 6 grams per day.
Take Niacor with a meal to reduce common adverse reactions like flushing (reddening and warming of skin), pruritus (red itchy skin), and stomach upset. Flushing may also be reduced by taking a nonsteroidal anti-inflammatory drug (NSAID) such as Advil (ibuprofen) or Aleve (naproxen) before the Niacor dose.
Store Niacor in a tight container at room temperature of 68 F to 77 F. Keep Niacor away from moisture and heat (e.g., the bathroom). Keep out of the reach of children and pets. When traveling, transport Niacin in your carry-on or your checked baggage with its original label.
Healthcare providers may prescribe medications off-label for medical conditions that they are not approved to treat but have proven to be beneficial for.
Niacor can be used off-label to treat pellagra, although niacinamide is preferred by many healthcare providers due to a more favorable side effect profile.
Pellagra is a condition caused by Vitamin B-3 deficiency. Common symptoms of pellagra include watery diarrhea, decreased appetite, nausea, skin inflammation, and hallucinations/delusions.
Niacor is rapidly absorbed through the stomach. It enters the bloodstream within an hour. It is completely removed from the body in a few hours.
This is not a complete list of side effects, and others may occur. A healthcare provider can advise you on side effects. If you experience other effects, contact your pharmacist or a healthcare provider. You may report side effects to the FDA at fda.gov/medwatch or 1-800-FDA-1088.
As with all medications, Niacor can cause side effects. Tell your healthcare provider about any side effects you experience while taking this medication.
The most common side effects of Niacor are:
Call your healthcare provider right away if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:
Niacor may cause other side effects. Call your healthcare provider if you have any unusual problems while taking this medication.
If you experience a serious side effect, you or your healthcare provider may send a report to the FDA's MedWatch Adverse Event Reporting Program or by phone (800-332-1088).
The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.
The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.
Users should be aware of the following before beginning Niacor:
Severe allergic reaction: Avoid using Niacor if you have a known allergy to it or any of its ingredients. Ask your pharmacist or healthcare provider for a complete list of the ingredients if you're unsure.
Pregnancy: Consult with a healthcare provider if you plan on becoming pregnant during your use of Niacor, as there stand potential risks for the unborn fetus due to uncertainty over whether doses typically used for lipid disorders can cause fetal harm when administered to a pregnant person or whether it can affect reproductive ability.
Breastfeeding: Caution is recommended with breastfeeding as limited data on its effects is available. Talk with your healthcare provider if you plan to breastfeed, and weigh the benefits and risks of taking Niacor while nursing and the different ways to feed your baby
Adults over 65: Studies performed have not demonstrated specific problems that would limit the usefulness of Niacor extended-release tablets in older adults.
Children: Safety and effectiveness in children have not been established. Therefore, Niacor use in adolescents is not recommended.
People who smoke: Smoking can lower the effectiveness of Niacor. Try to stop smoking before starting Niacor, and avoid smoking while taking the medication. Your healthcare provider can help you with this goal.
If you forget to take a dose of Niacor, do not panic. You can skip the missed dose and resume your regular schedule. Do not try to double up to make up for the missed dose. Do not abruptly stop your prescription without first consulting your healthcare provider.
Do not take more Niacor than directed on the package label. Niacor overdose can happen when one takes too much of it. The manufacturer recommends a daily maximum of 12 tablets. Anything over that may result in an overdose. Overdose may lead to symptoms like severe skin flushing combined with dizziness, rapid heartbeat, nausea and vomiting, abdominal pain, diarrhea, and gout.
Taking too much Niacor can cause symptoms such as:
If you think you or someone else may have overdosed on Niacor, call a healthcare provider or the Poison Control Center (800-222-1222).
If someone collapses or isn't breathing after taking Tylenol, call 911 immediately.
It is very important that your doctor check your progress at regular visits. This will allow your doctor to see if the medicine is working properly to lower your cholesterol and triglycerides and if you should continue to take it. Blood and urine tests may be needed to check for unwanted effects.
Check with your doctor right away if you have dark-colored urine, diarrhea, a fever, muscle cramps or spasms, muscle pain or stiffness, or feel very tired or weak. These could be symptoms of a serious muscle problem called rhabdomyolysis, which can cause kidney problems.
Check with your doctor right away if you have pain or tenderness in the upper stomach, pale stools, dark urine, loss of appetite, nausea, unusual tiredness or weakness, or yellow eyes or skin. These could be symptoms of a serious liver problem.
This medicine may affect blood sugar levels. If you notice a change in the results of your blood or urine sugar tests or if you have any questions, check with your doctor.
This medicine may cause you to feel dizzy or faint, especially when you get up from a lying or sitting position. Getting up slowly may help. This effect should lessen after a week or two as your body gets used to the medicine. However, if the problem continues or gets worse, check with your doctor.
Do not stop taking niacin without first checking with your doctor. When you stop taking this medicine, your blood cholesterol levels may increase again. Your doctor may want you to follow a special diet to help prevent this from happening.
Before you have any medical tests, tell the medical doctor in charge that you are taking this medicine. The results of some tests may be affected by this medicine.
Do not take vitamins or other dietary supplements unless they have been discussed with your doctor. This especially includes vitamins or dietary supplements that contain niacin or similar ingredients.
Niacor is not appropriate for everyone. You should not take this medication if you are allergic to niacin or any of the inactive ingredients in Niacor.
Niacor may be used with caution in some people only if your healthcare provider determines it is safe. This includes:
Tell your healthcare provider about all of the medicines you take, including prescription and over-the-counter (OTC) medicines, and vitamins or supplements.
The following medications can increase the risk of toxicity when taken with Niacor:
Medications similar to Niacor include:
Niaspan (niacin, vitamin B3): Niaspan is extended-release niacin. It contains the same active ingredient as Niacor and works in the same way in the body. It is taken once daily at bedtime. It may be a better option for those who have trouble keeping track of their medications. Note: It is not interchangeable with other niacin products.
Vascepa (icosapent ethyl): Vascepa is used to treat excessively high triglycerides or prevent heart attacks. It needs to be taken with food. The exact way it works in the body to reduce triglyceride production is unknown.
Zetia (ezetimibe): Zetia is a cholesterol absorption inhibitor. It works by limiting the absorption of cholesterol in the small intestine. It is usually taken once daily at the same time each day. It can be used in people as young as 10 and might be a better option for children.
This is a list of drugs also prescribed to reduce the risk of strokes and heart attacks. It is NOT a list of drugs recommended to take with Niacor. Ask your pharmacist or a healthcare provider before using other medicines for stroke or heart attack prevention. They may contain ingredients similar to niacin.
Niacor reduces the levels of cholesterol and triglycerides (fatty substances) in your blood. It is used in combination with diet, exercise, and weight loss.
Niacin is a water-soluble B vitamin. Specifically, it is Vitamin B3 which can be found naturally in foods. However, the niacin in Niacor is synthesized chemically.
Niacor is an immediate-release tablet while Niaspan is an extended-release tablet. Niaspan is also associated with reduced flushing as the dose is not all released at once.
Niacor is only part of a complete treatment program that may also include diet, exercise, and weight control. You should follow your recommended diet and exercise routines very closely.
Niacin is usually started at a lower dose and increased gradually based on individual toleration. The recommended dose is one to two tablets taken two to three times a day. If you keep forgetting to take it, consider setting alarms on your phone.
It is best to take Niacor with food to reduce the risk of flushing, skin reactions, and stomach upset. Your healthcare provider may also recommend taking aspirin or an NSAID about 30 minutes before taking Niacor to reduce flushing. Ask your healthcare provider or pharmacist any questions you might have about the medication.
If you stop taking niacin for any length of time, talk with your healthcare provider before starting it again. You may need to restart the medication at a lower dose.
Verywell Health's drug information is meant for educational purposes only and is not intended to replace medical advice, diagnosis, or treatment from a healthcare provider. Consult your healthcare provider before taking any new medication(s). IBM Watson Micromedex provides some of the drug content, as indicated on the page.
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Capuzzi DM, Guyton JR, Morgan JM, et al. Efficacy and safety of an extended-release niacin (Niaspan): a long-term study. Am J Cardiol. 1998;82(12A):74U-86U. doi:10.1016/s0002-9149(98)00731-0
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