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I am taking over the counter niacin extended release for my high cholesterol along with simvastatin and zetia. This niacin says it is inositol nicotinate.

In researching niacin. I have found a number of references saying that for the niacin to be effective for reducing cholesterol, it must be nicotinic acid, not nicotinamide or inositol hexaniacinate. Since the niacin I am taking is not any of these three. Since what I am taking does not fall within any of these definitions, am I doing any good taking the niacin to reduce cholesterol?

I have a prescription for niaspan, but it is expensive through my HMO and I would prefer to use the OTC niacin, assuming it is doing the same thing.



Inositol nicotinate is the same thing as inositol hexaniacinate. It is hydrolysed to nicotinic acid (actually six nicotinic acid molecules). There are few large studies other than those for Niaspan. The studies that are available indicate that niacin functions best when co-adminsitered with a fibrate such as clofibrate. It also appears to work best at rather high concentrations (2400 mg).

Are you doing any good by taking niacin? Maybe. You should examine your blood work numbers carefully over a year of so to see if there is any improvement that can be attributed to the niacin. That, however, requires regular blood work (perhaps quarterly) which can start to get costly.

I have mixed thoughts on niacin. I've been taking Niaspan for a few years now. If it's doing anything, it's raising my HDL more than it's reducing my LDL or triglycerides. I'm considering stopping taking it, but not because I think it may not be worth it (BTW, I HATE the flushing which occurs about one a week for me... I feel like I'm going to spontaneously combust!!). I have Type 2 diabetes and want to start taking another medication that may not be compatible with the Niaspan. The diabetes medication is brand name, as is the Niaspan, so I may drop Niaspan to reduce my cost. The other medications I take are doing just fine at controling my lipids so I don't think stopping Niaspan will hurt much.

Sorry, got off track there. As I said, monitor your lipid numbers and see if you can discern any benefit from taking the niacin.