Niacin
Question: What is the optimal dosage for the non-prescription drug, niacin, available in several forms? I understand that it is beneficial in lowering triglycerides and raising HDL cholesterol, but that it can also be quite hepatotoxic.

Answer: Niacin is a naturally occuring vitamin. Many years ago it was found to lower cholesterol and until the advent of zocor and some of the newer drugs was used extensively. Although it is non-prescription use in excess of 500-750mg a day can produce elevated liver enzymes and in some cases liver damage. Consequently, it needs to be monitored regularly. The optimim dose is dictated by ones cholesterol. Some patients are very sensitive to this drug and will have their cholesterol lowered by 750-lOOOmg a day. Others will need 1500-2000mg a day. Diarrhea and flushing are usually the limiting side effects-the flushing can sometimes be blocked by an aspirin taken 20-30 minutes before the drug.
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