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High Cholesterol Message Board

High Cholesterol Board Index

I have no problem with anyone who chooses to use Niaspan. But I do not feel that it is necessarily superior or safer than some other products which can be purchased over the counter. Nowadays, there are several reputable vitamin manufacturers who do market quality products. The fact that Niaspan is the only extended-release niacin product approved by the Food and Drug Administration should come as no surprise, since it is, to the best of my knowledge, the only form of niacin that is currently available by prescription. That means that Niaspan is the only product that the FDA by law is required to evaluate. So, what kind of competition does it have in the way of FDA endorsements? Absolutely none.

A previous poster stated that since Niaspan has been evaluated by the FDA, it is therefore the safest form of niacin to take. I don't agree with that. Nor do I agree with the statement concerning flush-free niacin. Time-release nicotinic acid generally poses an increased risk for potential liver abnormalities. So Niaspan can hardly be considered to be safer than other forms of over the counter products just because the FDA endorses it. In fact, if it truly was a safer product, then it would be available over the counter, like all the rest of them, and not by prescription. This illusion of safety is largely due to the fact that it is available by prescription only, and you therefore need to be under a doctor's care while taking it. But that doesn't make the product itself any safer. You can purchase a good quality time-release product over the counter, and still be afforded the same added measure of safety if you are routinely checked by your doctor.

I have to admit that the marketing of Niaspan was a rather clever move on the part of the drug industry. Here they took this relatively simple, inexpensive over the counter supplement and tweaked it a bit in order to obtain a patent. They then market it as a prescription drug in order to jack up the cost, then aggressively promote the product to physicians everywhere. Bingo! A genuine cash cow is born!
Can anyone bear, or has anyone here KNOWN anyone who can bear a dose of "regular" immediate releast niacin of 1000 mg.(or god, 2000 mg.) with or without 81, 325, or even 650 mg aspirin...and then to do it for LIFE!

If not, you have to wonder why all the books keep prattling on and on about using doses like this for cholesterol control. If nobody can bear this much "flush," why don't the texts just drop the subject. I guess I answered my own SELL MORE VITAMINS and now PHARMACEUTICALS. Sad!

The word "flush" is such a misnomer. For me, it's like calling being smashed between two railroad cars a "pinch injury." Only advantage to the flush is that at least you know there's SOME niacin in the pills you bought :D!

My final take on niacin efficacy: Immediate Release works pretty well(cholesterol lowering) and causes extreme flush and is dirt cheap. Extended Release doesn't work at all and thus causes no flush but puts the liver at big risk.

Niaspan ("sustained release"- really somewhat extended release)) goes mid-road and gives some flush, some benefit, and some liver damage. Cost is really huge!

On the cost:
My cheapest US on-line pharmaceutical house prices 2000 mg Niaspan at $ 105.98 per 30 day supply.

The same company prices Lipitor at:
20 mg....$94.99/30 days
10 mg....$62.99/30 days
(splitting the 20's of course costs $47.50/ month.)
So Niaspan is considerably pricier than statins...unless you have a REALLY cheap Niaspan supplier? :D
No doubt the Niaspan has done good things for you.

I believe most of the extended release references I've seen are for simply the capsules with granules of plain old niacin wrapped in carriers that dissolved in different parts of the digestive system. Except for this board I haven't run accross anything on the inositol compound, so I've formed no opinion on it.
I'll look round for info on it.

I repeat the first part of my question....has ANYONE been able to take 1000 or 2000 mg. of "regular" niacin without feeling like he was being slaughtered! :D

[This message has been edited by zip2play (edited 10-25-2003).]
I think that if a person has a prescription drug plan which covers approximately 80% of the cost, then the price of the Niaspan is really not too big of an issue, since out of pocket expenses will only amount to $21/month.

But what about those people who have no such prescription drug plan? That $106/month out of pocket expense is quite costly for many people.

Far more often than not, there is absolutely no reason at all why a patient cannot be allowed to first try an over the counter product. Even in the case of inositol hexanicotinate, which is more expensive than ordinary niacin, the out of pocket expense would be considerably lower. Certainly the doctor can still monitor the patient, and advise him or her in regards to dosages. Take a reputable brand like TWINLAB for example, which manufactures an inositol hexanicotinate supplement. Each capsule contains 640mg niacin. You can get it at a reasonable price. Even if you were to take 4 of these capsules each day, which works out to 2560mg niacin, the monthly cost would be just $27.30! If it doesn't work, Niaspan would still be an option. And if it does work, well, all the better! My point is that the patient should at least be allowed this option first.

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