How do you reduce or eliminate "flushing" while taking Niaspan?

Question

The only way I have been able to eliminate it completely is to drink Egg Nog (of all things) at the same time. But 1) Egg Nog is only available from Thanksgiving to New Years in my area, 2) the calories are killing me even with light versions, and 3) I think I might be lactose intolerant.

I already take a baby aspirin with it.

Non-Alcoholic Egg Nog is what I drink. It is the only thing that makes me NOT flush...

Answer 1

About the booze (assuming your egg nog is alcoholic): as you can see below, booze is one of the last things a person who has a problem with flushing would want to take. It's very strange that you perceive it to help... But, besides the vasodialation, you should remember that niacin can be hard on the liver. (http://www.bodyandfitness.com/Information/Health/Research/niacin.htm -- this page talks about it under the "cautions and side effects" section.) Strangely, it's also something alcoholics are deficient in... Damned if you do, and if you don't (that is, once you've developed liver problems from being an alcholic and consequently become deficient in niacin yet can't take it because it hurts the liver!)

All that said: I'm surprised you're dealing with much flushing in a time-release formulation... Ask your doctor if there are any other forms of niacin that you could take instead of this one. (There are many other forms of niacin, and I know for a fact that some of them do not cause flushing, and have other benefits. I doubt that any particular brand that you could buy would have any studies done on that particular brand, unlike this prescription Niaspan. However, you could find a reliable manufacturer that makes a form of niacin with documented benefits (for the form of niacin [if not the particular brand]).

One of these forms of niacin with less flushing is niacinamide. This page seems to indicate that there *is* a prescription niacinamide product: http://www.vastrx.com/druginfo/niacinamide_niacin_oral_00536406801.htm.

This page explicitly states there is a niacinamid product approved by the FDA:
http://www.dusapharma.com/newnicomide1.html

Thus, even without taking "dietary supplement" niacin, you have an alternative form of niacin that you can take. (Niacinamide is not the form of niacin in Niaspan.) And niacinamid *does* have a reputation for causing less flushing.

Anyhow, I suggest you talk to your doctor about niacinamide, and alternative forms of niacin in general. Be sure to mention that there is a prescription product with niacinamide. (According to the Mayo Clinic, regular niacin and niacinamide are the only niacin products approved by the FDA for prescription use.)

Other than switching to prescription niacinamide, or to another non-prescription niacin formulation, there are some ways of coping with your current pill's side effect.

These two pages tackle the flushing associated with Niaspan:
http://www.niaspan.com/Niaspan_Flushing/index.asp
AND PARTICULARLY THIS SECOND ONE...
http://www.niaspan.com/Niaspan_Flushing/Flushing_Tips.asp

The second page suggests:
1) taking it with a low-fat snack
2) taking it with aspirin -- ha, pie in my eye! -- but they say to take regular strength aspirin or ibuprofen, not baby doses, 30 minutes before taking it -- so, take it earlier, and take a regular strength *if your doctor says it's OK to do* -- i.e., bring up the suggestion of the website -- and tell him that this is the manufacturer's website
3)Take it at bedtime -- this sounds like a very good suggestion -- if you sleep through it, it can't really bother you, can it?
4) Here's a quote: "one way you can help minimize flushing is to avoid doing other things that cause vasodilatation, such as the items on this list. * Alcohol * Hot drinks such as coffee or tea * Spicy foods * Hot showers or baths * Vigorous exercise
----uh oh, it sounds like egg nog, if it contains alcohol, is going to make things worse.

As the page says, this flushing is caused by vasodialation, i.e. the widening of blood vessels, which is what alcohol also does. (This is why alcohol makes you feel warm -- it opens up those blood vessels around your body. This is why it makes freezing people feel better, and it's also why it kills them -- it opens those vessels, making you feel warmer temporarily, but also causing you to lose that heat, and thus killing you quicker.)

So, avoid the booze if flushing is a problem!!! (And avoid those other things, too!) It might solve the problem.

5) "Focus on the benefit." -- basically, they recommend you deal with it! Ha!

6) -- this is on this mayo clinic page: http://www.mayoclinic.com/health/niacin/NS_patient-niacin
According to this page, taking an antihistamine 15 minutes prior to dosing can help. (Also, this page claims that flushing should may be reduced in "one to two weeks", and that extended release products should cause less flushing, which I already mentioned, than immediate release products. Also, it states that extended release formulations (may) cause higher incidences of stomach upset and liver "irritation" (ha! my liver's irritated!) than the immediate release products. It also also states that food may reduce the stomach upset -- I would particularly be diligent in taking it with food especially if I was combining it with ibuprofen or aspirin which, as we all know, are associated with serious stomach upset, and even ulcers.)

Obviously, if you're going to take aspirin or ibuprofen or an anti-histamine with your niacin (remember, they suggested half an hour before for the aspiring or ibuprofen, and 15 minutes before for the antihistamine [such as Benadryl -- that's an example, they didn't actually mention it]), you need to get your doctor's approval. Just bring it up. But remember -- food! Eat with aspirin or ibuprofen and niacin, too, as apparently niacin can irritate the tummy, esp. the extended release version. (I gotta say that I'm sorry that the extended release is still causing flushing -- which is exactly what it's supposed to cure. Who knows, maybe you'd be better off with an immediate release one with an aspirin or ibuprofen -- because otherwise the niacin will be released over a longer period than the aspirin or ibuprofen, thus outlasting the protection of the aspiring or ibu... or does the flushing, even from the extended release, disappear as quickly as with the immediate release, even though the vitamin continues to be released for many hours? Either way...)

---Finally, and this is very important -- FLUSHING IS A SIDE-EFFECT WHICH DIMINISHES WITH TIME!

I don't have detailed info about how long it generally takes to "peter out", but if it's been less than 3 months or so, I bet you have a good chance of enjoying a significant reduction in the flushing if you wait it out.

Also, try just going to www.niaspan.com (the first part of the links above), and from there you can see a link towards the bottom-left corner to the "Prescribing Information". You may be able to find some worthwhile information in there. Don't you want to know as much about your doctor regarding a pill that *you* are taking? I know I do!

Anyhow... Just talk to your doctor before doing anything / changing anything.

Basically:
1)consider different forms (niacinamide -- it's not effective for cholesterol lowering, but it has many of the other benefits. This is outlined on the Mayo Clinic page I've linked, I believe)
2) Consider ibuprofen or aspirin, but not at the baby dose, at the adult dose they reference in the links -- 30 minutes before taking the niacin.
3) Consider anti-histamine (they didn't mention a specific drug) -- 15 minutes before taking the niacin
4) Consider waiting -- it may take a couple weeks, but it might get better even after longer. You never know!
5) Finally, consider taking it at bedtime! This could work really well! Also, if taking an anti-histamine solves your problem, taking the anti-histamine with the niacin at bed would surely be better than taking the two during the day, as anti-histamines make you drowsy. This could work, with or without the anti-histamine
6) Be sure to try avoiding the things that worsen the flushing -- including alcohol!!! If you avoid it, and it doesn't get better, then maybe you don't need to concern yourself. But if the flushing is more bothersome than booze is enjoyable, your path is clear.

Well, that's it. Talk to your doctor about the things to consider above -- don't start taking things like higher doses of aspirin or ibuprofen or the anti-histamines without talking to the doc. Seriously. Good luck with your niacin treatment! -- there's good reasons for taking it, and I hope it serves you well!

Answer 2

This Site Might Help You.

RE:
How do you reduce or eliminate "flushing" while taking Niaspan?
The only way I have been able to eliminate it completely is to drink Egg Nog (of all things) at the same time. But 1) Egg Nog is only available from Thanksgiving to New Years in my area, 2) the calories are killing me even with light versions, and 3) I think I might be lactose intolerant.

I...

Answer 3

Geez, Louise, what a long answer above. I take it at night before I go to bed, and sleep through the flush.

Answer 4

Appearently Yahoo Canada never took a breather... but I got drunk to.

Answer 5

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