Nicotinic Acid-

Potentiates the effects of ganglionic blocking agents resulting in postural hypotension Increased risk of rhabdo-myolysis with concomittant admin ogf HMG -CoA reductase inhibitors Alcohol or hot drinks may increase the side effects of flushing and pruritus and should be avoided at the time of drug ingestion

Xanthine nicotinate- Cerebral circulatory disturbances Nicotinic acid- Primary hypercholesterolaemia

Nicotinic acid

Vomiting,diarrheoa, peptic ulceration Jaundice, abnormal LFTs Decreased glucose tolerance Hyperuricaemia, gout, toxic ambblyopia Flushing, pruritus, Hyperpigmentation, dry skin, and headace Artial fibrillation, orthostasis, Cystoid oedema

Hepatic dysfunction, active peptic ulcer, severe hypotension, hemorrhage. Special precautions: May cause GI upsets.Take with meals. If dizziness occurs,avoid sudden changes in posture.

Nicotinic acid-

Liver disease, active peptic ulcer Severe hypotension Artreial bleedding Special precautions- Gout, special cases of hepatic toxicity including fulminant hepatic necrosis have occured in patients who have substituted SR nicotinic acid products for immediate-release nicotinic acid at equiv. doses Monitor LFT , DM , diabetic patients may experience a dose related rise in glucose intolerance Children, adolescents, Pregnancy, lactation ( contraindicated at high doses)

Indications:

Xanthine nicotinate- Cerebral circulatory disturbances Nicotinic acid- Primary hypercholesterolaemia

Dosage- Xanthine nicotinate- amp- 300mg i.m. or i.v. or i.v. infusion to be given slowly Max- 900mg tabs- 300-600mg thrice daily with meals tabs 1-2 tabs twice daily after meals

Nicotinic acid- Initially 375mg dailty at bedtime for week 1 500mg daily at bed time for week 2 750mg daily at bed time for week 3 Increase to 2x 500mg tabs at bed time for weeks 4-7 After week 7 titrate dose according to patients response and tolerance increassing if required to 2x 1000mg tabs daily in increment of maximum 500mg at minimum 4 weeks intervals Maintenance - 1000-2000mg once daily at bed time Not recommended for children

For Availability/supplies 

Classification:

Vitamins Patent position: Major Brands: BEPLEX-ZEE AFD HEPATOGLOBINE RAPTAKOS LIVOGEN GLAXO-WELLCOME

NICOTINIC ACID DERIVATIVES- PERIPHERAL VASODILATORS- 

1.Cutaneous flushing and a sensation of warmth, especially in the area of the face, neck and ears, may occur, within the first 2 hours. Itching or tingling and headache may also occur. These effects are transcient and will usually subside with continued therapy.

2. May cause GI upset, take with meals.

3. If dizziness (postural hypotension ) occurs, avoid sudden changes in posture.

4. Allergy- Tell your doctor if you had any allrgic reaction to Nicitinic acid, or food substances, preservatives,, dyestuffs etc

5. Pregnancy- It is important that you are receiving enough vitamins when you are pregnant and that you continue to receive right amounts of vitamins through out your pregnancy. However lage amounts of dietary supplemens are harmful to the mother or the fetus and should be avoided.

6. Breast feeding- It is important that you receivetherightamountf vitamins so that your baby will also get the vitamins needed to grow properly.However lage amounts of dietary supplemens are harmful to the mother and or the baby and should be avoided.

7. Children- Problems in children have not been reported with normal intake of vitamins

8. Medicines and other dietary supplements- Certain medicines and dietary supplements should not be used at all, it important that your doctor knows if you are taking other medicies or OTC products.

9. Other medical problems- Tell your doctor if you are having any other medical problems especially- Bleeding problemsor Diabetes mellitus or Glaucoma or Gout or Liver disease or Low blood pressure or Stomach ulcer or Niacior niacinamide may make these conditions worse.

10. Dosing- Follow doctors instructions

11. Missed dose- If you miss a dose of this medicine take it as soon as possible. However, it is almost time for the next dose, skip the missed dose and go back to normal schedule. Do not double doses.

12. Storage- Keep the medicines our of reach of children Store the medicines away heat and direct light Do not store tablets or capsules in the bath room, in damp places near the kitchen sink Heat and dampness will cause the medicines to break down Do not store out dated medicines or medicines no longer needed. Make sure that all discared medicines are kept out of reach of children

Pharmacology:

Nicotinic acid functions in the body as a component of two coenzymes; NAD (nicotinamide adenine dinucleotide, coenzyme I ) and NADP ( nicotinamide adenine dinucleotide phosphate, coenzyme II ). Nicotinic acid causes a release of histamine, which acts directly on peripheral vessels, producing vasodilation and increased blood flow.

Pharmacokinetics:

Niacin is rapidly absorbed from the G I tract; peak serum concentrations usually occur within 45 minutes. The plasma elimination half-life is about 45 minutes.

Not siginficant

Pregnancy:

Use doses in excess of nutritional requirements during pregnancy or lactation only when clearly needed and when potential benefits outweigh potential hazards to the fetus or nursing infant.

Children:

Safety and efficacy in children have not been established.