New research suggests that cholesterol may not be the single most important factor leading to heart disease. Nonetheless, it is still relevant in many situations, and doctors will still focus on improving cholesterol profiles. One old medication that is still used occasionally is niacin (nicotinic acid). One drawback to this drug is the flush, with itching and tingling, that it commonly triggers. How can you fight niacin flush?
Alka-Seltzer to Fight Niacin Flush?
Q. My husband’s doctor prescribed niacin for cholesterol control. His HDL was too low and the doctor said niacin would improve that.
After taking the niacin, he had terrible tingling, itching and flushing. On his doctor’s advice, he started taking an Alka-Seltzer one half hour before taking the niacin (Niaspan) to fight niacin flush. He has had no symptoms since.
A. Niacin can raise HDL as well as lowering total cholesterol, but many people can’t tolerate the uncomfortable symptoms you describe. Using an extended-release formulation such as Niaspan helps a little. People also tend to get used to the niacin with time so that the flush is less bothersome.
Aspirin for Niacin Flush:
Doctors have long known that taking aspirin (an ingredient in Alka-Seltzer) with niacin or half an hour earlier cuts down on the flushing (International Journal of Clinical Pharmacology and Therapeutics, Feb., 2007). We are cautious about recommending regular use of Alka-Seltzer or other aspirin-containing products on a regular basis for older people, however. The FDA has just issued a warning about a “serious bleeding risk with over-the-counter antacid products containing aspirin.” Regular use could result in a life-threatening bleeding ulcer.
Apple Pectin to Fight Niacin Flush:
Another option to control the niacin flush is apple pectin. One placebo-controlled trial found that 2,000 mg of apple pectin taken half an hour before niacin reduced the duration of flushing about as well as aspirin (Journal of Clinical Lipidology, March-April, 2013). You can buy apple pectin supplements or eat an apple.
