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Tolerance to nicotinic acid flushing.

R H Stern1, J D Spence, D J Freeman

  • 1Department of Medicine, University of Western Ontario, London, Canada.

Clinical Pharmacology and Therapeutics
|July 1, 1991
PubMed
Summary
This summary is machine-generated.

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Tolerance to nicotinic acid flushing develops as skin blood flow normalizes. This occurs not due to reduced nicotinic acid levels, but a decrease in the prostaglandin mediator responsible for the flushing effect.

Area of Science:

  • Pharmacology
  • Dermatology
  • Biochemistry

Background:

  • Nicotinic acid (niacin) causes flushing, a common side effect limiting its use.
  • The mechanism of tolerance development to this flushing is not fully understood.

Purpose of the Study:

  • To investigate the mechanism of tolerance to nicotinic acid-induced flushing.
  • To correlate objective measures of skin blood flow with plasma mediator levels.

Main Methods:

  • Subjects received a 5-day course of nicotinic acid treatment.
  • Objective measures of skin blood flow were recorded.
  • Plasma levels of nicotinic acid and prostaglandin F2 were analyzed.

Main Results:

  • Tolerance to flushing, confirmed by normalized skin blood flow, developed within 5 days.

Related Experiment Videos

  • Plasma nicotinic acid levels showed high variability but did not decrease with tolerance.
  • Plasma levels of prostaglandin F2, a metabolite of prostaglandin D2, became undetectable in tolerant subjects.

    • Conclusions:

    • Tolerance to nicotinic acid flushing is associated with decreased levels of prostaglandin F2, not nicotinic acid itself.
    • The prostaglandin mediator, not nicotinic acid levels, is key to flushing and tolerance development.