Clinical utility of extended-release niacin: update and summary

In the treatment of dyslipidemia and coronary heart disease, niacin extended-release (ER) (Niaspan) uniquely targets the atherogenic lipid abnormalities of the metabolic syndrome. Niacin ER raises high-density lipoprotein cholesterol more effectively than other agents, while reducing triglyceride and lipoprotein(a) levels and increasing low-density lipoprotein particle size. It is formulated to minimize the toxicities and adverse effects associated with other niacin formulations, making niacin ER more tolerable for patients. Previous concerns of hyperglycemia have been addressed by numerous studies demonstrating that morbidity and mortality benefits outweigh potential increases in glucose levels. Niacin ER is an important lipid-lowering agent in preventing fatal and nonfatal coronary events and slowing the progression of atherosclerosis.