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Adverse ocular effects associated with niacin therapy
F W Fraunfelder1, F T Fraunfelder, D R Illingworth
1Oregon Health Sciences University, Department of Ophthalmology, Portland 97201.
The British Journal of Ophthalmology
|January 1, 1995
Summary
High-dose niacin (nicotinic acid) may cause adverse ocular side effects like blurred vision and macular edema. These vision problems are reversible upon discontinuing niacin, with severity linked to dosage.
Area of Science:
- Ophthalmology
- Pharmacology
- Cardiology
Background:
- Hyperlipidemia is a significant risk factor for cardiovascular disease.
- Niacin (nicotinic acid) is a lipid-lowering agent used to manage hyperlipidemia.
- Ocular side effects associated with niacin have been anecdotally reported.
Purpose of the Study:
- To investigate the association between niacin use and adverse ocular events.
- To compare the incidence of ocular side effects in patients taking niacin versus other lipid-lowering agents.
- To characterize the spectrum and reversibility of niacin-induced ocular toxicity.
Main Methods:
- Retrospective survey of patients undergoing treatment for hyperlipidemia.
- Analysis of spontaneous reporting systems for drug-associated adverse events.
- Comparison of ocular side effect incidence between niacin users and non-niacin users.
Main Results:
- Patients taking niacin reported higher incidences of sicca syndromes, blurred vision, eyelid edema, and macular edema (p < 0.05).
- Seven percent of niacin users discontinued the drug due to ocular side effects, a rate significantly higher than other lipid-lowering agents (p = 0.016).
- Spontaneous reports suggest associations between high-dose niacin and decreased vision, cystoid macular edema, and eyelid/periorbital changes.
Conclusions:
- Niacin use, particularly at high doses, is associated with a range of adverse ocular effects.
- These ocular side effects appear to be dose-dependent and are reversible upon drug discontinuation.
- Ophthalmologists and healthcare providers should be vigilant for these potential ocular complications in patients treated with niacin.