Question of the Day – Monday August 13, 2018

Question – What are the commonly recognized toxicities and adverse effects associated with the therapeutic use of niacin?

Answer – The cited article notes “the following adverse events of clinical significance with niacin were collected: 1) new-onset diabetes or worsening glucose tolerance in patients with pre-existing diabetes; 2) gastrointestinal side effects (abdominal pain, nausea, dyspepsia, diarrhea); 3) liver toxicity (transaminases >3 upper limits normal); 4) musculoskeletal events (myositis with creatine kinase elevation); and 5) skin flushing.” (Garg A et al. Role of niacin in current clinical practice: A systematic review. 2017 Am J Med 130:173-187)