Diminishing the Flush of Niacin

Niacin effectively lowers LDL and triglyceride levels and is the most effective agent available for raising HDL levels. Unfortunately, niacin is not well tolerated by many patients because of flushing, a process mediated primarily by prostaglandin D₂. In a placebo-controlled, dose-ranging study conducted by the manufacturer of the prostaglandin D₂ receptor antagonist laropiprant (not yet approved for marketing in the U.S.), investigators evaluated the drug’s ability to reduce the incidence or severity of flushing associated with extended-release niacin (ERN). In the first phase, 154 patients with dyslipidemia were randomized to laropiprant (150 mg daily) or placebo in a 9-week crossover study. In the second phase, the 122 patients who compl…