Nicotinic acid - Oral

Nicotinic acid helps lower your cholesterol and triglyceride (fat) levels in the blood.

Excessive cholesterol and triglycerides in your body can clog up your blood vessels. This can lead to many health problems such as stroke and heart diseases, including heart attack.

This medicine is meant to be taken as part of a complete cholesterol management programme that should include exercise, a healthy diet and lifestyle.

Nicotinic acid may be used to treat other conditions as decided by your doctor.

Take Nicotinic acid exactly as directed by your doctor or according to the instructions on the label. Do not take more or less than instructed by your doctor.

Take this medicine together with food or immediately after a meal. Try to take it at the same time each day.

Nicotinic acid is available as a conventional tablet and extended-release tablet.

If you are taking the extended-release type of tablet (usually labelled as "ER"), swallow it whole, and take it at bedtime after taking a low-fat snack. Do not divide, chew, or crush the tablet.

Nicotinic acid must be taken regularly for it to be effective. Continue taking this medicine even when you feel better. Do not stop taking it unless instructed by the doctor.

Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and return to your normal dosing schedule.

DO NOT double a dose under any circumstances.

If you often forget to take your medicine, let your doctor and pharmacist know.

Alert your doctor if you have the following conditions:

• peptic ulcer disease (open sores in the lining of the stomach, small intestine, or lower food pipe)
• bleeding problems in the blood vessels of the heart
• severe liver disease

as Nicotinic acid may not be suitable for you.

Inform your doctor if you have the following conditions:

• unstable angina (chest pain that occurs randomly or unexpectedly)
• recent heart attack
• diabetes
• gout (high uric acid level in the blood)
• history of peptic ulcer disease
• history of gallbladder disease
• jaundice (yellowing of the skin and whites of the eyes with stomach pain, persistent tiredness, nausea or vomiting)
• kidney disease

Notify your doctor if you consume large amounts of alcohol or if you have problems related to alcohol withdrawal.

Let your doctor know if you are pregnant or breastfeeding.

If you are going to have certain laboratory tests (e.g. urine glucose tests) inform your doctor that you are taking Nicotinic acid.

Do not switch between conventional tablet and extended-release tablet unless instructed by your doctor. This is because different preparations of Nicotinic acid may have slightly different ways of working in your body.

Why is it important to keep my appointments with the doctor?

Keep your appointments with your doctor. Your doctor needs to monitor your condition and check your response to the medication regularly.

• Liver function tests must be done before and during treatment to know if this medicine is suited for you to take.
• Routine tests (e.g. cholesterol levels, blood sugar levels, uric acid levels) may be done while you are being treated with this medicine. Your doctor will advise you about how often you need to have these tests.
• Regular monitoring of signs of liver problems, muscle pain and weakness, and severe skin flushing (redness, warmth, tingling or itching that usually occurs on the face, neck, chest, or back) may also be needed.

What lifestyle changes should I make to reduce my cholesterol levels?

A healthy, balanced diet and regular exercise are keys to helping you reduce your cholesterol levels. Try to control the type and amount of food that you eat each meal. Include lots of fruits and vegetables in your diet, and avoid eating fried foods or foods that are high in fat. If you have not been exercising, start slow and gradually step up your exercise capacity.

Nicotinic acid may cause any of the following side effects: headache, dizziness, nausea, vomiting, diarrhoea, indigestion, cough, rash, itching, and darkening of the skin.

Some side effects may need immediate medical help. Alert your doctor quickly if you experience any of the following:

• rashes, breathlessness, swelling of the face, eyes, mouth or throat
• yellowing of the skin or eyes, abdominal pain, dark coloured urine, tiredness, swelling in the legs and ankles
• irregular or abnormal heartbeat
• sleepiness, confusion, passing urine more often, unusual thirst or hunger, fast breathing or breath that smells like fruit

Inform your doctor if any of these side effects do not go away or are severe, or if you experience other side effects.

Inform your doctor and pharmacist if you are taking any of these medicines:

• other cholesterol-lowering medicines e.g. pravastatin, simvastatin
• medicines for high blood pressure e.g. clonidine
• medicines for diabetes e.g. insulin
• aspirin (blood-thinning medicine)

This list does not include all medicines that may interact with Nicotinic acid.

Always notify your doctor and pharmacist if you are taking any other medicines, including herbal tonics such as traditional Chinese medicines, supplements, and medicines that you buy without a prescription.

Avoid alcohol. Consuming large amount of alcohol is very damaging to the liver.

Store in a cool, dry place away from the reach of children.

Medicines must not be used past the expiry date.