Doctors suggest that Niaspan, a common medication presribed to lower cholesterol, may not actually lower “bad” cholesterol enough to counteract the risk of serious side effects, making it a bad treatment option.
In a large study published in the New England Journal of Medicine on July 17, researchers from Oxford University in England found that patients taking niacin, which is commonly sold under the brand name Niaspan, may face an increased risk of bleeding, ulcers and other side effects.
Researchers evaluated data on nearly 26,000 adults with vascular disease in Europe and China. Patients were given a combination of 2 grams of extended-release niacin and 40 milligrams of laropiprant or a placebo. Researchers followed up with patients over the course of four years.
Participants who were given the niacin-laropiprant combo had a low-density lipoprotein (LDL), “bad” cholesterol, average of 10 mg per deciliter lower. Patients also had an average of 6 mg per deciliter higher level of high-density lipoprotein (HDL), or “good” cholesterol.
The Niaspan combo lowered the bad cholesterol and raised the good cholesterol, but had no effect on reducing rates of stroke, heart attack or chest pain. The drug combination also had negative side effects, such as increased adverse events involving the gastrointestinal system, musculoskeletal system, skin and increased rates of infection and bleeding.
Patients were more likely to suffer bleeding, stomach ulcers, heartburn, diarrhea and infections than those on placebo. The study’s authors also indicate patients on Niaspan are also nine percent more likely to die, although since few people in the study died, the rate of death is harder to measure.
The drug was also linked to a 32% increase in the risk of diabetes.
Other Studies Warn of Niaspan Side Effects
Niaspan is a prescription form of niacin, which is widely available as a generic. Also known as vitamin B3, naicin is found in many food and over-the-counter tablets.
Use of niacin in the U.S. tripled from 2002 to 2009, with doctors writing nearly 700,000 prescriptions of Niaspan each month in the United States.
Prior studies have also shown that niacin can help lower LDL, “bad” cholesterol, levels while raising the HDL or “good” cholesterol levels. But a number of previous studies also cautioned about the potential side effects of Niaspan.
In 2011, researchers halted a study on Niaspan 18 months early after concerns of increased risk of side effects, including stroke, were raised. During the clinical trial 27 patients given Niaspan suffered an ischemic stroke.
Another Niaspan study was stopped in 2013, after too many patients dropped out after suffering muscle damage and skin problems. One-in-four of the 25,000 patients began developing muscle damage.
The authors concluded that millions of people are taking Niaspan and increasing their risk of suffering adverse events while not receiving the benefits they are seeking. They suggest Niaspan may continue to be an option for patients who are at high risk of cardiovascular disease but who have contraindications for taking statins. They do not recommend Niaspan for the general population.