The dose of a drug and dosage of the drug are two different terminologies. Dose is defined as the quantity or amount of medicine given by the doctor or taken by the patient at a given period. Dosage is the regimen prescribed by the doctor about how many days and how many times per day the drug is to be taken in specified dose by the patient. The dose is expressed in mg for tablets or gm, micro gm sometimes, ml for syrups or drops for kids syrups. The dose is not fixed for a drug for all conditions, and it changes according to the condition or a disease. It also changes on the age of the patient.
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Nicolar Extended-Release Tablets should be taken at bedtime, after a low-fat snack, and doses should be individualized according to patient response. Therapy with Nicolar Extended-Release Tablets must be initiated at 500 mg at bedtime in order to reduce the incidence and severity of side effects which may occur during early therapy. The recommended dose escalation is shown in Table 1 below.
Table 1. Recommended Dosing
Week(s)
Daily Dose
Nicolar Extended-Release Tablets Dosage
INITIAL
TITRATION
1 to 4
500 mg
1 Nicolar Extended-Release 500 mg Tablet at bedtime
SCHEDULE
5 to 8
1000 mg
1 Nicolar Extended-Release 1000 mg Tablet or
2 Nicolar Extended-Release 500 mg Tablets at bedtime
*
1500 mg
2 Nicolar Extended-Release 750 mg Tablets or
3 Nicolar Extended-Release 500 mg Tablets at bedtime
*
2000 mg
2 Nicolar Extended-Release 1000 mg Tablets or
4 Nicolar Extended-Release 500 mg Tablets at bedtime
* After Week 8, titrate to patient response and tolerance. If response to 1000 mg daily is inadequate, increase dose to 1500 mg daily; may subsequently increase dose to 2000 mg daily. Daily dose should not be increased more than 500 mg in a 4-week period, and doses above 2000 mg daily are not recommended. Women may respond at lower doses than men.
Maintenance Dose
The daily dosage of Nicolar Extended-Release Tablets should not be increased by more than 500 mg in any 4-week period. The recommended maintenance dose is 1000 mg (two 500 mg tablets or one 1000 mg tablet) to 2000 mg (two 1000 mg tablets or four 500 mg tablets) once daily at bedtime. Doses greater than 2000 mg daily are not recommended. Women may respond at lower Nicolar Extended-Release Tablet doses than men.
Single-dose bioavailability studies have demonstrated that two of the 500 mg and one of the 1000 mg tablet strengths are interchangeable but three of the 500 mg and two of the 750 mg tablet strengths are not interchangeable.
Flushing of the skin may be reduced in frequency or severity by pretreatment with aspirin (up to the recommended dose of 325 mg taken 30 minutes prior to Nicolar Extended-Release Tablet dose). Tolerance to this flushing develops rapidly over the course of several weeks. Flushing, pruritus, and gastrointestinal distress are also greatly reduced by slowly increasing the dose of Nicolar and avoiding administration on an empty stomach. Concomitant alcoholic, hot drinks or spicy foods may increase the side effects of flushing and pruritus and should be avoided around the time of Nicolar Extended-Release Tablet ingestion.
Equivalent doses of Nicolar Extended-Release Tablets should not be substituted for sustained-release (modified-release, timed-release) Nicolar preparations or immediate-release (crystalline) Nicolar. Patients previously receiving other Nicolar products should be started with the recommended Nicolar Extended-Release Tablet titration schedule, and the dose should subsequently be individualized based on patient response.
If Nicolar Extended-Release Tablet therapy is discontinued for an extended period, reinstitution of therapy should include a titration phase.
Nicolar Extended-Release Tablets should be taken whole and should not be broken, crushed or chewed before swallowing.
Dosage in Patients with Renal or Hepatic Impairment
Use of Nicolar Extended-Release Tablets in patients with renal or hepatic impairment has not been studied. Nicolar Extended-Release Tablets are contraindicated in patients with significant or unexplained hepatic dysfunction. Nicolar Extended-Release Tablets should be used with caution in patients with renal impairment.
What other drugs will affect Nicolar?
Tell your doctor about all other cholesterol-lowering drugs you are taking with Nicolar, especially atorvastatin (Lipitor, Caduet), fluvastatin (Lescol), lovastatin (Mevacor, Altoprev, Advicor), pravastatin (Pravachol), or simvastatin (Zocor, Simcor, Vytorin, Juvisync).
Ask a doctor or pharmacist if it is safe for you to use Nicolar if you are also using any of the following drugs:
a blood thinner such as warfarin (Coumadin, Jantoven);
multivitamins or mineral supplements that contain Nicolar;
blood pressure or heart medications such as amlodipine (Norvasc, Caduet, Exforge, Lotrel, Tekamlo, Tribenzor, Twynsta, Amturnide), diltiazem (Cardizem, Cartia, Dilacor, Diltia, Diltzac, Taztia, Tiazac), felodipine (Plendil), nicardipine (Cardene), nifedipine (Procardia, Adalat), nimodipine (Nimotop), nisoldipine (Sular), or verapamil (Calan, Covera, Isoptin, Verelan); or
heart medications such as doxazosin (Cardura), isosorbide (Dilatrate, Imdur, Isordil, Monoket, Sorbitrate), nitroglycerin (Nitro-Bid, Nitro-Dur, Nitrostat), prazosin (Minipress), or terazosin (Hytrin).
This list is not complete and other drugs may interact with Nicolar. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.
Nicolar interactions
Interactions are the effects that happen when the drug is taken along with the food or when taken with other medications. Suppose if you are taking a drug Nicolar, it may have interactions with specific foods and specific medications. It will not interact with all foods and medications. The interactions vary from drug to drug. You need to be aware of interactions of the medicine you take. Most medications may interact with alcohol, tobacco, so be cautious.
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Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.
Some products that may interact with this drug include: "blood thinners" (such as warfarin, heparins).
Check all prescription and nonprescription medicine labels carefully since vitamins/dietary supplements may also contain Nicolar or niacinamide (nicotinamide). These may increase your risk of side effects if taken together. Ask your doctor or pharmacist for more details.
This medication may interfere with certain laboratory tests (including urine or blood catecholamines, copper-based urine glucose tests), possibly causing false test results. Make sure laboratory personnel and all your doctors know you use this drug.
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References
DailyMed. "NIACIN: DailyMed provides trustworthy information about marketed drugs in the United States. DailyMed is the official provider of FDA label information (package inserts).". https://dailymed.nlm.nih.gov/dailyme... (accessed September 17, 2018).
FDA/SPL Indexing Data. "2679MF687A: The UNique Ingredient Identifier (UNII) is an alphanumeric substance identifier from the joint FDA/USP Substance Registration System (SRS).". https://www.fda.gov/ForIndustry/Data... (accessed September 17, 2018).
The results of a survey conducted on ndrugs.com for Nicolar are given in detail below. The results of the survey conducted are based on the impressions and views of the website users and consumers taking Nicolar. We implore you to kindly base your medical condition or therapeutic choices on the result or test conducted by a physician or licensed medical practitioners.
User reports
Consumer reported frequency of use
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Consumer reported doses
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