Nicotinic Acid Overdose

Rating: 5 - 1 review(s)
Did you have any side effects with this medicine?
sponsored

What happens if I overdose Nicotinic Acid?

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local, or emergency room immediately. Symptoms may include flushing.

Proper storage of Nicotinic Acid controlled-release tablets:

Store Nicotinic Acid controlled-release tablets at room temperature, between 68 and 77 degrees F (20 and 25 degrees C). Store away from heat, moisture, and light. Do not store in the bathroom. Keep Nicotinic Acid controlled-release tablets out of the reach of children and away from pets.

Overdose of Nicotinic Acid in details

When a dose is taken in higher dose than the recommended doses, it is called Overdose. Overdose always needs a clinical supervision. Any medicine or drug when consumed in Overdose produces untoward side effects on one or various organs in the body. A medicine is excreted in the kidney or metabolized in the liver most of the times. This process goes without any hurdles when taken in normal dose, but when taken in an overdose, the body is not able to metabolize it or send it out properly which causes the effects of anoverdose.
sponsored

If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center.

Notes

If you are taking this for high cholesterol, in addition to eating a proper diet (such as a low-cholesterol/low-fat diet), other lifestyle changes that may help this medication work better include exercising, losing weight if overweight, and stopping smoking. Consult your doctor for more details.

Remember that it is best to get your vitamins and minerals from food whenever possible. Maintain a well-balanced diet, and follow any dietary guidelines as directed by your doctor. B vitamins (including Nicotinic Acid) are found in meat, fish, poultry, enriched/whole grain bread products, and fortified cereals. Eat more of these foods to increase the amount of Nicotinic Acid in your diet if you have a Nicotinic Acid deficiency.

There are many Nicotinic Acid products available. Some can be purchased without a prescription. Consult your doctor or pharmacist about the best product for you.

Laboratory tests (such as blood lipids, blood sugar, liver function tests, uric acid levels) may be performed (especially if prescribed for cholesterol/triglyceride control) to monitor your progress or check for side effects. Consult your doctor for more details.

Do not share this medication with others.

Missed Dose

If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch up.

Storage

Store at room temperature away from moisture and light. Do not store in the bathroom. Refer to storage information printed on the package. If you have any questions about storage, ask your pharmacist. Keep all medications away from children and pets.

Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

What should I avoid while taking Nicotinic Acid?

Avoid drinking hot beverages shortly after taking Nicotinic Acid. Hot drinks can worsen Nicotinic Acid's flushing effect (warmth, itching, redness, or tingly feeling under your skin).

Avoid drinking alcohol while taking Nicotinic Acid. Alcohol may increase your risk of liver damage, and can also worsen the flushing effects of Nicotinic Acid.

Avoid taking colestipol (Colestid) or cholestyramine (Locholest, Prevalite, Questran) at the same time you take Nicotinic Acid. If you take either of these other medications, take them at least 4 to 6 hours before or after you take Nicotinic Acid.

Avoid getting up too fast from a sitting or lying position, or you may feel dizzy. Get up slowly and steady yourself to prevent a fall.

Nicotinic Acid warnings

Warnings are a mix of Precautions. Contraindications and interactions and serious harmful effects associated with the medicine intake. A diabetic or Hypertensive patient need to be warned about few drug interactions. A known hypersensitivity patient needs to be careful about the reactions or anaphylactic shock. A pregnant woman or a breastfeeding woman should be warned of certain medications. A Hepatitis [liver disease] patient or a cardiac patient should avoid few drugs.
sponsored

Nicotinic Acid extended-release tablet preparations should not be substituted for equivalent doses of immediate-release (crystalline) Nicotinic Acid. For patients switching from immediate-release Nicotinic Acid to Nicotinic Acid extended-release tablets, therapy with Nicotinic Acid extended-release tablets should be initiated with low doses (i.e., 500 mg at bedtime) and the Nicotinic Acid extended-release tablet dose should then be titrated to the desired therapeutic response.

Caution should also be used when Nicotinic Acid extended-release tablets are used in patients with unstable angina or in the acute phase of an MI, particularly when such patients are also receiving vasoactive drugs such as nitrates, calcium channel blockers, or adrenergic blocking agents.

Nicotinic Acid is rapidly metabolized by the liver, and excreted through the kidneys. Nicotinic Acid extended-release tablets are contraindicated in patients with significant or unexplained hepatic impairment and should be used with caution in patients with renal impairment. Patients with a past history of jaundice, hepatobiliary disease, or peptic ulcer should be observed closely during Nicotinic Acid extended-release tablet therapy.

Mortality and Coronary Heart Disease Morbidity

Nicotinic Acid extended-release tablets have not been shown to reduce cardiovascular morbidity or mortality among patients already treated with a statin.

The Atherothrombosis Intervention in Metabolic Syndrome with Low HDL/High Triglycerides: Impact on Global Health Outcomes (AIM-HIGH) trial was a randomized placebo-controlled trial of 3414 patients with stable, previously diagnosed cardiovascular disease. Mean baseline lipid levels were LDL-C 74 mg/dL, HDL-C 35 mg/dL, non-HDL-C 111 mg/dL and median triglyceride level of 163 to 177 mg/dL. Ninety-four percent of patients were on background statin therapy prior to entering the trial. All participants received simvastatin, 40 to 80 mg per day, plus ezetimibe 10 mg per day if needed, to maintain an LDL-C level of 40 to 80 mg/dL, and were randomized to receive Nicotinic Acid extended-release tablets 1500 to 2000 mg/day (n = 1718) or matching placebo (IR Nicotinic Acid, 100 to 150 mg, n = 1696). On-treatment lipid changes at two years for LDL-C were -12% for the simvastatin plus Nicotinic Acid extended-release tablets group and -5.5% for the simvastatin plus placebo group. HDL-C increased by 25% to 42 mg/dL in the simvastatin plus Nicotinic Acid extended-release tablets group and by 9.8% to 38 mg/dL in the simvastatin plus placebo group (P < 0.001). Triglyceride levels decreased by 28.6% in the simvastatin plus Nicotinic Acid extended-release tablets group and by 8.1% in the simvastatin plus placebo group. The primary outcome was an ITT composite of the first study occurrence of coronary heart disease death, nonfatal myocardial infarction, ischemic stroke, hospitalization for acute coronary syndrome or symptom-driven coronary or cerebral revascularization procedures. The trial was stopped after a mean follow-up period of 3 years owing to a lack of efficacy. The primary outcome occurred in 282 patients in the simvastatin plus Nicotinic Acid extended-release tablets group (16.4%) and in 274 patients in the simvastatin plus placebo group (16.2%) (HR 1.02 [95% CI, 0.87 to 1.21], P = 0.79. In an ITT analysis, there were 42 cases of first occurrence of ischemic stroke reported, 27 (1.6%) in the simvastatin plus Nicotinic Acid extended-release tablets group and 15 (0.9%) in the simvastatin plus placebo group, a non-statistically significant result (HR 1.79, [95%CI = 0.95 to 3.36], p = 0.071). The on-treatment ischemic stroke events were 19 for the simvastatin plus Nicotinic Acid extended-release tablets group and 15 for the simvastatin plus placebo group.

Skeletal Muscle

Cases of rhabdomyolysis have been associated with concomitant administration of lipid-altering doses (≥ 1 g/day) of Nicotinic Acid and statins. Elderly patients and patients with diabetes, renal failure, or uncontrolled hypothyroidism are particularly at risk. Monitor patients for any signs and symptoms of muscle pain, tenderness, or weakness, particularly during the initial months of therapy and during any periods of upward dosage titration. Periodic serum creatine phosphokinase (CPK) and potassium determinations should be considered in such situations, but there is no assurance that such monitoring will prevent the occurrence of severe myopathy.

Liver Dysfunction

Cases of severe hepatic toxicity, including fulminant hepatic necrosis, have occurred in patients who have substituted sustained-release (modified-release, timed-release) Nicotinic Acid products for immediate-release (crystalline) Nicotinic Acid at equivalent doses.

Nicotinic Acid extended-release tablets should be used with caution in patients who consume substantial quantities of alcohol and/or have a past history of liver disease. Active liver diseases or unexplained transaminase elevations are contraindications to the use of Nicotinic Acid extended-release tablets.

Nicotinic Acid preparations have been associated with abnormal liver tests. In three placebo-controlled clinical trials involving titration to final daily Nicotinic Acid extended-release tablet doses ranging from 500 to 3000 mg, 245 patients received Nicotinic Acid extended-release tablets for a mean duration of 17 weeks. No patient with normal serum transaminase levels (AST, ALT) at baseline experienced elevations to more than 3 times the upper limit of normal (ULN) during treatment with Nicotinic Acid extended-release tablets. In these studies, fewer than 1% (2/245) of Nicotinic Acid extended-release tablet patients discontinued due to transaminase elevations greater than 2 times the ULN.

Liver-related tests should be performed on all patients during therapy with Nicotinic Acid extended-release tablets. Serum transaminase levels, including AST and ALT (SGOT and SGPT), should be monitored before treatment begins, every 6 to 12 weeks for the first year, and periodically thereafter (e.g., at approximately 6 month intervals). Special attention should be paid to patients who develop elevated serum transaminase levels, and in these patients, measurements should be repeated promptly and then performed more frequently. If the transaminase levels show evidence of progression, particularly if they rise to 3 times ULN and are persistent, or if they are associated with symptoms of nausea, fever, and/or malaise, the drug should be discontinued.

Laboratory Abnormalities

Increase in Blood Glucose: Nicotinic Acid treatment can increase fasting blood glucose. Frequent monitoring of blood glucose should be performed to ascertain that the drug is producing no adverse effects. Diabetic patients may experience a dose-related increase in glucose intolerance. Diabetic or potentially diabetic patients should be observed closely during treatment with Nicotinic Acid extended-release tablets, particularly during the first few months of use or dose adjustment; adjustment of diet and/or hypoglycemic therapy may be necessary.

Reduction in Platelet Count: Nicotinic Acid extended-release tablets have been associated with small but statistically significant dose-related reductions in platelet count (mean of -11% with 2000 mg). Caution should be observed when Nicotinic Acid extended-release tablets are administered concomitantly with anticoagulants; platelet counts should be monitored closely in such patients.

Increase in Prothrombin Time (PT): Nicotinic Acid extended-release tablets have been associated with small but statistically significant increases in prothrombin time (mean of approximately +4%); accordingly, patients undergoing surgery should be carefully evaluated. Caution should be observed when Nicotinic Acid extended-release tablets are administered concomitantly with anticoagulants; prothrombin time should be monitored closely in such patients.

Increase in Uric Acid: Elevated uric acid levels have occurred with Nicotinic Acid therapy, therefore use with caution in patients predisposed to gout.

Decrease in Phosphorus: In placebo-controlled trials, Nicotinic Acid extended-release tablets have been associated with small but statistically significant, dose-related reductions in phosphorus levels (mean of -13% with 2000 mg). Although these reductions were transient, phosphorus levels should be monitored periodically in patients at risk for hypophosphatemia.

What should I discuss with my healthcare provider before taking Nicotinic Acid?

Some medical conditions may interact with Nicotinic Acid controlled-release tablets. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

Some MEDICINES MAY INTERACT with Nicotinic Acid controlled-release tablets. Tell your health care provider if you are taking any other medicines, especially any of the following:

This may not be a complete list of all interactions that may occur. Ask your health care provider if Nicotinic Acid controlled-release tablets may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

Nicotinic Acid precautions

Certain people who are very sick or very old or who are sensitive show an exacerbation of side effect of the drug which can turn dangerous at times. So, it is very important to remember the precautions while taking the medicine. Pregnancy and Breastfeeding are also special categories wherein extra care or precaution is needed when taking a drug. Few patients may have a hypersensitivity reaction to few medications, and that can be life-threatening rarely. Penicillin hypersensitivity is one example. Diarrhea, rashes are few other symptoms which need a watch. A patient with other co-existing diseases like liver disease, heart disease, kidney disease should take special precautions.
sponsored

Nicotinic Acid extended-release tablet preparations should not be substituted for equivalent doses of immediate-release (crystalline) Nicotinic Acid. For patients switching from immediate-release Nicotinic Acid to Nicotinic Acid extended-release tablets, therapy with Nicotinic Acid extended-release tablets should be initiated with low doses (i.e., 500 mg at bedtime) and the Nicotinic Acid extended-release tablet dose should then be titrated to the desired therapeutic response.

Caution should also be used when Nicotinic Acid extended-release tablets are used in patients with unstable angina or in the acute phase of an MI, particularly when such patients are also receiving vasoactive drugs such as nitrates, calcium channel blockers, or adrenergic blocking agents.

Nicotinic Acid is rapidly metabolized by the liver, and excreted through the kidneys. Nicotinic Acid extended-release tablets are contraindicated in patients with significant or unexplained hepatic impairment and should be used with caution in patients with renal impairment. Patients with a past history of jaundice, hepatobiliary disease, or peptic ulcer should be observed closely during Nicotinic Acid extended-release tablet therapy.

Mortality and Coronary Heart Disease Morbidity

Nicotinic Acid extended-release tablets have not been shown to reduce cardiovascular morbidity or mortality among patients already treated with a statin.

The Atherothrombosis Intervention in Metabolic Syndrome with Low HDL/High Triglycerides: Impact on Global Health Outcomes (AIM-HIGH) trial was a randomized placebo-controlled trial of 3414 patients with stable, previously diagnosed cardiovascular disease. Mean baseline lipid levels were LDL-C 74 mg/dL, HDL-C 35 mg/dL, non-HDL-C 111 mg/dL and median triglyceride level of 163 to 177 mg/dL. Ninety-four percent of patients were on background statin therapy prior to entering the trial. All participants received simvastatin, 40 to 80 mg per day, plus ezetimibe 10 mg per day if needed, to maintain an LDL-C level of 40 to 80 mg/dL, and were randomized to receive Nicotinic Acid extended-release tablets 1500 to 2000 mg/day (n = 1718) or matching placebo (IR Nicotinic Acid, 100 to 150 mg, n = 1696). On-treatment lipid changes at two years for LDL-C were -12% for the simvastatin plus Nicotinic Acid extended-release tablets group and -5.5% for the simvastatin plus placebo group. HDL-C increased by 25% to 42 mg/dL in the simvastatin plus Nicotinic Acid extended-release tablets group and by 9.8% to 38 mg/dL in the simvastatin plus placebo group (P < 0.001). Triglyceride levels decreased by 28.6% in the simvastatin plus Nicotinic Acid extended-release tablets group and by 8.1% in the simvastatin plus placebo group. The primary outcome was an ITT composite of the first study occurrence of coronary heart disease death, nonfatal myocardial infarction, ischemic stroke, hospitalization for acute coronary syndrome or symptom-driven coronary or cerebral revascularization procedures. The trial was stopped after a mean follow-up period of 3 years owing to a lack of efficacy. The primary outcome occurred in 282 patients in the simvastatin plus Nicotinic Acid extended-release tablets group (16.4%) and in 274 patients in the simvastatin plus placebo group (16.2%) (HR 1.02 [95% CI, 0.87 to 1.21], P = 0.79. In an ITT analysis, there were 42 cases of first occurrence of ischemic stroke reported, 27 (1.6%) in the simvastatin plus Nicotinic Acid extended-release tablets group and 15 (0.9%) in the simvastatin plus placebo group, a non-statistically significant result (HR 1.79, [95%CI = 0.95 to 3.36], p = 0.071). The on-treatment ischemic stroke events were 19 for the simvastatin plus Nicotinic Acid extended-release tablets group and 15 for the simvastatin plus placebo group.

Skeletal Muscle

Cases of rhabdomyolysis have been associated with concomitant administration of lipid-altering doses (≥ 1 g/day) of Nicotinic Acid and statins. Elderly patients and patients with diabetes, renal failure, or uncontrolled hypothyroidism are particularly at risk. Monitor patients for any signs and symptoms of muscle pain, tenderness, or weakness, particularly during the initial months of therapy and during any periods of upward dosage titration. Periodic serum creatine phosphokinase (CPK) and potassium determinations should be considered in such situations, but there is no assurance that such monitoring will prevent the occurrence of severe myopathy.

Liver Dysfunction

Cases of severe hepatic toxicity, including fulminant hepatic necrosis, have occurred in patients who have substituted sustained-release (modified-release, timed-release) Nicotinic Acid products for immediate-release (crystalline) Nicotinic Acid at equivalent doses.

Nicotinic Acid extended-release tablets should be used with caution in patients who consume substantial quantities of alcohol and/or have a past history of liver disease. Active liver diseases or unexplained transaminase elevations are contraindications to the use of Nicotinic Acid extended-release tablets.

Nicotinic Acid preparations have been associated with abnormal liver tests. In three placebo-controlled clinical trials involving titration to final daily Nicotinic Acid extended-release tablet doses ranging from 500 to 3000 mg, 245 patients received Nicotinic Acid extended-release tablets for a mean duration of 17 weeks. No patient with normal serum transaminase levels (AST, ALT) at baseline experienced elevations to more than 3 times the upper limit of normal (ULN) during treatment with Nicotinic Acid extended-release tablets. In these studies, fewer than 1% (2/245) of Nicotinic Acid extended-release tablet patients discontinued due to transaminase elevations greater than 2 times the ULN.

Liver-related tests should be performed on all patients during therapy with Nicotinic Acid extended-release tablets. Serum transaminase levels, including AST and ALT (SGOT and SGPT), should be monitored before treatment begins, every 6 to 12 weeks for the first year, and periodically thereafter (e.g., at approximately 6 month intervals). Special attention should be paid to patients who develop elevated serum transaminase levels, and in these patients, measurements should be repeated promptly and then performed more frequently. If the transaminase levels show evidence of progression, particularly if they rise to 3 times ULN and are persistent, or if they are associated with symptoms of nausea, fever, and/or malaise, the drug should be discontinued.

Laboratory Abnormalities

Increase in Blood Glucose: Nicotinic Acid treatment can increase fasting blood glucose. Frequent monitoring of blood glucose should be performed to ascertain that the drug is producing no adverse effects. Diabetic patients may experience a dose-related increase in glucose intolerance. Diabetic or potentially diabetic patients should be observed closely during treatment with Nicotinic Acid extended-release tablets, particularly during the first few months of use or dose adjustment; adjustment of diet and/or hypoglycemic therapy may be necessary.

Reduction in Platelet Count: Nicotinic Acid extended-release tablets have been associated with small but statistically significant dose-related reductions in platelet count (mean of -11% with 2000 mg). Caution should be observed when Nicotinic Acid extended-release tablets are administered concomitantly with anticoagulants; platelet counts should be monitored closely in such patients.

Increase in Prothrombin Time (PT): Nicotinic Acid extended-release tablets have been associated with small but statistically significant increases in prothrombin time (mean of approximately +4%); accordingly, patients undergoing surgery should be carefully evaluated. Caution should be observed when Nicotinic Acid extended-release tablets are administered concomitantly with anticoagulants; prothrombin time should be monitored closely in such patients.

Increase in Uric Acid: Elevated uric acid levels have occurred with Nicotinic Acid therapy, therefore use with caution in patients predisposed to gout.

Decrease in Phosphorus: In placebo-controlled trials, Nicotinic Acid extended-release tablets have been associated with small but statistically significant, dose-related reductions in phosphorus levels (mean of -13% with 2000 mg). Although these reductions were transient, phosphorus levels should be monitored periodically in patients at risk for hypophosphatemia.

What happens if I miss a dose of Nicotinic Acid?

When you miss a dose, you should take it as soon as you remember, but you should take care that it should be well spaced from the next dose. You should not take an extra dose at the time of the second dose as it will become a double dose. The double dose can give unwanted side effects, so be careful. In chronic conditions or when you have a serious health issue, if you miss a dose, you should inform your health care provider and ask his suggestion.

Take the missed dose as soon as you remember. Be sure to take the missed dose with food if you normally take your Nicotinic Acid dose with a meal or snack.

Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.



References

  1. 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).
  2. DrugBank. "nicotinic acid". http://www.drugbank.ca/drugs/DB00627 (accessed September 17, 2018).
  3. MeSH. "Vitamin B Complex". https://www.ncbi.nlm.nih.gov/mesh/68... (accessed September 17, 2018).

Reviews

Consumer reviews


There are no reviews yet. Be the first to write one!


Your name: 
Email: 
Spam protection:  < Type 5 here

Information checked by Dr. Sachin Kumar, MD Pharmacology

| Privacy Policy
This site does not supply any medicines. It contains prices for information purposes only.
© 2003 - 2022 ndrugs.com All Rights Reserved