Niacin and Hepatic Failure
Authors: Robert H. Knopp
Journal: Annals of Internal Medicine (1989)

Letters and Corrections1 November 1989Niacin and Hepatic FailureRobert H. Knopp, MDRobert H. Knopp, MDSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-111-9-769 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the Editor:I read with interest the recent report by Mullin and associates (1) on fulminant hepatic failure in a patient after ingestion of sustained-release nicotinic acid. Development of toxicity when switching suddenly from crystalline niacin to time-release niacin is not surprising. In addition to the early observation by Christensen (2), we observed greater gastrointestinal upset and fatigue and slightly greater serum glutamicoxoacetic transaminase (SGOT) rise in a randomized trial (3) comparing unmodified niacin (Nicolar [Roer Pharmaceuticals, Ft. Washington, Pennsylvania]) with time-release niacin (Nicobid [Roer]). The syndrome of fatigue, gastrointestinal upset, and elevations in liver enzymes was particularly notable...References1. MullinGreensonMitchell GJM. Fulminant hepatic failure after ingestion of sustained-release nicotinic acid. Ann Intern Med. 1989;111:253-5. LinkGoogle Scholar2. ChristensenAchorBergeMason NRKH. Nicotinic acid treatment of hypercholesterolemia, comparison of plain and sustained action preparations, and report of two cases of jaundice. JAMA. 1961;177:546-50. CrossrefMedlineGoogle Scholar3. KnoppGinsbergAlbers RJJ. Contrasting effects of unmodified and time-release forms of niacin on lipoproteins in hyperlipidemic subjects: clues to mechanism of action of niacin. Metabolism. 1985;34:642-50. CrossrefMedlineGoogle Scholar4. . Report of the National Cholesterol Education Program expert panel on detecting, evaluation, and treatment of high blood cholesterol in adults. Arch Intern Med. 1988;148:36-69. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Northwest Lipid Research Clinic University of Washington Medical School Seattle, WA 98104 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byModification of High-Density Lipoprotein Cholesterol in the Management of Cardiovascular RiskMultiple-dose efficacy and safety of an extended-release form of niacin in the management of hyperlipidemiaEfficacy and safety of an extended-release niacin (niaspan): a long-term studyA new extended-release niacin (niaspan): efficacy, tolerability, and safety in hypercholesterolemic patientsClinical profiles of plain versus sustained-release niacin (niaspan) and the physiologic rationale for nighttime dosingClinical trial experience with extended-release niacin (niaspan): dose-escalation studyEquivalent efficacy of a time-release form of niacin (Niaspan) given once-a-night versus plain niacin in the management of hyperlipidemiaAggressive medical therapy for the prevention and treatment of coronary artery diseaseTreatment Effect of Niaspan, a Controlled-release Niacin, in Patients with Hypercholesterolemia: A Placebo-controlled TrialNicotinic Acid and DerivativesHepatic toxicity of unmodified and time-release preparations of niacin 1 November 1989Volume 111, Issue 9Page: 769-769KeywordsAcute liver failureAminotransferasesEnzymesFatigueIngestionLiverNiacinRandomized trialsSerum glutamic oxaloacetic transaminaseToxicity ePublished: 1 December 2008 Issue Published: 1 November 1989 PDF downloadLoading ...