Slo-Niacin vs Niaspan

Does anyone know if a generic for Niaspan is on the horizon? I've lost my "good" insurance, and have been forced into an HDHP and HSA that requires me to pay full cost of drugs till I reach the $5000 deductible.

FYI: I have used Niaspan 1000mg for about 12 years, and am now going off of it. I have been taking Simvastatin 80mg (yeah, I know!) for same period. Always normal LFT's. TC 153, HDL 57, LDL 80. (Had M.I. in 1989 at age 36. No stents available at that time LOL. No follow up after angioplasty for 11 years, then 2 stents placed in 2000 and started the whole regimen of Fish Oil, Folic Acid, statins, Niaspan, vitamins, and bp meds, cardio exercise 3 days per week. Am now 59 and still feel good.) This is a great website, and I appreciate everyone's viewpoint/opinions. Thanks.

 

Check out Endur-acin........

 

He is not the only one that pays $120 for Niaspan. Anyone with Medicare does. Unless they have a supplemental insurance they pay a lot for.

 

Re: Slo-Niacin

I have been taking a dose of 1500 mg. of Slo-Niacin for over 15 years. I had been dividing it up into morning and evening doses. I did present high liver enzyme numbers and I learned that because of the time release factor that the liver needs time to "rest" so I take One dose of 1500 mg in the the morning and the enzyme problem stopped. My HDL is 77.

 

Re: Slo-Niacin

 

Just thought about putting my 2 cents in:

I read this thread that's why I started using Slo-Niacin and dropped my Niaspan use due to high cost despite of insurance coverage. In my physical last month, I mentioned to my PCP that I did just that and asked him to write me a script for lipid and liver panels. To my surprise -- very surprised -- my HDL went up slightly but triglycerides went down to 160! My triglycerides has never gone down below 250 ever, it even has gone up to 1000s at one time. The lowest I've been was 256 (taking Niaspan 2000mg and 4 caps of Lovaza a day).

So now, I'm keeping my Slo-Niacin and Lovaza combo. I don't know...I may have to try taking that krill oil for a spin.

 

I was on Niaspan for over a year, and it worked. When my provider changed their formulary, I was given Slo-Niacin. Later labs showed reversion to prior HDL levels.

To top things off, I started seeing weird colors in my stool. After a few days of this, I checked it out (I'll spare you the details), and lo-and-behold, what did I find in my stool? Two complete, intact Slo-Niacin tablets.

(I should also mention that while I received a flush on Niaspan, there was none with Slo-Niacin.)

At the next appointment with my GP, she thought it was weird also. While in her office, she called the pharmacy and spoke with someone (didn't know if it was a pharmacist or a tech), and they told her this was normal.

I say this is B.S. and why Slo-Niacin is so cheap - because it is so cheap!! And I bet it is not a prescription simply because it would never pass the required tests.

I am now in the process of appealing the formulary. I am sure Slo-Niacin is junk, and will be fighting this. I am also very sure that the makers of Slo-Niacin give the V.A. a very nice discount over Niaspan, again, because the product is crap.

 

You take 2 tablets at a time? Because if you don't, how would 2 tablets end up side by side in your stool?

 

Yes, when I took it, I took two tablets every night.

 

So, is there any consensus here? After reading the entire thread, it certainly seems to lean toward suggesting that the cost of Niaspam is way out of line for its difference to Slo-Niacin or to Enduracin. I plan to discuss this with my doctor next week (I have been on 1000mg nightly of Niaspam for 3 years with good results, but I'm co-paying $56/month for it).

Also, any thoughts on Slo-Niacin vs. Enduracin?

I'm also wondering about Lovaza (I will search this site for a thread about it)... are there OTC omega3 formulations that are as effective? My copay for 4gm Lovaza daily is $61/month.

 

www.endur.com

 

My doctor just switched me from Niaspan to SLO-Niacin due to cost. I have some strange feelings in my heart when taking the SLO-Niacin that I didn't seem to have with Niaspan. After reading the additional ingredients in the SLO-Niacin, I noticed that it also has hydronated vegetable oil and silicon dioxide. Why would anyone take a supplement that contain these ingredients. I know cost is a major concern for most people but if hydronated anything and silicon dioxide are part of the ingredients, I would stay away.

Need to investigate the ingredients in Niaspan. Altough this would explain the heart reaction. I would say again, I did not have these reactions when taking the Niaspan.

 

Exactly what are the side-effects of Vitamin B3 toxicity

Normally the side effects of vitamin b3 toxicity or the utilization of non-flushing vitamin b3 dietary supplements are linked to digestive tract difficulties like:

• Vomiting and nausea

• Unwanted wind

• Puffed up abdomen

• Diarrhea

• Unpredicted decrease of blood pressure level

We could also point out numerous similar unwanted side effects however they come about almost never and some of these are dry skin, liver organ complications, difficulties with the eye sight and many others.

Precisely what are the symptoms of nicotinic acid overdose?

Exactly what are the warning signs of nicotinic acid overdose? First, it's good to know that vitamin b3 overdose cannot induce dying. Unfortunately we could feel numerous severe health problems. The warning signs of niacin overdose are very just like the uncomfortable side effects we have referred to in the past. Nonetheless, as you can see they're rarely intense and they can be simply eliminated, so you'll find nothing to worry about.

Read more: http://www.sideeffectsguide.org/niacin-side-effects/

Like with other vitamins, niacin poisoning can’t be triggered because of substantial nicotinic acid rich food consumption. We have to use higher doasage amounts of niacin nutritional supplements for that to happen. Along with the doasage amounts have to be very excessive as a way to increase the risk for side effects we have mentioned. If you listen to the doctor’s requests, you will not go through niacin overdose.

 

So on the lovaza issue, there is a product by Ocean Blue "omega3 2100" that has similar amounts of Omega 3's per pill as Lovaza. 120 of those is about 40.00 OTC. Ocean Blue's product has 675 EPA and 300 DHA per capsule compared to Lovaza's 465 EPA and 375 DHA.

My conclusion from everything I have read(a lot of studies, not just abstracts) on Niacin is

1. That if you can tolerate the flushing IR niacin in 3 divided doses is best at raising HDL.
2. ER niacin formulations actually seem to work a little better on LDL-c
3. Studies about the release of OTC products indicate that SLO-Niacin may be released a little faster than Niaspan, but really for all intents and purposes it is close enough for me.
4.Others have closer release to Niaspan yet others that claim to be ER are just IR, so all OTC's are not created equal.

Best to use these products under supervision of your doc. None are without risk.

I'd change from Niaspan to SLO-Niacin in a heartbeat.(Pharmacy student, not a salesperson)

 

Thanks to everyone for all of this helpful info (and especially to The Chaun, whoever you are).

I've been on 1000 mg Niaspan with simvastatin (Simcor) for a couple of years -- good results and it's been easy to tolerate. But when I started working out more this summer I noticed that my muscles got sore real easily and stayed sore longer. I know, it could be age (I'm 57), but I also wondered if it might be from the simvastatin. So I've tried switching to just Niacin for a while using Slo-Niacin.

I had no problems (no flushing) when I took one 500mg Slo Niacin pill twice a day. When I took 2 - 500 mg at bedtime (11:00 pm), I'd wake up hot and tossing off the covers at 3:00 am. Still, it wasn't too bad for me, but I wondered what was better and started reading up.

One other key thing to mention, I've taken the Berkeley Heartlab blood tests (which I highly recommend) and learned that I have lipoprotein (a), also known a Lp(a) which I gather is a real nasty form of LDL. It's inherited, very highly correlated with bad cardiac events, and unresponsive to diet, exercise and statins. (Which is a big "Oh shit!") The only thing known to help lower Lp(a) is niacin. So I might try doing without the simvastatin for a while, but I'm not dropping the niacin.

My conclusion from all this is that I want to increase the level of niacin, while keeping cost down and avoiding liver problems. It seems clear that the best way to do that is with IR niacin, so long as I can tolerate it and stay on it, at a decent dosage.

This article was one of the best and most complete that I've found:
http://archinte.jamanetwork.com/article.aspx?articleid=216937 . I especially like the graph that compares the effectiveness of IR and ER/SR niacin on HDL, LDL, and TG.

I'm up to 500 mg IR niacin 3 times a day (for a total of 1,500 mg a day), and I plan to go higher. I know some people/studies have said that ER niacin may be better for lowering LDL, and perhaps also for lowered Lp(a). But I believe that conclusion was from tests when the IR and ER dosages were the same. Since IR niacin is so much safer for the liver, my plan is to significantly increase the daily niacin dosage that I get by taking it IR, instead of ER/SR. My bet is that I'll get lower LDL and Lp(a) from the increased dosage, while also getting higher HDL and no liver damage by taking it IR.

I see the doctor in a month and we'll see how well this IR niacin regimen works (without simvastatin) compared to the Simcor that I was on for the last visit. If I need to add simvastatin back, I will. But this sounds like the best approach for taking niacin, for me.

 

So, I know this thread is old, but I see someone posted on my birthday just a couple weeks ago. I found this forum looking for information on Slo-Niacin and Niaspan. My doctor wanted to put me on a statin, and from what I've read on those, there's no real evidence that the risks outweigh the benefits. I'm 34, not to old to change unhealthy habits in my lifestyle. So I chose Niacin (Niaspan) as my drug of choice, given my options. I have BCBS (emphasis on the BS), and pay $30/month for my Niaspan. There is no generic, so this is what I'm stuck paying. I wasn't concerned about this until I looked at my BCBS account the other day and saw that they pay out $215 to my $30/month! There are a lot of problems with our healthcare system, and gouging by the pharmaceuticals for a "special" vitamin release system is a big one. I don't want any company making that much money off of nicotinic acid. It's not right, and it increases premiums for everyone else. So, I could eat 60 oz of tuna per day, or find a safe alternative. I've had no luck finding "Niacor" otc, online or elsewhere.

So, about 6 months on Niaspan, at about 2g/day for most of it. I've lowered my TG by 300 points (from over 500), but my total cholesterol remains about the same with a slight increase in my HDL. During my time on Niaspan, I also adopted a 5 day per week weightlifting routine and went on a modified Atkins diet (more veggies than they prescribe). No pasta, no simple carbs of any kind, really, exercise and Niaspan. I've lost nearly 30 lbs since July, and I really wish I'd starting exercising sooner, so I could see if my drop in TG has more to do with exercise and diet than with Niaspan. I will also say that based on my past lipid profiles, diet almost certainly has more to do with it than Niaspan. The leads me to aggravation with my MD that she thinks it unwise for me to switch to Slo-Niacin at a lower dose and add in fish oil, since my total cholesterol isn't bad, just my triglycerides.

If anyone reading this is like I was, i.e. overweight, sedentary, and eating pasta almost everyday, do yourself a favor. Unless you're unable to ambulate, start exercising, stop eating junk, and avoid all those prescriptions that a healthy lifestyle will allow you to. I met a lot of interesting healthcare professionals while I was a nursing assistant, the most interesting being a woman who worked for a pharmaceutical testing company and refused to take any medications other than acetaminophen and penicillin following a knee replacement surgery. "I know what they do, and I see what goes into them," she said to me. "Don't take any drug you don't have to."

 

Thanks for bringing up diet and exercise. I’m amazed at how many people will dwell on the controversial issues, like statins and these niacin formulations, and ignore those actions that everyone agrees will help, namely exercise and losing weight. Also, the newer research clearly supports low-carb diets over low-fat diets, for improving one’s cholesterol and reducing CV risk.

Shocking fact: 40% of the people in the US that die from heart disease each year had NORMAL lipid panels! Clearly, something is wrong with the standard lipid panel. Now leading researchers know what it is.

The #1 factor that has the highest correlation with cardio-vascular and heart disease is the NUMBER of LDL particles. That’s not the LDL measurement in the standard lipid panel, also known as LDL-C, which measures the total weight of the LDL particles. The measurement that really counts is the measurement of the number of LDL particles, which is LDL-P. (That can also be determined by an ApoB test, since there is one ApoB protein for each LDL particle.)

So all these other things we’ve been told to do – to lower TC, TG, & LDL, and to raise HDL -- only help to the extent that they also help lower the number of LDL particles. (That’s also where LDL particle size comes into play. If the particles are small, you must have a whole lot of them to carry around that same weight of LDL cholesterol.)

The problem is that one can have a normal lipid panel, with “normal” or “good” LDL numbers (LDL-C or LDL weight), and still have a high LDL particle count (LDL-P). You might be at high risk and not know it (like the 40% of people who have heart attacks each year with normal cholesterol numbers).

Here’s a great write-up by Dr. Peter Attia on the topic:
http://eatingacademy.com/nutrition/the-straight-dope-on-cholesterol-part-i

The good news, for those reading this thread, is that niacin also seems to help reduce the number of LDL particles.

Many believe that the standard lipid panel everyone gets will soon be modified to include LDL-P (or ApoB). Then, we’ll all have a better idea of our real risk, and whether our diets, lifestyles, and meds are working.

 

Agree with diet and excerise, 4 stents (July 2011) on 500mg niaspan 81mg aspirin bedtime, recommend miniwheats/skim milk with dose (low fat recommendation should be low fat and high fiber, because water and or yogurt are low fat), had all the side effects thought i was having another heart attach. jog 5k 5-6 days a wk since august 2011, diet change, lost 40 pounds so it is impossible to know what role niaspan plays...HDL was 26 now 44 ... no way niaspan responsible for 70% increase w/most people take at 1500mg. everything else is good.

loved the look on my doctors, when i said i would lose the weight, exercise and change diet... now they say the transformation is down right outstanding. At the time, I could tell the doctors were blowing me off to the commitment, says more about the rest of their patients than me... do yourself a favor buy food you find on the walls of the grocer not the aisles and don't eat at McD's

 

The ONE thing I don't see posted here or anywhere else, are you sure you are drinking enough water?

 

The bottom line is,Who can you trust. Since the FDA is totally controlled by Pharmaceutical companies. A lot of doctors owe a big debt to these people, Its scary out there. Try to stay healthy & stay away from doctors