Lipid Disorder Education Program
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Niacin Alert
Five Questions to Ask Before Starting Niacin!
- 1) Is patient diabetic (fasting glucose >125-140 mg/dl)?
- Greater than 50% chance of worsening glycemic control with niacin.
- 2) Does patient have active gout or peptic ulcer disease?
- Treat the gout or ulcer first before starting niacin: may use niacin after active disease has resolved after six months.
- 3) Does the patient have liver disease?
- Active liver disease is an absolute contraindication to niacin use.
- 4) Is the patient a previous niacin failure?
- He/she is unlikely to tolerate a re-challenge, but it may be worthwhile to try anyway.
- 5) Is the patient willing and able?
- The patient must be cooperative to withstand the initiation of niacin therapy!
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