Lowering "bad" cholesterol helps heart health.
Good arterial health depends on the proper balance between "good" and "bad" cholesterol levels. Two medications, Niaspan and inositol hexanicotinate, can optimize cholesterol levels in healthy patients. Both drugs have advantages and drawbacks, but currently Niaspan, a form of niacin, remains the safer, better-researched medication.
Cholesterol
Cholesterol, a waxy substance that plays a vital role in several body functions, exists in the body as either high-density lipoprotein (HDL) or low-density lipoprotein (LDL). LDL can clog arteries with cholesterol buildup known as plaque, which then narrows the diameter of the artery and restricts blood flow. A clogged artery can cause heart attack or stroke. HDL, by contrast, is considered "good cholesterol" because it can remove excess LDL from the bloodstream.
Niaspan
Niaspan, an extended-release form of niacin, improves cholesterol levels by boosting HDL. Niacin, a common B vitamin, aids the body in a variety of tasks, including digestion, skin and eye health and nerve function. Although you can buy niacin supplements over the counter to help maintain general health, prescription-strength niacin medications such as Niaspan focus on cholesterol health. Niaspan may be able to boost HDL levels by up to 35 percent, the highest performance rating of any HDL-raising drug. It also may help lower triglyercide and LDL levels for added protection against heart disease. These benefits make it easier to accept some unpleasant side effects of taking niacin, most notably a flushing or hot sensation in the skin, along with headaches, dizziness, high blood sugar and liver problems.
Inositol Hexanicotinate
Inositol hexanicotinate, sometimes referred to as "no-flush niacin," produces similar HDL-boosting effects as niacin with less of niacin's flushing and other unpleasant side effects. Two separate studies on participants with high cholesterol indicated that inositol hexanicotinate can lower total cholesterol and raise HDL as effectively as the cholesterol drug clofibrate. Even with these studies, however, medical science has relatively little information on inositol hexanicotinate's true potential as a cholesterol medication.
Comparisons
Niacin-based drugs such as Niaspan have received a great deal more study by the medical community than inositol hexanicotinate, making them a safer bet for regular use. While inositol hexanicotinate seems to deliver fewer unpleasant side effects than niacin, the studies that have analyzed its effectiveness imply that it may work only in relatively large doses. Since the long-term effects of inositol hexanicotinate on the body, including possible dangers, remain largely unknown, doses of this size may pose unwarranted risks. The safety and reliability of niacin, when taken as directed, outweigh its inconveniences.
Considerations
Niaspan can be dangerous when combined with aspirin, blood pressure drugs, blood thinning medications or other cholesterol treatments. People with kidney or liver problems should exercise extreme caution with Niaspan. Even the milder, over-the-counter versions of niacin may cause unwanted effects in excessive doses. Consult your physician before beginning any course of niacin treatment.
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