I'm looking for a less expensive option for my medication. The Niaspan ER has been effective but the costs are a challenge.
At the time this question was originally asked the answer was no, but in the intervening years at least one generic medication has become available. Niacin ER is an extended-release tablet as well, which just means that the tablets relase a consisten amount of the drug over time, compared to sustained release tablets that release the drug slowly, but not necessarily at a consistent rate.
Many pharmacies are required to dispense the generic equivalent for any medication, but it's always worth checking with your doctor to make sure. Remember, too, that your local pharmacist is a great resource about your medication options.
For more information on niacin for high cholesterol, this article may be useful: Niacin myths and facts
Is pill-splitting an option with Niaspan ER?
With all due respest, there is significant miss-information here. There is no difference between the terms "sustained-release", and "extended-release". There is a PERCEPTION, that non-prescription, sustained-release preparations are a slower release than prescription Niaspan, but actual dissolution testing in a study funded by its manufacturers demonstrates this is not true. (Poon et al. Amer Jour Health-Syst Pharm. 2006.) While there is significant variability between over-the counter preparations, only one demonstrated an equivalent release to Niaspan, according to the dissolution tests - endur-acin. ALL, others were a quicker release!
So why does SR/ER, non-prescription niacin have an association with raising liver enzymes which can lead to hepatotoxicity, when Niaspan does not? The simple answer is dosing regimen, and monitoring procedures. When SR niacin was first developed, it was dosed frequently, like the immediate release, crystalline niacin, and investigators did not understand the prolonged the exposure to the liver dramatically increased its clinical effect on lowering LDL, and increased the liklihood of hepatotoxicity. (read The Niacin Solution, by William Parsons Jr, MD, the pioneering investigator of niacin for cholesterol from Mayo clinic. retired in 1999 with 5 decades of experience with niacin.) While dosing an extended release niacin 2 or 3 times a day maximizes tolerability and increases LDL response, it must be used in smaller doses than immediate release niacin.
Regardless of what niacin preparation you choose, it should be physician monitored so one can determine its effect on cholesterol and and liver enzymes. Dosing once daily will cause more flushing, but is probably less likely to increase these enzymes. It also improves HDL response, and reduces LDL response. (read Usage Guide to Niacin by Joseph Keenan, MD)
Because of this side-effect potential, you and your physician should choose a preparation that has published data demonstrating its release, consistency, safety, and efficacy. Only two, non-prescription preparations have been identified in the medical literature as "..objectively shown to be safe and effective.."
Rugby offers Niacin 500mg ER. You can get it @ Swansons Vitamins $21+$5 shipping for 1000 tabs (I think that is $.026 a tab vs $5 a tab for Niaspan). You do not need the combo statin drug. Take them separately and use a generic. Most superdrugs now offer 3mo generic statin for $10.00.
Another Niacin ER is made by Endur Products of Oregon (Enduracin :Niacin ER 500mg). I think it runs about $35 for 1000 tabs. It also has medical/chemical info (clinic trial info) on the drug similar to what you would find enclosed with Niaspan.
And which two non-prescription preparations of niacin have been identified in the medical literature as "safe and effective"?
BCBonarigo, PhD. MD.
Enduracin and Sloniacin have both been cited as having published data to support their use.
TJP, I am really jazzed to learn about these Niaspan substiututes and just ordered Enduracin on Amazon directly from Endurance. Thank you. I had researched Niaspan substitutes months ago on the interent and never found Enduracin or the other med you cited. I had tried to order Niaspan the past few days through several different Canadian pharmacies that held themselves out as selling it, only to find out after I faxed the Rx that they were out of stock, which tranlsated to me as never carrying them as their first offer was to sell some other alleged generic, and the Niaspan ER they allegedly sold was $150/4 mo. supply versus $50 for Enduracin ($45+$4.90 shipping).
I'm wondering the same thing. I've been taking Niaspan (2000mg at bedtime) for a long time (years), with great results. My last lipids test using the generic Niaspan from Teva (Niacin ER), posted worse results for my total cholesterol and LDL, but better results for my triglycerides and HDL.
As I'm not 100% sure it was due to the substitution of the Niaspan with the generic, I'm going to continue taking it for a few more months and then get another lipids test and see what the results are. In case you're wondering, my total cholesterol jumped from 149 to 180; my LDL from 86 to 117; my triglycerides dropped from 109 to 65; my HDL increased from 41 to 50. So, some conflicting results as my total cholesterol and LDL increased and triglycerides decreased. I've also changed quite a lot about my diet in this time frame, so I'm going to give it a little more time before I consider paying more for the real thing as oppsoed to the generic.
I have been using a sustained release niacin for four years now since I couldn't afford Niaspan. The brand name is Enduracin from Endurance Products, INC (endur.com). Subjectivly, it feels the same as Niaspan and my labs are the same as with Niaspan. I first learned of it from Kawalski's books. I seems to be the same wax matrix as Niaspan. One interesting sidenote: Their website cites a number of independant research studies by universities, etc. that used their product. Niaspan's only published research is from their own studies that they funded and controlled. FWIW. Best, Aaron
I have been using (generic) Nialip 500mg tabs to get a 1000mg dose. I order them from Canada Pharmacy, but other stores sell them. So far they seem fine.
I take two tables a day at bedtime. niaspan 1000mg er . Looking for another place to buy . I cant afford it other wise.
I consulted with both my family doctor and my cardiologist and decided to try taking Endur-Acin (a niacin SR product from Endurance Products) instead of Niaspan. It's just $73.50 for 1000 tablets - significantly cheaper than my Niaspan had been. After 6 weeks went back in and re-did lab work. Results were the same as with Niaspan! Needless to say, I switched to Endur-Acin.
Suggest you talk with your doctor about trying the niacin SR product and re-test for results at the interval suggested by your doctor. Hopefully, it will work for you too.
What is the equivalent dosage for Enduracin. I take 2 1000 mg. Niaspan ER tabs per day.
Puritan's Pride (puritan.com) has a whole host of options for niacin, the actiove ingresient in Niaspan. For example,they have 100, 500 mg, time release capsules of niacin for $7.59.
When I asked pharmacist if buying Puritan's Pride Niacin was the same as Niaspan, I was told no, that the niacin they sell on the shelves were as a supplement only, and did not help to raise the good choloesterol, lower the bad as the drug Niaspan ER
Again, this is partially correct. Many supplements called niacin do not have an impact on cholesterol. It must be nicotinic acid to have an effect. Inositol hexanicotinate (No-Flush niacin), and niacinamide (typical vitamin B3 ingredient), are all niacin, but do not improve cholesterol. You have to do your research to determine which non-prescription nicotinic acid preparations have published randomized clinical trials. (There are only two.)
"It must be nicotinic acid to have an effect." you are the only source that suggests this, all others i find on this question equate the two as forms of vit-b3 without further qualification as to efficacy. are they not the same thing, and if they are not, can you post a link that shows the difference? thank you.
Jay, I checked Mayo clinic and was disapointed how "basic" the information was. Like you said, they just refer to niacin and do not differentiate the forms. I checked wikipedia and they did an excellent job of explaining terminology and effect on lipids. To sum up, niacinamide is a metabolite of nicotinic acid, and does not have any affect on lipids. It is active as a vitamin and is commonly used in multi-vitamins. Inositol hexanicotinate ("No-Flush Niacin") is a unique molecule containing 6 molecules of nicotinic acid, and was believed to be a safe and effective alternative to nicotinic acid (plain niacin) based on a study in rabbits and an uncontrolled study in 16 human subjects, published in a german(?) back in the 60's. It has since been determined that inositol releases the nicotinic acid so slowly in humans -over 48 hrs - that one does not achieve therapeutic levels capable of changing lipid levels. Placebo-controlled clinical trials in the united states have confirmed this.
thanks for the follow up. i read the article and it would appear that the product endur-acin (label- "niacin as nicotinic acid") is neither niacinamide nor inositol hexancotinate but does advertise as "extended release". I would infer then that this specific product is an effective alternative to a prescription for Niaspan
at a much lower cost. Does your analysis confirm this?
yes, it does.
I don't know!
go to "drugdigest.org" and type in niaspan. you can get 500 mg niacin extended release for $6.00 to $8.00/100 capsules at many drug stores no Rx requiired. I AM NOT A DOCTOR so discuss with you doctor and pharmasist re: dosage, frequency, side effects, and if they agree to substitution.
Having just retired and having Medicare D and AARP coverage, my first non-previous-insurance medication buy (Niaspan ER) occured today. The pharmacist substituted NIACIN ER. Cost to me: 30 days, $263, about $9.00/day.
I went home, looked up Endur-acin, bought an 250 day supply for $79.99, .32/day
I will never buy Niaspan ER or Niacin ER again.
Today at wallgreens I was offered NIASIN, generic of Niaspan for $15.
NIACOR IS OR IS NOT A GENERIC FOR NIASPAN
I have found, over the counter, at the local pharmacy and reccomended by the pharmacist (SLO NIACIN) YOU CAN GO ON LINE WWW.SLO-NIACIN.COM
THE COST IS ONLY 19.00 FOR 100 500MG. PILLS. IT IS ALSO AVAILABLE IN 250 AND 750 STRENGTHS.