FROM OUR EXPERTS

  • Dr. Thomas
    Health Pro
    July 30, 2008
    Dr. Thomas
    Health Pro
    July 30, 2008

    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

    • David
      November 04, 2009
      David
      November 04, 2009

      Is pill-splitting an option with Niaspan ER?

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    • TJP
      TJP
      October 27, 2010
      TJP
      TJP
      October 27, 2010

      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.." 

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    • BobBoise85205
      July 21, 2011
      BobBoise85205
      July 21, 2011

      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.

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    • Ben C. Bonarigo
      January 26, 2012
      Ben C. Bonarigo
      January 26, 2012

      And which two non-prescription preparations of niacin have been identified in the medical literature as "safe and effective"?

       

                                          BCBonarigo, PhD. MD.

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    • TJP
      TJP
      January 30, 2012
      TJP
      TJP
      January 30, 2012

      Enduracin and Sloniacin have both been cited as having published data to support their use.

       

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    • undrdog
      September 28, 2012
      undrdog
      September 28, 2012

      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).

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    • KSY
      KSY
      November 15, 2013
      KSY
      KSY
      November 15, 2013
      Our pharmacy just substituted my husbands 1000 mg Niaspan ER with Niacin ER now that we have met our deductable and they have to pay for 100% of the drug.  He takes 2000 mg every night with no flushing.  We are wondering if this drug has been proven to be as effective as Niaspan.  What are you thought?   READ MORE
    • bluesman13
      January 13, 2014
      bluesman13
      January 13, 2014

      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.

       

      comments?

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