Tuesday, September 02, 2014
Friday, July 11, 2008 Ralph, Community Member, asks

Q: Is there a generic for Niaspan ER?

I'm looking for a less expensive option for my medication.  The Niaspan ER has been effective but the costs are a challenge.

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Answers (13)
Dr. Thomas, Health Pro
7/30/08 8:48am

Niaspan ER is extended-release** nicotinic acid. There are alternative preparations, but the only other one that is extended-release is combined with another medication called lovastatin. Niacor and Nicolar are immediate-release nicotinic acid, and Slo-Niacin is sustained release. The cost is often determined by which preparation your medical insurance company has agreed to cover. You may want to check with your doctor to see if you absolutely need the extended-release form, and if not you can consult your pharmacist or call your insurance company to see if one of these other preparations is “formulary,” i.e. your insurance covers it at less cost to you.

**Extended release tablets release a consistent amount of the drug over time, compared to sustained release tablets that release the drug slowly, but not necessarily at a consistent rate.

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David, Community Member
11/ 4/09 9:24am

Is pill-splitting an option with Niaspan ER?

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TJP, Community Member
10/27/10 2:03pm

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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Ben C. Bonarigo, Community Member
1/26/12 6:39pm

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, Community Member
1/30/12 6:25pm

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

 

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undrdog, Community Member
9/28/12 1:44pm

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, Community Member
11/14/13 10:21pm

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?

 

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bluesman13, Community Member
1/13/14 2:08pm

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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BobBoise85205, Community Member
7/21/11 12:05pm

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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Nialip User, Community Member
7/29/08 9:19am

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.

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Aaron, Community Member
2/23/09 1:49pm

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

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Carolyn J. Bridgeman, Community Member
5/11/10 3:03pm

I take two tables a day at bedtime. niaspan 1000mg er . Looking for another place to buy . I cant afford it other wise.

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Ralph, Community Member
5/11/10 4:21pm

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.

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Frank, Community Member
9/19/10 8:57pm

Ralph,

 

 

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. 

 

 

Frank 

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Linda, Community Member
10/20/10 4:02pm

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

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TJP, Community Member
10/27/10 4:12pm

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.)

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jay, Community Member
1/11/11 2:49pm

"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.

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TJP, Community Member
1/14/11 12:51pm

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.

TJP

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jay, Community Member
1/18/11 1:05pm

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?

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TJP, Community Member
1/18/11 1:51pm

yes, it does.

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Thomas Angelone, Community Member
10/30/10 10:14am

I don't know!

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jimbuck, Community Member
11/29/10 11:14am

What is the equivalent dosage for Enduracin.  I take 2 1000 mg. Niaspan ER tabs per day.

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george, Community Member
12/ 7/10 1:20am

yes,niacin sr

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frank, Community Member
4/13/11 7:05pm

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.

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frank, Community Member
5/ 4/11 10:58am

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.

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G HOLLAND, Community Member
2/13/12 5:43pm

NIACOR IS OR IS NOT A GENERIC FOR NIASPAN

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Pio, Community Member
9/29/13 8:08pm

Today at wallgreens I was offered NIASIN, generic of Niaspan for $15.

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kurtayers, Community Member
8/26/14 5:46pm

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.

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By Ralph, Community Member— Last Modified: 08/26/14, First Published: 07/11/08