CLINICAL USE

Hyperlipidaemia

DOSE IN NORMAL RENAL FUNCTION

375 mg – 2 g daily at night

PHARMACOKINETICS

  • Molecular weight                           :123.1
  • %Protein binding                           :High
  • %Excreted unchanged in urine     : 12
  • Volume of distribution (L/kg)       :Very high
  • half-life – normal/ESRD (hrs)      :1–5

    DOSE IN RENAL IMPAIRMENT

    GFR (mL/MIN)

    30–50 50% of dose and increase according to response15–30 50% of dose and increase according to response<15 25% of dose and increase according to response

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

  • CAPD                :Dialysed. Dose as in GFR<15 mL/min
  • HD                     :Dialysed. Dose as in GFR<15 mL/min
  • HDF/high flux   :Dialysed. Dose as in GFR<15 mL/min
  • CAV/VVHD      :Dialysed. Dose as in GFR=15–30 mL/min

    IMPORTANT DRUG INTERACTIONS

    Potentially hazardous interactions with other drugsLipid-regulating drugs: increased risk of myopathy when used in combination with statinsAspirin: increased flushing

    ADMINISTRATION

    Reconstition

    –

    Route

    Oral

    Rate of Administration

    –

    Comments

    –

    OTHER INFORMATION

    Doses from National Kidney Foundation Inc. American Journal of Kidney Disease. 2003; 41(4) Suppl. 3: S1:S91 K/DOQI guidelinesUse with caution in renal failure due to increased risk of rhabdomyolysisToxic reactions are frequent in CKD 5 Nicotinic acid and its metabolites are renally excreted and the metabolites account for some of the side effects of nicotinic acidOne study showed that once daily nicotinic acid used in patients with a GFR<60 mL/min (average 61 mL/min) was safe and effective.

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