nicotinic acid

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.

See how to identify renal failure stages according to GFR calculation

See how to diagnose irreversible renal disease

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