Niaspan (Vitamin B3 or Niacin)


  • Start with a low dose (usually 500 mg), once per day at bedtime. Gradually increase as instructed.
  • Always take with food or skim milk.
  • Always take full dose aspirin (325 mg) prior to taking Niacin, unless told otherwise:

Regular aspirin, not enteric-coated, works best.
Ibuprofen (Motrin, Advil - 200 mg) or Naproxen
(Aleve – 220 mg) may also be acceptable.

  • Avoid heavy alcohol use (no more than 1 regular drink per day).
  • Avoid spicy foods or hot drinks like coffee or tea immediately before or after taking Niaspan, since they may aggravate the flushing symptoms.
  • Do not skip doses, since flushing can recur if a dose is missed.
  • If you develop a rash or blurred vision, stop the medication and call your doctor.
  • Remember: Niaspan is not a substitute for a heart healthy diet! It will work best only if you are choosing foods to reduce your cholesterol.
  • Treatment is usually long-term. When your cholesterol levels are at goal, you will still need to take your medicine. If you stop taking it, your cholesterol will rise again.

Common Side Effects

Flushing and itching may occur. Flushing is a brief reddening of the skin, which occurs when the blood vessels in your skin open wider. It usually happen while you are asleep, so many people don’t notice. This is the main advantage of Niaspan compared to other types of niacin.

Remember, if you flush, it means that the medicine is in your blood and is working!

The flushing usually goes away within a week.

Less Common Side Effects

  • Nausea
  • Increased blood sugar
  • Blurred vision
  • Liver inflammation or liver test abnormalities
  • Stomach pain (ulcer)
  • Allergic response
  • Gout (rare)
  • Skin changes (rare)
  • Muscle aches

Niaspan Schedule - Take at Bedtime

Week 1

500 mg

Week 2

500 mg

Week 3

500 mg

Week 4

500 mg

Week 5

1000 mg

Week 6

1000 mg

Week 7

1000 mg

Week 8

1000 mg

Week 9

1500 mg

Week 10

1500 mg

Week 11

1500 mg

Week 12

1500 mg

Week 13

2000 mg

Follow Up

Laboratory tests should be done 6-8 weeks after any major change in your dose and about 2 times per year when you are on a steady dose of niacin.