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Nicotinic acid, commonly known as niacin, is a form of vitamin B3. It is a naturally occurring vitamin that may be used to treat high cholesterol. Niacin may be referred to as a cholesterol-reducing drug, even though it is available over-the-counter. As a supplement, it is not subject to the same government regulation as prescription or over-the-counter medications.

Other cholesterol-reducing medications include statins, fibrates and bile acid resins. While statins are the considered the first line of defense for treating high cholesterol, nicotinic acid is effective at lowering blood levels of triglycerides and increasing blood levels of HDL (or “good” cholesterol). At a higher dosage, nicotinic acid is also effective at lowering blood levels of LDL (or “bad” cholesterol). Nicotinic acid may sometimes be prescribed in addition to other cholesterol-reducing medications.

High levels of cholesterol, triglycerides and other fats in the bloodstream increase the risk of hardening of the arteries (atherosclerosis), heart attack, stroke and other heart-related conditions.

Nicotinic acid is available over-the-counter (as niacin), but physicians often prefer to prescribe it in time-released pills. Side effects include flushing or hot flashes, which can be intense at large doses. As with other medications and supplements, patients should consult a physician before taking niacin. In addition, patients who use nicotinic acid should be closely monitored by their physician to avoid complications.