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At the high doses of niacin used to treat hyperlipidemia, side effects are common. These include cutaneous flushing (partially prevented by pretreatment with aspirin, 81–325 mg/day, and use of ER nicotinic acid preparations) and gastric irritation. Elevation of liver enzymes, hyperglycemia, and gout are less common side effects.

D'Andrea  E  et al. Assessment of the role of niacin in managing cardiovascular disease outcomes: a systematic review and meta-analysis. JAMA Netw Open. 2019;2:e192224.
[PubMed: 30977858]  
Handelsman  Y  et al. Consensus statement by the American Association of Clinical Endocrinologists and American College of Endocrinology on the management of dyslipidemia and prevention of cardiovascular disease algorithm—2020 executive summary. Endocr Pract. 2020;26:1196.
[PubMed: 33471721]  
Simha  V. Management of hypertriglyceridemia. BMJ. 2020;371:m3109.
[PubMed: 33046451]  

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