📋 Indications & Clinical Dosage
*Hypercholesterolaemia, pellagra, hyperlipidemia, hypertriglyceridemia, adjunct to statin in dyslipidaemia or used alone if statin not tolerated:*
Adults: 375 mg once daily at night for 1 wk, then 500 mg once daily at night for 1 wk then750 mg once daily at night for 1 wk, then 1 gm once daily at night for 4 wk, increase if necessary in steps of 500 mg at intervals of at least 4 wk up to 2 gm daily; usual maintenance dose 1-2 gm once daily at night, dose to be taken after a low-fat snack.
Children: Not recommended.
⛔ Contraindications
Diabetes mellitus, gout, arterial bleeding, active peptic ulcer.
⚠️ Precautions & Warnings
Unstable angina, acute myocardial infarction, diabetes mellitus, gout, history of peptic ulceration.
🔄 Drug Interactions
Adrenergic blocking agents.
⚠️ Adverse Reactions / Side Effects
Urticaria, jaundice, hyperuricemia, cramps myalgia, blurred vision, acanthosis nigricans, ichthyosis, toxic amblyopia, atrial arrhythmias, elevated serum creatine kinase and aspartate transaminias, hepatic failure, hepatic fibrosis (discontinue), GI disturbance, hypotension, flushing, faintness, headache.
🤰 Pregnancy & Lactation Safety
Pregnancy Risk:
Caution advised
Lactation / Breastfeeding:
Caution advised
📚 Official Regulatory & Clinical References
- Drug Regulatory Authority of Pakistan (DRAP): Drug Registration, S.R.O. Price Gazettes & National Essential Medicines List (NEML).
- World Health Organization (WHO): Collaborating Centre for Drug Statistics Methodology (ATC/DDD Index).
- Formulary Standards: British National Formulary (BNF) & Pakistan National Formulary (PNF) guidelines.