Niacin is a B-complex
vitamin which has been used for decades for the management of mixed
dyslipidemias and primary
hypercholesterolemia. It decreases the risk of cardiovascular events either when used as a monotherapy or in combination with other
lipid lowering medications. However, a major limitation to its use is
niacin-induced
flushing occurring even with the
extended-release formulations.
Laropiprant, a selective prostaglandin-2 receptor inhibitor, specifically targets the cascade of events causing the
flushing. It has been recently used in combination with extended-release
niacin. This article will review the early experience with this combination with focus on efficacy, safety, tolerability and current place in
therapy. Early data are promising and suggest that more patients in clinical practice will benefit from
niacin combined with
laropiprant. Ongoing clinical trials will provide a better insight on the long-term safety of the
drug and its efficacy for reducing cardiovascular events.