Nicotinic acid - instructions, use, indications, contraindications, action, side effects, analogues, composition, dosage. Nicotinic acid: instructions for use

APPROVED
By order of the Chairman of the Committee
control of medical and
pharmaceutical activities
Ministry of Health and
social development
Republic of Kazakhstan
from "____" ____________ 201__
№ ____________________

Instructions for medical use
medicine

A nicotinic acid

Tradename
A nicotinic acid

International nonproprietary name
A nicotinic acid

Dosage form
Solution for injection 1%, 1 ml

Compound
1 ml of solution contains
active substance - nicotinic acid 10 mg,
Excipients: sodium bicarbonate, water for injection.

Description
Transparent, colorless liquid.

Pharmacotherapeutic group
Lipid-lowering drugs. Hypocholesterolemic and hypotriglyceridemic drugs. Nicotinic acid and its derivatives . A nicotinic acid.
ATX code C10AD02

pharmachologic effect
Pharmacokinetics
Nicotinic acid is rapidly absorbed when administered parenterally. Evenly distributed throughout organs and tissues. Inactivated mainly by methylation and less by conjugation. Partially biotransformed in the liver with the formation of N-methylnicotinamide, methylpyridonecarboxamides, glucuronide and a complex with glycine. Half-life (T 1/2) - 45 minutes. It is excreted from the body by the kidneys in unchanged form and in the form of metabolites. Renal clearance depends on the concentration of nicotinic acid in the blood plasma and may decrease at high plasma concentrations.

Pharmacodynamics
The structure of nicotinic acid is close to nicotinamide.
Nicotinic acid and its amide play a significant role in the life of the body: they are prosthetic groups of enzymes - codehydrase I (diphosphopyridine nucleotide - NAD) and codehydrase II (triphosphopyridine nucleotide - NADP), which are hydrogen carriers and carry out redox processes. Codehydrase II is also involved in phosphate transport.
Nicotinic acid replenishes the deficiency of vitamin PP and has a vasodilating effect. Participates in the regulation of tissue respiration, fat metabolism, reduces total cholesterol and low-density lipoproteins (especially triglycerides).

Indications for use
- prevention and treatment of pellagra (vitaminosis RR)
As part of complex therapy: vascular spasm of the extremities (obliterating endarteritis, Raynaud's disease), neuritis of the facial nerve, ischemic cerebrovascular accidents

Directions for use and doses
Nicotinic acid is administered to adults subcutaneously, intramuscularly or slowly intravenously.
For intravenous jet administration a single dose of the drug is diluted in 10 ml of 0.9% sodium chloride solution, administered no less than 5 minutes (no faster than 2 mg of nicotinic acid in 1 minute).
For intravenous drip administration a single dose of the drug is diluted in 100-200 ml of 0.9% sodium chloride solution, the rate of administration is 30-40 drops per minute.
Subcutaneous and intramuscular injections are painful.
For pellagra, a 1% solution of 1 ml is administered intravenously or intramuscularly 1-2 times a day for 10-15 days.
In case of ischemic cerebrovascular accident, 1 ml of 1% solution is administered intravenously (slowly).
For other indications prescribed subcutaneously or intramuscularly at 10 mg (1 ml) 1 time per day for 10-15 days. It is possible to add to the infusion solution: 10 mg (1 ml) of nicotinic acid per 100-200 ml of infusion solution.
Higher doses for intravenous administration: single - 100 mg (10 ml), daily - 300 mg (30 ml).

Side effects
- hyperemia of the face and upper half of the body with a sensation
tingling and burning (in people with hypersensitivity)
- urticaria, skin rash, itching
- dizziness, feeling of a rush of blood to the head, headache
- orthostatic hypotension, collapse (with rapid intravenous administration)
With long-term use of large doses
- dry skin, exfoliative dermatitis
- anorexia, vomiting, diarrhea
- liver dysfunction, incl. fatty liver, jaundice
- arrhythmias
- paresthesia
- hyperuricemia
- hyperpigmentation, hyperkeratosis
- decreased glucose tolerance
- hyperglycemia
- transient increase in aspartate aminotransferase activity,
lactate dehydrogenase, alkaline phosphatase
- irritation of the mucous membrane of the gastrointestinal tract.
- asthenia
- pain at the site of subcutaneous and intramuscular injections.

Contraindications
- increased sensitivity to nicotinic acid
- severe forms of arterial hypertension
- atherosclerosis (for intravenous injections)
- peptic ulcer of the stomach and duodenum (at the stage
exacerbation)
- severe liver dysfunction: hepatitis, liver cirrhosis
- recent myocardial infarction
- decompensated diabetes mellitus
- gout and hyperuricemia
- pregnancy, lactation period
- children under 18 years of age

Drug interactions
Oral contraceptives and isoniazid reduce the conversion of tryptophan to niacin and thus may increase the need for niacin.
Nicotinic acid reduces effectiveness and toxicity barbiturates, antituberculosis drugs, sulfonamides. When used together with sulfonylureas, it may increase blood glucose levels. Nicotinic acid also reduces the toxicity of neomycin and prevents the decrease in the concentration of cholesterol and high-density lipoproteins induced by it.
Antibiotics may increase skin redness caused by nicotinic acid.
Acetylsalicylic acid reduces the effect of skin redness that occurs under the influence of nicotinic acid.
Ciprofibrate It is not recommended to combine with nicotinic acid.
Lovastatin, pravastatin Due to the increased risk of adverse reactions, it is not recommended to combine it with nicotinic acid.
Caution must be exercised when combined with antihypertensive drugs(possible increased hypotensive effect), anticoagulants, acetylsalicylic acid(due to the risk of developing hemorrhages).
The drug potentiates the effect fibrinolytic agents, antispasmodics and cardiac glycosides, toxic effects of alcohol on the liver.
Do not mix with thiamine chloride solution (thiamine is destroyed).

special instructions
Before using the drug, you should consult your doctor.
Since long-term use can lead to fatty liver disease, to prevent the latter, patients’ diets include foods rich in methionine or prescribe methionine and lipoic acid. During treatment it is necessary to monitor liver function. If hypersensitivity to the drug occurs (except when used as a vasodilator), it can be replaced with nicotinamide.
Carefully the drug is used for hyperacid gastritis, gastric and duodenal ulcers (outside the acute stage).
The use of the drug may lead to an increase in the need for insulin in patients with diabetes. It is not advisable to use for the correction of dyslipidemia in patients with diabetes mellitus.
It is necessary to regularly monitor glucose due to a possible decrease in glucose tolerance, as well as serum uric acid levels due to a possible increase as a result of long-term therapy.
Carefully prescribed for glaucoma, bleeding, arterial hypotension, impaired liver and kidney function, liver diseases and a history of impaired liver function, diabetes mellitus, heart rhythm disturbances, migraines, alcohol abuse.
Features of the effect of the drug on the ability to drive a vehicle or potentially dangerous mechanisms
Considering the side effects of the drug, caution should be exercised when driving vehicles and moving machinery.

Overdose
Symptoms: increased side effects from the cardiovascular system - arterial hypotension, headache, possible loss of consciousness, dizziness, a feeling of a rush of blood to the head.
Treatment: drug withdrawal, detoxification therapy, symptomatic treatment. There is no specific antidote.

Release form and packaging
1.0 ml of the drug in neutral glass ampoules or sterile ampoules for syringe filling.
A label made of label or writing paper is glued onto each ampoule, or the text is applied directly to the ampoule using intaglio printing ink for glass products.
5 or 10 ampoules are packed in blister packs made of polyvinyl chloride film and aluminum foil.
10 ampoules are placed in a box made of cardboard or chrome ersatz with a corrugated liner. An ampoule scarifier is placed in each box. The box is covered with a label-parcel made from label or writing paper.
An ampoule scarifier is included in each package.
When packaging ampoules with notches, rings and dots, scarifiers are not included.
Boxes with ampoules or contour packages are placed in cardboard boxes.
Approved instructions for medical use in the state and Russian languages are placed in group packaging with boxes or contour packages. The number of instructions is calculated according to the number of boxes or packages.

Storage conditions
Store in a place protected from light, at a temperature not exceeding 30 o C.
Keep out of the reach of children!

Shelf life
5 years
Do not use after expiration date.

Conditions for dispensing from pharmacies
On prescription

Manufacturer

Registration Certificate Holder
JSC "Khimpharm", Republic of Kazakhstan
Address of the organization that accepts claims from consumers regarding the quality of products (products) on the territory of the Republic of Kazakhstan
JSC "Khimpharm", Republic of Kazakhstan
Shymkent, st. Rashidova, 81
Phone number 7252 (561342)
Fax number 7252 (561342)
E-mail address [email protected]

Instructions for use:

Nicotinic acid is a vitamin preparation, also referred to as vitamin PP.

pharmachologic effect

Nicotinic acid is a compound similar in structure to nicotinamide.

The use of nicotinic acid is important for stimulating blood circulation, brain activity, metabolism of amino acids, fats, carbohydrates, and proteins.

This vitamin is of great importance for the prevention of cardiovascular diseases. It helps reduce cholesterol, lipoprotein and triglyceride levels - substances that clog blood vessels, contribute to increased blood pressure and the formation of blood clots, and limit blood supply.

Release form

Nicotinic acid is produced in tablets and in the form of a solution.

Indications for use of Nicotinic acid

The vitamin is administered intravenously, taken orally, and subcutaneous and intramuscular injections of nicotinic acid are given.

The drug is used for the treatment and prevention of pellagra, the treatment of mild forms of diabetes, heart disease, ulcers of the gastrointestinal tract, liver, enterocolitis, gastritis with low acidity, poorly healing skin lesions, to relieve spasms of blood vessels in the brain, arms and legs, and kidneys.

The drug is also included in the complex therapy of neuritis of the facial nerve, atherosclerosis, and various infections.

Contraindications

The vitamin should not be administered intravenously for hypertension; do not use the drug for hypersensitivity.

In case of increased individual sensitivity to the drug, you can replace the acid with nicotinamide, except in cases where the acid was prescribed as a vasodilator.

Instructions for use of Nicotinic acid

Nicotinic acid for prevention is prescribed for adults 15-25 mg, children 5-20 mg per day.

To treat pellagra, adults take nicotinic acid in tablets of 100 mg up to four times a day for 15-20 days. You can administer a 1% acid solution - 1 ml up to two times a day for 10-15 days. Children are given 5-50 mg two or three times a day.

For other indications, adults take the vitamin 20-50 mg, children – 5-30 mg up to three times a day.

As a vasodilator for ischemic stroke, 1 ml of nicotinic acid is administered intravenously.

Intramuscular and subcutaneous injections of nicotinic acid, unlike intravenous administration, are painful. In order to avoid irritation, you can use the sodium salt of nicotinic acid.

Thanks to the ability of this vitamin to dilate blood vessels, nicotinic acid is useful for hair - it stimulates hair growth. To treat hair, the solution is rubbed into the scalp for 30 days, 1 ml (one ampoule).

Apply the solution in its pure form to slightly damp, washed hair. After a month of hair treatment with nicotinic acid, the scalp is cleared of dandruff, the roots are strengthened, and the hair grows by 4-6 cm. If necessary, rubbing courses can be repeated periodically, with breaks of 15-20 days.

Nicotinic acid has been successfully used for weight loss. Weight correction is facilitated by the fact that the vitamin speeds up metabolism, helps cleanse blood vessels, level cholesterol levels, and remove heavy metals and toxins. The dosage of nicotinic acid for weight loss is individual for each person and is 100-250 mg per day. Nicotinic acid is usually taken in tablets, no more than 1g per day, several times a day. A reaction to acid in the form of redness of the skin and a flush of heat is considered normal. In case of increased acidity of stomach secretions, take the vitamin only after meals.

Side effects

The use of nicotinic acid can cause: redness of the skin of the face, upper half of the body, rash, numbness in the extremities, dizziness, hot flash. These side effects go away on their own.

With rapid intravenous administration of the vitamin, blood pressure can drop sharply, and with prolonged use and in high dosages, the drug can provoke the appearance of fatty liver degeneration. To prevent this disease, the vitamin is prescribed simultaneously with methionine.

Nicotinic acid or, as it is also called, “Nicotinka” (injections) refers to vitamin-like substances. The strength of blood vessels and the normal functioning of the circulatory system depend on the content of this vitamin in a person’s blood. This is why the medicine is so often used in modern medicine.

The drug "Nikotinka" (injections): pharmacological properties

Nicotinic acid (vitamin PP) is very important for the normal functioning of all human organ systems. Once in the body, it is quickly converted into nicotinamide, a substance that is involved in the metabolism of fats, lipids, proteins, and purines. Nicotinamide is also important for normal hydrogen ion transport.

Nicotinic acid affects the concentration of lipoproteins in the blood, and in certain doses can reduce cholesterol levels.

The drug "Nikotinka" improves brain microcirculation and also partially increases the fibrinolytic activity of the blood.

It is worth noting that with a deficiency of nicotinic acid in the body, the development of a disease called pellagra begins. Therefore, the drug is used both to treat the disease and as a preventive measure.

The drug "Nikotinka" (injections): instructions for use

Today, the drug “Nicotinic acid” has become quite widespread among medical personnel. Of course, it is primarily used for the prevention and treatment of pellagra, but its importance does not end there.

It has already been mentioned that this vitamin has a beneficial effect on the circulatory system, especially on the blood supply to the brain. Therefore, the drug “Nicotinic acid” is used in the presence of peripheral vascular spasm, as well as in cases of chronic migraines, as well as for the treatment of atherosclerosis.

In some cases, this medicine is used as part of complex therapy in the treatment of infectious diseases, disorders of the digestive tract, and hypercoagulation. The drug is also effective in the presence of neuritis of the facial nerve.

The drug "Nikotinka": instructions for use

It is not recommended to take this remedy on your own; first, you should consult your doctor. The specialist will determine the dose, dosage regimen and route of administration. The solution can be administered subcutaneously, intramuscularly or intravenously. It is believed that injections are quite painful, especially intramuscular ones.

The daily dose of the drug directly depends on the type of disease and its severity. For preventive purposes, adults are recommended to administer 0.025 g of vitamin per day. For children, the dose is less - from 0.005 to 0.025 g per day.

If pellagra has already begun, then the daily dose is recommended to be increased. Adults should be administered 0.05 g intravenously 1-2 times a day. Treatment in this case lasts from 10 to 15 days.

The drug "Nikotinka" (injections): contraindications

Firstly, this medicine is strictly contraindicated for those patients who have developed hypersensitivity to nicotinic acid. Secondly, it is not recommended for people with diabetes.

On the other hand, the medicine is not used to treat patients with severe atherosclerosis or hypertension. Exacerbation of an intestinal or stomach ulcer may also be a contraindication. It is not recommended to use this remedy if you have gout or severe liver disease. During pregnancy and breastfeeding, the use of the drug should be very careful.

The drug "Nikotinka" (injections): side effects

Adverse reactions are recorded quite rarely, but all of them are in one way or another associated with the active release of histamine. For example, a patient complains of dizziness, a feeling that blood is rushing to the head. Sometimes diarrhea, nausea, vomiting and other disorders of the digestive tract are observed.

Nicotinic acid is a component of the vitamin B complex. This substance is also called vitamin PP. Nicotinic acid is very necessary for our body, as it takes part in many metabolic processes.

pharmachologic effect

Without nicotinic acid, the human body will not be able to function fully. It influences educational and metabolic processes:

dilates blood vessels;
improves liver function;
stimulates the gastrointestinal tract;
restores the hematopoietic system in the bone marrow;
promotes healing of ulcers and wounds;
removes toxins from the body;
improves the functioning of the cardiovascular system;
lowers blood sugar levels.

This vitamin is simply irreplaceable in cosmetology, because it helps to cope with skin problems. It also improves the condition of hair and nails. With regular consumption of vitamin PP, lipid metabolism in the body improves. In addition, in patients with atherosclerosis, the level of cholesterol in the blood decreases.

Indications for use

Doctors prescribe nicotinic acid for pellagra. Already after the first course of treatment, patients' condition significantly improves. In addition, it is possible to cure not only the underlying disease, but also get rid of diseases of the gastrointestinal tract and central nervous system. Patients' skin clears after treatment with nicotinic acid. After three weeks of treatment, disorders in the stomach and intestines also disappear. After a month of treatment, a person’s pellagritic psychoses disappear.

Vitamin PP is useful for those who want to lose weight. After all, this vitamin normalizes metabolism and removes toxins and waste from the body.

Instructions for use

In order for nicotinic acid to benefit the body, it must be taken in the correct dosages. Nicotinic acid is available in the form of dragees and tablets, as well as injections. Injections of nicotinic acid can be done subcutaneously, intramuscularly and intravenously. However, injections with vitamin PP are very painful, so doctors rarely prescribe them.

Dosage of the drug

The dosage of vitamins is prescribed based on the disease. As a rule, nicotinic acid should be taken three times a day, 0.1 g at a time. The vitamin is taken after meals and washed down with water. For prevention, nicotinic acid is prescribed in a smaller dosage - 0.020 g at a time, three times a day.

Injections with vitamin PP should be done slowly. It is allowed to administer no more than 0.1 g intramuscularly and 0.01 g intravenously at a time. The course of treatment with this vitamin depends on the disease and its severity. On average, such treatment can last from three to five weeks. After this, you need to take a two-week break and, if necessary, the course of treatment can be repeated. Doctors do not advise exceeding the dosage of the drug. You can take no more than 5 g of the drug per day. If the drug is given as injections, then its daily dose should not exceed 0.3 g.

Benefits for hair

Many cosmetologists use nicotinic acid for hair care. This vitamin is also prescribed for many diseases of the scalp and hair. The thing is that nicotinic acid dilates blood vessels. After vitamin PP is rubbed into the hair roots, it is absorbed into the skin and delivered through the blood vessels to the cells of the scalp, enriching them and the hair follicles with useful substances.

Some trichologists recommend rubbing nicotinic acid from ampoules into the scalp. This helps stop hair loss and speed up hair growth. Nicotinic acid also helps get rid of dandruff and hair problems. For a course of treatment you will need 30 ampoules of the vitamin. One ampoule for one use. After opening, the drug must be very quickly applied to the roots of clean hair and rubbed in. Vitamin PP very quickly loses its beneficial properties in air, so you should not leave the ampoules open. During the period of using the drug, you should stop using various shampoos and masks with silicone. It is best to apply the product to slightly damp hair.

To make it more convenient to distribute the vitamin over the head, you can divide your hair into partings. You can apply the vitamin using your finger or a syringe. Even if you have thick hair, one ampoule will be enough. After all, the vitamin penetrates well into blood vessels, and through them into the blood. Thanks to this, nicotinic acid will be evenly distributed over all surfaces of the head.

Some people experience redness and burning of the scalp after applying the drug. This phenomenon is normal. If redness and burning do not go away, but intensify, severe hives, headache or itching appear, then you should stop using nicotinic acid. Most likely, these symptoms indicate individual intolerance to the drug.

Nicotinic acid does not pollute the hair, so there is no need to rinse it off. The course of treatment should be a month. The drug must be applied to the hair every day. Then a month-long break is taken and, if necessary, the course of treatment is resumed. After such treatment, not only hair loss stops and scalp problems disappear, but hair growth also increases.

Benefits for the skin

Nicotinic acid takes part in oxygen exchange in skin cells. It dilates blood vessels and improves blood supply, making the skin look healthy and elastic. Nicotinic acid helps remove excess fluid from the body, so it is prescribed for swelling of the body. Almost all decongestant cosmetics contain vitamin PP.

Nicotinic acid takes part in protein metabolism, as well as in the formation of elastin and collagen, which makes the skin elastic, well-groomed and smooth. In addition, this vitamin is very important for women, as it affects the formation of sex hormones. Thanks to this woman’s body, wrinkles do not appear when there is an excess of hormones in her body.

Cosmetologists and doctors recommend using cosmetics with vitamin PP in sunny weather. Preparations containing this substance reduce the risk of developing melanoma and reduce the negative effects of ultraviolet rays on the skin.

Nicotinic acid is very useful for wraps. It helps get rid of cellulite. To make an anti-cellulite wrap, you need to take one ampoule of nicotinic acid and dissolve it in water in a ratio of 1:3. After this, you need to moisten a wide bandage in this liquid and wrap it around problem areas. Cling film and a warm blanket are placed on top. The skin should warm up well.

Side effects

The following side effects may occur from nicotinic acid: dizziness, nausea, burning, nausea, diarrhea, a sharp decrease in blood pressure and an increase in the secretion of gastric juice.

If side effects begin to appear, you should immediately stop using the drug and inform your doctor. Perhaps the doctor will reduce the dosage of nicotinic acid or discontinue the drug.

Contraindications

Nicotinic acid should not be used if:

kidney dysfunction;
bleeding tendency;
gout, glaucoma or low blood pressure;
exacerbation of gastrointestinal diseases, especially with ulcers;
inflammation of the large intestine.

pharmachologic effect

Vitamin and lipid-lowering agent. In the body, nicotinic acid is converted into nicotinamide, which binds to coenzymes codehydrogenase I and II (NAD and NADP), which transport hydrogen, and participates in the metabolism of fats, proteins, amino acids, purines, tissue respiration, glycogenolysis, and synthetic processes. Replenishes deficiency of PP (vitamin B 3), is a specific antipellagric agent (vitaminosis of vitamin PP). Normalizes the concentration of blood lipoproteins; in high doses (orally 3-4 g/day) reduces the concentration of total cholesterol, LDL, TG, reduces the cholesterol/phospholipid index, increases the content of HDL, which has an antiatherogenic effect. It has a vasodilating effect at the level of small vessels (including the brain), improves microcirculation, and has a weak anticoagulant effect (increases the fibrinolytic activity of the blood).

The hypocholesterolemic effect is observed within a few days, and a decrease in TG is observed within a few hours after administration.

Indications

Hypo- and avitaminosis RR: pellagra, inadequate and unbalanced nutrition (including parenteral), malabsorption syndrome (including against the background of impaired pancreatic function), rapid weight loss, gastrectomy, Hartnup disease (hereditary disease accompanied by impaired absorption of certain amino acids, including tryptophan), gastrointestinal diseases (gluten enteropathy, persistent diarrhea, tropical sprue, etc.).

Conditions of increased body need for vitamin PP: prolonged fever, diseases of the hepatobiliary region (acute and chronic hepatitis, cirrhosis of the liver), hyperthyroidism, chronic infections, malignant tumors, prolonged stress, pregnancy (especially against the background of nicotine and drug addiction, multiple pregnancy), period lactation.

Hyperlipidemia, incl. primary hyperlipidemia (types IIa, IIb, III, IV, V).

Ischemic cerebrovascular accidents, obliterating vascular diseases of the extremities (obliterating endarteritis, Raynaud's disease), vascular spasm of the extremities, biliary and urinary tracts; diabetic polyneuropathy, microangiopathy.

Neuritis of the facial nerve, hypoacid gastritis, enterocolitis, colitis, non-healing wounds and trophic ulcers.

Contraindications

Hypersensitivity to nicotinic acid.

For oral administration: peptic ulcer of the stomach and duodenum in the acute phase, children under 2 years of age (as a lipid-lowering agent).

For parenteral use: severe arterial hypertension, atherosclerosis, gout, hyperuricemia, childhood.

Dosage

To prevent pellagra for adults, 15-25 mg/day orally, for children - 5-20 mg/day. For pellagra in adults, 100 mg orally 2-4 times a day for 15-20 days, parenterally - 10 mg 1-2 times a day for 10-15 days. Children orally - 5-50 mg 2-3 times a day. For other indications, adults: 20-50 mg (up to 100 mg), children: 5-30 mg 2-3 times a day. For ischemic stroke, 10 mg is administered intravenously.

Side effects

From the cardiovascular system: hyperemia of the skin of the face and upper half of the body with a feeling of tingling and burning; with rapid administration - a decrease in blood pressure, orthostatic hypotension, collapse.

From the central nervous system and peripheral nervous system: paresthesia, dizziness.

From the digestive system: with long-term use - fatty liver degeneration.

From the side of metabolism: with long-term use - hyperuricemia, decreased tolerance to, increased blood levels of AST, LDH, alkaline phosphatase.

Local reactions: pain at the site of subcutaneous and intramuscular injections.

Other: allergic reactions.

Drug interactions

Caution must be exercised when combined with antihypertensive drugs, anticoagulants, etc.

Nicotinic acid reduces the toxicity of neomycin and prevents the decrease in cholesterol and HDL concentrations induced by it.

special instructions

Use orally with caution in patients with hemorrhages, glaucoma, gout, hyperuricemia, liver failure, arterial hypotension, hyperacid gastritis, gastric and duodenal ulcers (in remission).

Use parenterally with caution in patients with hemorrhages, glaucoma, liver failure, arterial hypotension, hyperacid gastritis, gastric and duodenal ulcers (in the acute phase).

During treatment it is necessary to monitor liver function.

It is not advisable to use for the correction of dyslipidemia in patients with diabetes mellitus.

To prevent liver complications, it is recommended to include foods rich in methionine (cottage cheese) in the diet or use methionine and other lipotropic agents.

Use in childhood

Contraindications:

— for oral administration: children under 2 years of age (as a lipid-lowering agent).

— for parenteral use: children's age.

For liver dysfunction

Use with caution in patients with liver failure.

With long-term use of nicotinic acid in high doses, fatty infiltration of the liver may develop.

During treatment it is necessary to monitor liver function. To prevent complications from the liver, it is recommended to include rich foods (cottage cheese) in the diet or use methionine, lipoic acid and other lipotropic agents.