Nicotinic acid (Acidum nicotinicum) tabs 50mg #50

Nicotinic acid instruction for use

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Composition

One milliliter of 0.1% solution for injection contains 10 mg of active ingredient, as well as sodium hydrogen carbonate and water for injection.
In the State Pharmacopoeia of the USSR, the X edition indicates that the solution is a transparent, colorless liquid with a pH of 5.0 to 7.0.
The concentration of nicotinic acid in one tablet is 0.05 grams.

Form of issue

Pharmacological forms of nicotinic acid: 1% injection and 50 mg tablets.
Ampoules with 1 ml of solution are packed into 10 units in contour cell packs, 5 packs per pack.
The tablets are sold prepacked:
    50 pieces in cans of polymeric materials or dark glass;
    10 pieces per contour cell pack, 5 packs per pack.

pharmachologic effect

Vitamin B group. Compensates the lack of vitamin PP (B3), has a vasodilating (vasodilating), hypocholesterolemic and hypolipidemic action.

Pharmacodynamics and pharmacokinetics

Vitamin PP (nicotinic acid) - a vitamin that takes part in a large number of living cells of oxidative reactions.
The drug has a specific anti-pelagic effect and is used to improve the activity of blood vessels.
The purpose of nicotinic acid preparations allows to normalize the permeability of the vascular walls and, accordingly, to reduce the swelling of the tissue, to improve the tissue (in particular, nitrogen and carbohydrate) metabolism and microcirculation, to widen the lumen of the vessels (the vasodilating effect is noted at the level of small blood vessels, including the vessels of the head brain), to increase the fibrinolytic activity of blood plasma and to reduce platelet aggregation by suppressing the synthesis of TxAj (thromboxane A2), the mediator of their aggregation and de granulation.
In the body, the vitamin PP is biotransformed into nicotinamide, which binds to hydrogen-transferring coenzymes NAD and NADP. Regulates oxidation-reduction reactions, takes part in synthetic processes, amino acid metabolism, fats, purines, proteins, as well as in glycogenesis and tissue respiration.
Reduces the speed of VLDL synthesis and inhibits lipolysis (fat degradation) in adipose tissue. Helps normalize the lipid composition of the blood: reduces the concentration of LDL, triglycerides and total cholesterol, while increasing the blood levels of HDL. It shows anti-atherogenic and detoxifying properties.
Provides the transformation of the trans-form of retinol to cis-retinal, which is used in the synthesis of the visual pigment of rhodopsin, stimulates the release of histamine and promotes the activation of kininogenesis.
Vitamin B3 is well absorbed in the pylorus of the stomach and the upper parts of the duodenum. With the participation of pyridoxine and riboflavin can be produced by bacterial flora of the intestine of tryptophan, which comes with food. The amount of tryptophan required for the formation of a milligram of substance is 60 mg.
Metabolization occurs in the liver. Nicotinic acid and the products of its metabolism are excreted by the kidneys, when taken in high doses the substance is excreted mostly in pure form.

Indications for use

Indication for the use of nicotinic acid are:

    hypo and avitaminosis caused by insufficient intake of vitamin B3 with food, exclusively parenteral nutrition, malabsorption syndrome (including pancreatic disorders), Hartnup disease, rapid weight loss, gastrectomy, digestive system diseases (persistent diarrhea, including tropical, gluten enteropathy, Crohn's disease);
    conditions accompanied by increased demand for vitamin PP (diseases of the hepatobiliary system, prolonged fever, hyperthyroidism, prolonged stress, chronic infections, pregnancy, lactation, oncological diseases);
    hyperlipidemia (including triglyceridemia and hypercholesterolemia);
    atherosclerosis;
    obliterating diseases of the vessels of the lower extremities (eg Raynaud's disease);
    ischemic circulatory disorders of the brain;
    spasm of the urine and biliary tract, vessels of the extremities;
    microangiopathy;
    diabetic polyneuropathy;
    hypoacid gastritis;
    colitis and enterocolitis;
    facial nerve neuropathy;
    trophic ulcers and non-healing wounds.

Contraindications

Categorical contraindications for both drug forms of the drug are serious violations of liver function, bleeding, hemorrhage in the brain, hypersensitivity to nicotinic acid.
Nicotinic acid in tablets should also not be taken during peptic ulcer episodes and children under 2 years of age (as an antisclerotic).
Additional contraindications to the appointment of nicotinic acid in ampoules are: atherosclerosis, hyperuricemia, severe arterial hypertension, gout, children's age.

Side effects

The drug stimulates the release of histamine, which in some cases may be accompanied by:
    reddening of the skin (mainly the upper half of the trunk and face) with a burning sensation and tingling sensations;
    hypotension;
    orthostatic hypotension (with rapid introduction into the vein);
    increased release of gastric juice;
    dyspepsia;
    dizziness;
    sensation of a rush of blood to the head;
    urticaria;
    itching.
The side effects associated with prolonged use of high doses of vitamin B3 are expressed as:
    anorexia;
    impaired function and obesity of the liver;
    vomiting;
    diarrhea;
    irritation of the mucosa of the digestive canal;
    ulceration (ulceration) of the gastric mucosa;
    transient increase in the activity of alkaline phosphatase, aspartate aminotransferase, lactate dehydrogenase;
    paresthesia;
    arrhythmias;
    reducing glucose tolerance;
    hyperglycemia.

Instructions for use Acidum nicotinicum

Instructions for tablets

Tablets are taken after meals.
The prophylactic dose for adults varies from 12.5 to 25 mg per day, for children from 5 to 25 mg per day.
When pellagra, adult patients are prescribed to take 2 to 4 times a day for 100 mg of nicotinic acid. The duration of the course is 2-3 weeks. Children receive the drug 12.5-50 mg two or three times a day.
When lesions of vessels of atherosclerotic genesis, patients are recommended to take in 2-4 doses of 2 to 3 grams of vitamin RR.
The starting dose for dyslipidemia is 50 mg per day in one session. Subsequently, - if therapy does not provoke adverse reactions, - the frequency of application is increased to 2-3 times a day. The duration of the course is from one month. Between repeated courses should be maintained intervals.
In all other cases, the daily intake for adults is from 20 to 50, for children - from 12.5 to 25 mg. In some cases, an adult patient may be required to increase the daily dose to 100 mg. Tablets, depending on the readings, drink 2 or 3 times a day.

Overdose

High doses of the drug can cause a rush of blood to the upper body and head, indigestion and itching.
Overdose shows supportive treatment.

Interaction

Nicotinic Acid enhances the action of vasoactive drugs (in particular, ganglion blockers), which can be accompanied by attacks of orthostatic hypotension.
Sequestants of bile acids (for example, colestipol or cholestyramine) reduce the bioavailability of acid preparations, including n. acid, so the drug should be taken at least one hour before or no earlier than four hours after taking these drugs.
When performing an analysis to determine the glucose level in the urine, the drug can provoke a false positive reaction with the Benedict reagent (copper sulphate solution).
Nicotinic acid has a hyperglycemic potential and is capable of significantly reducing acarbose activity, which can cause the development of diabetes decompensation.
Because of the ability to Nicotinic acids cause hyperglycemia, in patients who are prescribed a drug in combination with metformin + saxagliptin or metformin + sitagliptin, the parameters of glycemic control should be constantly monitored.
In patients taking nadroparin calcium, it is necessary to keep under control hemocoagulation.
With the simultaneous use of n. acids and combinations of "amlodipine + atorvastatin", n. acid and simvastatin, n. acid and lovastatin may increase the risk of myopathy. The combination of n. acid with simvastatin can also provoke rhabdomyolysis.
Myopathy and rhabdomyolysis are also possible in the case of a combination of "n. acid in lipid-lowering doses and Simvastatin + Ezetimibe. "
The risk of developing myopathy also increases with the appointment of lipid-lowering (exceeding 1 gram per day) doses of n. acid in combination with rosuvastatin. In this regard, treatment with rosuvastatin should begin with 5 mg / day.
The combination "nicotine + ascorbic acid" should be used with caution.
The probability of drug interaction with heparin of sodium is not excluded.
High doses of n. acids reduce the effectiveness of the combination "Glybenklamid + Metformin", hypoglycemic action of Gliclazide and the effectiveness of the combination "Gliclazide + Metformin", as well as hypoglycemic action of Glimepiride.
With simultaneous application with Nicotinic acid reduces the effect:
    Glypyside;
    hypoglycemic effect of glycidone;
    Insulin Lizpro (including biphasic);
    Metformin;
    Repaglinide;
    hypnotic effect of Phenobarbital.
Do not mix in the same syringe Nicotinic acid and Thiamine.
Despite the fact that simultaneous application of n. acids with inhibitors of HMG-CoA-reductase can provoke myopathy, while concomitant administration of the drug with fluvastatin bioavailability of the latter, as well as bioavailability of n. acid, does not change. However, this combination should be used with caution.

Storage conditions

Store at room temperature in a well-ukuporennoy, protect from exposure to sunlight tare. Keep away from children.

Shelf life

For solution - 5 years. For tablets - 4 years.

special instructions

What is Vitamin PP?

Wikipedia on the question "what is nicotinic acid" answers that this powdery substance is white, odorless and slightly acidic in taste. The powder is poorly soluble in cold water, ethanol, ether and slightly better - in hot water.
The gross formula of the substance is C₆H₅NO₂. It was first obtained in 1867 by the oxidation of nicotine H2CrO4 (chromic acid).
The Benefits and Harms of Vitamin B3
Pure vitamin B3 can strengthen immunity to such an extent that the human body acquires a natural defense against Staphylococcus aureus and a number of other equally serious viruses.
Scientists are sure that very high doses can stop even HIV infection and bacterial infection, before which most of the existing drugs are powerless.
In addition, vitamin B3 has the properties of a detoxifier.
The body of an adult male daily requires 16 to 28 mg of vitamin B3, the body of a woman - from 14 to 20 mg.
The need for a vitamin will increase with intense nervous and mental activity, increased physical activity, in people working in hot shops, in hot climates and in conditions of the Far North, during pregnancy and during breastfeeding, in people whose dietary proteins predominate over the diet animals (including people who keep fasting, and people who stick to a low-protein diet).
Nicotinic acid is necessary for the release of fat and carbohydrates energy, as well as for the normal course of protein metabolism. It normalizes the operation of the pancreas and stomach, and is also part of the enzymes that provide cellular respiration.
Vitamin beneficially affects the heart, blood vessels, the nervous system, maintains in a healthy state the mucous membranes of the mouth and intestines, the skin; takes part in providing normal vision, reduces high blood pressure and improves blood flow.
Some scientists are inclined to believe that vitamin B3 interferes with the cancerous degeneration of cells.
Lack of this substance in the body is accompanied by apathy, lethargy, fatigue, headaches, dizziness, dryness and pallor of the skin, insomnia, irritability, decreased appetite and body weight, constipation, palpitations, reduced resistance to infections.
If a person loses nicotinic acid, he develops a pellagra disease. The first signs of the disease are:
    frequent, watery stools (3 or more times a day, without any admixture of blood and mucus);
    bad appetite, heaviness in the stomach;
    eructation and heartburn;
    reddening of the oral mucosa;
    salivation, burning in the mouth;
    puffiness and cracking of the lips;
    protrusion of tongue papillae with red dots;
    the appearance of deep cracks in the tongue and red spots on the face, hands, elbows and neck;
    swelling of the skin (the code can hurt, itch, bubbles appear on it);
    noise in ears;
    severe weakness;
    headache;
    a feeling of crawling and a feeling of numbness;
    pressure fluctuations;
    shaky gait.
Excess of the vitamin in turn can cause the appearance of rashes on the skin, itching and fainting.
Products containing vitamin B3
To prevent hypovitaminosis PP, it is preferable to adjust the diet so that the vitamin B3 contains foods in the diet.
Where is nicotinic acid? In foods, the greatest amount of vitamin B3 can be found in the liver, egg yolk, yeast, nuts, fish, milk, chicken, green vegetables, meat, legumes, peanuts, buckwheat and any other food containing alpha-amino acid tryptophan.
Heat treatment for the amount of vitamin does not affect.

What is nicotinic acid used for in cosmetology?

Despite the fact that the instructions do not recommend the use of nicotinic acid for hair growth or for facial skin, this remedy is often used in beauty parlors.
The rejuvenating effect of the drug is based on the ability of nicotinic acid to expand blood vessels in the peripheral part of the circulatory system, increase the supply of oxygen in the tissues, enhance the outflow and the removal of aggressive slags and free radicals from the skin cells.
As a result, the skin is smoothed, becomes more hydrated and acquires a beautiful and even color.
Nicotinic acid is also used for hair growth. One course usually requires at least 30 ampoules with a solution.
After opening the ampoule, the solution is transferred by a syringe into a small container, after which it is distributed by fingers (or a syringe without a needle) over the entire scalp: first at the temples and along the hair growth line, then along the prothorals. Usually, one ml of solution is enough for one procedure (this corresponds to a volume of 1 ampoule content).
It is very important that the hair is clean, since dust and fat deposits will not allow the drug to absorb into the scalp. Before using the product, shampoos with silicones should not be used to wash the head, since they will create a barrier to penetration of the drug into the tissue.
Nicotinic acid breaks down rather quickly in the air, so the procedure should be performed as quickly as possible. Open ampoule is not subject to storage.
Normal reactions to the drug are a feeling of light burning, a sensation of crawling, a reddening and scalding of the skin.
The appearance of urticaria, rashes, itching, headaches indicate the intolerance of nicotinic acid. If these symptoms occur, you should wash your head and refrain from further use of the product.
If, after using nicotinic acid for hair, the scalp becomes dry or appears, it is recommended to dilute the solution in a 1: 1 ratio. Such reactions are a consequence of the sensitivity of the skin. Aloe vera juice can also be used as an alternative to water.
Once the solution has been completely applied, the procedure is considered complete. Repeat it daily for a month. To wash out a preparation it is not necessary.
After the completion of the course, almost all the girls mark a hair growth of 3 cm.
The injectable nicotinic acid solution has also been used as a remedy for cellulite. Before the procedure, the contents of one ampoule are diluted in 3 ml of water. Then in the resulting solution, a wide bandage is wetted and tightly - but not tight! - they wrap up problem zones.
Most effectively, this method allows you to get rid of cellulite on the hips and abdomen, because it is these parts of the body that it is most convenient to bandage. But to eliminate cellulite on the buttocks is recommended to use other means.
Bandages wrapped with food film and towel (for warming). Instead of a towel, you can use a blanket or a blanket.
The duration of the first procedure should not exceed 15 minutes. If the skin reacts well to the drug, and there are no adverse reactions, later the time can be increased.

Precautionary measures

It should be borne in mind that injections of nicotinic acid are painful.
During the treatment, it is necessary to constantly monitor liver function, especially if the patient is prescribed high doses of vitamin B3.
To prevent hepatotoxicity, it is recommended that a sufficient number of methionine-rich foods (milk, dairy products, buckwheat, legumes, fish) be prescribed in the patient's diet or prescribed lipotropic drugs (including methionine preparations).
Nicotinic acid, given its ability to irritate the mucosa, is used with caution in peptic ulcer disease (in remission) and hyperacid gastritis. If you need to prescribe the drug in these cases, taking large doses is contraindicated.
To reduce the irritant effect on the mucosa of the digestive tract, it is recommended to take the tablets with milk.
Because of the likelihood of hepatotoxicity, high doses of vitamin B3 are contraindicated in liver diseases (including hepatitis and cirrhosis) and diabetes mellitus.
The use of the drug for the correction of dyslipidemia in diabetes mellitus is inappropriate.

Nicotinic acid: compatibility with alcohol

The drug promotes the excretion of heavy metals and toxic substances from the body, so that it can be used both with the use of alcohol, and to eliminate the effects of poisoning them.

Nicotinic acid for weight loss

Nicotinic acid stimulates the course of metabolic processes, and it is this property that makes it appropriate to use the drug for weight loss.
The effect develops not by burning excess fat, but by balancing the concentration of cholesterol in the blood and detoxifying the body.
To achieve more pronounced results, taking tablets should be combined with reasonable physical exertion, a balanced diet and drinking enough water. To maximize the metabolism, tablets are best consumed immediately after a meal.
It should be remembered that people with high acidity of gastric juice should drink the drug recommended by warm milk or mineral water.

Nicotinic acid in pregnancy

During pregnancy and during breastfeeding, high doses of the drug are contraindicated.

Reviews about nicotinic acid

Reviews about nicotinic acid in tablets, as well as reviews about injections of nicotinic acid, in most cases, positive.
The drug has extensive indications for use and is effective in osteochondrosis of various parts of the spinal column, circulatory disorders in the brain and lower extremities, pellagra, decreased visual acuity, dyslipidemia, migraines, obesity, alcohol, occupational or drug intoxication, atherosclerosis and a number of other conditions.
Negative reviews are mainly due to the fact that after taking the pills or injecting the injection, the patient felt a feeling of heat and a strong reddening of the skin. Nevertheless, the instruction indicates that similar phenomena are a normal physiological reaction of the body.
Reviews about nicotinic acid for hair are also quite optimistic. It helps to strengthen the roots, improves the blood circulation of the scalp, perfectly moisturizes the hair, eliminates dandruff, speeds up hair growth and prevents them from falling out.
Cosmetologists recommend nicotinic acid for improving the complexion and skin condition, as well as for strengthening the nails. In addition, nicotinic acid is one of the most accessible and effective means of cellulite.
The metabolic action of the drug makes it possible to use it to accelerate the breakdown of fats in programs designed to reduce excess weight.
Despite the huge number of useful properties, nicotinic acid is a rather serious drug, thoughtless application of which can lead to negative consequences for the body.
The expediency of prescribing a drug in one form or another can be determined only by a doctor.