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Niacin (nicotinic acid) is a B vitamin used at pharmacological doses as an antihyperlipidemic agent to lower total cholesterol, LDL cholesterol, and triglycerides, and to increase HDL cholesterol. It is indicated for primary hyperlipidemia, mixed dyslipidemia, and as adjunctive therapy in severe hypertriglyceridemia. Niacin can also reduce the risk of recurrent nonfatal myocardial infarction in patients with a history of myocardial infarction and hyperlipidemia[6][8]. A common side effect of niacin therapy is cutaneous flushing due to prostaglandin-mediated vasodilation. Aspirin (acetylsalicylic acid), an antiplatelet agent that inhibits cyclooxygenase enzymes and thus prostaglandin synthesis, is often administered 30 minutes prior to niacin to reduce this flushing reaction[1][3][4][5]. The combination does not represent a fixed-dose pharmaceutical product but rather a clinical practice where both drugs are co-administered for improved tolerability of niacin.
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