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Article
July 11, 1990

Rechallenge With Crystalline Niacin After Drug-Induced Hepatitis From Sustained-Release Niacin

Author Affiliations

From the Department of Medicine, the Division of General and Preventive Medicine (Dr Henkin), the Division of Gerontology and Geriatric Medicine (Dr Segrest), and the Atherosclerosis Research Unit (Drs Henkin and Segrest), University of Alabama at Birmingham; and the Department of Preventive Medicine, Johns Hopkins University, Baltimore, Md (Dr Johnson).

From the Department of Medicine, the Division of General and Preventive Medicine (Dr Henkin), the Division of Gerontology and Geriatric Medicine (Dr Segrest), and the Atherosclerosis Research Unit (Drs Henkin and Segrest), University of Alabama at Birmingham; and the Department of Preventive Medicine, Johns Hopkins University, Baltimore, Md (Dr Johnson).

JAMA. 1990;264(2):241-243. doi:10.1001/jama.1990.03450020093033
Abstract

Niacin (nicotinic acid) is available in several forms, including crystalline preparations and various types of sustained-release preparations. Evidence exists that sustained-release niacin, with respect to both dosage and severity, is more hepatotoxic than crystalline niacin. Three patients who developed hepatitis during treatment with sustained-release niacin were rechallenged with equivalent or higher doses of crystalline niacin, with no evidence of recurring hepatocellular damage. Although the mechanism for niacin-induced hepatitis is unknown, these cases support previous observations that crystalline niacin may be less hepatotoxic than sustained-release preparations in certain patients.

(JAMA. 1990;264:241-243)

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