Take this medication by mouth with a low-fat snack as directed by your doctor, usually once daily at bedtime. Taking this drug with food will increase its absorption and help reduce side effects (such as flushing, stomach upset).
Do not crush or chew extended-release tablets. Doing so can release all of the drug at once, increasing the risk of side effects. Also, do not split the tablets unless they have a score line and your doctor or pharmacist tells you to do so. Swallow the whole or split tablet without crushing or chewing.
To lessen the chance of flushing, avoid alcohol, hot beverages, and spicy foods near the time you take this medication. Taking a plain aspirin (non-enteric coated, 325 milligrams) or a nonsteroidal anti-inflammatory drug (such as ibuprofen, 200 milligrams) 30 minutes before taking this medication may help prevent flushing. Ask your doctor if this treatment is right for you (especially if you are also taking a "blood thinner" such as warfarin).
The niacin in this product is an extended-release form. Your doctor may instruct you to take the individual extended-release niacin first until you reach the right dose and then switch you over to this combination product. Niacin is also available in other formulations (such as immediate- and sustained-release). Do not switch other strengths, brands, or forms of niacin with this product because doing so may cause severe liver problems.
The dosage is based on your medical condition, response to treatment, and other medications you may be taking. Be sure to tell your doctor and pharmacist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).
Avoid eating grapefruit or drinking grapefruit juice while using this medication unless your doctor instructs you otherwise. Grapefruit can increase the amount of this medication in your bloodstream. Consult your doctor or pharmacist for more details.
If you also take certain other drugs to lower your cholesterol (bile acid-binding resins such as cholestyramine or colestipol), take this product at least 1 hour before or at least 4 hours after taking these medications. These products can react with this medication, preventing its full absorption.
Take this medication regularly in order to get the most benefit from it. Remember to take it at the same time each day. If you have not taken this medication for an extended period (more than 7 days), consult your doctor or pharmacist for instructions on restarting it. You may need to restart your medication at a lower dose and slowly increase the dose over several weeks.
It is important to continue taking this medication even if you feel well. Most people with high cholesterol or triglycerides do not feel sick. It may take up to 4 weeks before you get the full benefit of this drug.