Antihyperlipidemics are medications used to treat clients with dyslipidemia, which refers to increased blood levels of lipids, such as cholesterol and triglycerides. In addition, they’re indicated to decrease the risk of cardiovascular events. Antihyperlipidemics include different classes of medications, including niacin, also known as vitamin B3 or nicotinic acid; PCSK9 inhibitors, like alirocumab and evolocumab; and omega-3 fatty acids, like icosapent and fish oil.
Let’s start with niacin, which is taken orally. Once administered, it works by inhibiting the enzyme lipoprotein lipase in adipose tissue, which decreases the release of free fatty acids into the bloodstream. As a result, there’s less fatty acids available for the liver to produce triglycerides. For that reason, niacin is primarily used to treat hypertriglyceridemia. LO1-LO3
Now, a common side effect is “niacin flush,” which leads to a red, flushed face, and pruritus. Clients may also experience headaches, dizziness, insomnia, and paresthesia or a sensation of pins and needles, as well as gastrointestinal side effects, including abdominal pain, nausea, vomiting, diarrhea, or flatulence. Other side effects include hyperglycemia, hyperuricemia, and hepatitis with increased blood transaminases.