Nicotinate d'inositol

Related Terms

Hexanicit?, hexanicotinoyl inositol, Hexopal?, inositol hexaniacinate, inositol hexanicotinate, inositol niacinate, m-inositol nicotinate, meso-inositol, meso-inositol hexanicotinate, niacin, niacinamide, nicotinamide, nicotinic acid, no-flush niacin, vitamin B3.
Note: Inositol nicotinate consists of six nicotinic acid (niacin) molecules linked with an inositol molecule. When taken by mouth, inositol nicotinate is broken down into nicotinic acid (niacin) and inositol. Therefore, although inositol nicotinate may produce similar effects and adverse effects as niacin, only those effects and adverse effects specific to inositol nicotinate are included in this monograph.

Background

Inositol nicotinate, also known as inositol hexaniacinate, consists of six nicotinic acid (niacin) molecules crossed-linked with an inositol molecule. Inositol nicotinate is a form of niacin (vitamin B3) which may decrease flushing, compared to niacin. Inositol nicotinate has been in use in Europe for over 30 years as a no-flush form of niacin.
Good scientific evidence supports the use of inositol nicotinate for peripheral artery disease. Inositol nicotinate has also been studied as a treatment for cerebral ischemia (lack of adequate blood flow to the brain), high cholesterol, high blood pressure, Raynaud's disease, and necrobiosis lipoidica (a skin condition associated with diabetes).

Evidence Table

These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider. GRADE *
These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider. GRADE *


Inositol nicotinate may have beneficial effects in patients with peripheral artery disease. More studies are needed to make any conclusions in this area.

 B


Inositol nicotinate may have beneficial effects in patients with peripheral artery disease. More studies are needed to make any conclusions in this area.

 B


Limited research suggests that inositol nicotinate may have beneficial effects in patients with cerebral ischemia. More studies are needed to make any conclusions in this area.

 C


Limited research suggests that inositol nicotinate may have beneficial effects in patients with cerebral ischemia. More studies are needed to make any conclusions in this area.

 C


Limited research suggests that inositol nicotinate may have beneficial effects in patients with high cholesterol. Additional research is needed before a conclusion can be made.

 C


Limited research suggests that inositol nicotinate may have beneficial effects in patients with high cholesterol. Additional research is needed before a conclusion can be made.

 C


Studies examining the effects of inositol nicotinate alone on high blood pressure are currently lacking. Further research on inositol nicotinate alone for this use is needed.

 C


Studies examining the effects of inositol nicotinate alone on high blood pressure are currently lacking. Further research on inositol nicotinate alone for this use is needed.

 C


Limited research suggests that inositol nicotinate may have beneficial effects in patients with Raynaud's disease. Additional research is needed in this area.

 C


Limited research suggests that inositol nicotinate may have beneficial effects in patients with Raynaud's disease. Additional research is needed in this area.

 C


Necrobiosis lipoidica is an inflammatory disorder associated with diabetes mellitus. The cause is unknown and there is a lack of traditional therapies. Additional research is needed to determine if inositol nicotinate may be effective in the treatment of this condition.

 C


Necrobiosis lipoidica is an inflammatory disorder associated with diabetes mellitus. The cause is unknown and there is a lack of traditional therapies. Additional research is needed to determine if inositol nicotinate may be effective in the treatment of this condition.

 C
* Key to grades

A: Strong scientific evidence for this use
B: Good scientific evidence for this use
C: Unclear scientific evidence for this use
D: Fair scientific evidence for this use (it may not work)
F: Strong scientific evidence against this use (it likley does not work)
* Key to grades

A: Strong scientific evidence for this use
B: Good scientific evidence for this use
C: Unclear scientific evidence for this use
D: Fair scientific evidence for this use (it may not work)
F: Strong scientific evidence against this use (it likley does not work)

Tradition / Theory

The below uses are based on tradition, scientific theories, or limited research. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider. There may be other proposed uses that are not listed below.

Dosing

Adults (18 years and older)
For high cholesterol, 600-800 milligrams of inositol nicotinate has been taken by mouth daily.
For peripheral artery disease, 2 grams of inositol nicotinate (Hexopal?) has been taken by mouth twice daily for three months. One gram of inositol nicotinate (Hexopal?) has been taken by mouth four times daily for three months.

Safety

The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.

Interactions

Interactions with Drugs
Inositol nicotinate may increase the risk of bleeding when taken with drugs that increase the risk of bleeding. Some examples include aspirin, anticoagulants ("blood thinners") such as warfarin (Coumadin?) or heparin, antiplatelet drugs such as clopidogrel (Plavix?), and nonsteroidal anti-inflammatory drugs such as ibuprofen (Motrin?, Advil?) or naproxen (Naprosyn?, Aleve?).
Inositol nicotinate may increase blood sugar levels. Caution is advised when using medications that may also affect blood sugar. Patients taking insulin or drugs for diabetes by mouth should be monitored closely by a qualified healthcare professional, including a pharmacist. Medication adjustments may be necessary.
Inositol nicotinate may cause changes in blood pressure. Caution is advised in patients taking drugs that affect blood pressure, including agents that widen blood vessels.
Inositol nicotinate may also interact with alcohol, carbamazepine, cardiovascular agents, lipid or cholesterol lowering agents, or nicotine.

Attribution

This information is based on a systematic review of scientific literature edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com).

Bibliography

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Cucinotta D, Silvestrini C, Mancini, M, et al. [Experience with the medical treatment of chronic cerebrovascular insufficiency: bamethan and inositol nicotinate versus placebo]. G Clin Med 1981;62(5):339-350.
Dorner V, Fischer FW. The influence of m-inositol hexanicotinate ester on the serum lipids and lipoproteins. Arzneim-Frosch 1961;11:110-113.
Head A. Treatment of intermittent claudication with inositol nicotinate. Practitioner 1986;230(1411):49-54.
Hentzer E. [Treatment of peripheral arterial insufficiency with inositol nicotinate (Hexanicit)]. Nord Med 1966;76(38):1090-1093.
Holti G. An experimentally controlled evaluation of the effect of inositol nicotinate upon the digital blood flow in patients with Raynaud's phenomenon. J Int Med Res 1979;7(6):473-483.
Hutt V, Wechsler JG, Klor HU, et al. [Effect of a clofibrate-inositol nicotinate combination on lipids and lipoproteins in primary hyperlipoproteinemia of types IIa, IV and V]. Arzneimittelforschung 1983;33(5):776-779.
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Kramer KD, Ghabussi P, Hochrein H. [Antihypertensive combination-therapy with inositol nicotinate in essential hypertension]. Med Welt 1977;28(27):1198-1201.
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Momsen AH, Jensen MB, Norager CB, et al. Drug therapy for improving walking distance in intermittent claudication: a systematic review and meta-analysis of robust randomised controlled studies. Eur J Vasc Endovasc Surg 2009;38(4):463-74.
O'Hara J, Jolly PN, Nicol CG. The therapeutic efficacy of inositol nicotinate (Hexopal) in intermittent claudication: a controlled trial. Br J Clin Pract 1988;42(9):377-383.
Rhodes EL. Fibrinolytic agents in the treatment of necrobiosis lipoidica. Br J Dermatol 1976;95:673-674.
Schwartzkopff W, Zschiedrich M. [Combination or monotherapy of hyperlipoproteinemia typus IIb, IV, V with clofibrate and m-inositolnicotinate or clofibrinic acid (author's transl)]. Med Klin 1978;73(7):231-239.
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