Praktické lekárnictvo 1/2011

Niacin-laropiprant combination: novel approach not only to treatment of dyslipidemia Complex management of dyslipidemia provides a chance of further reduction of atherosclerotic vascular

Complex management of dyslipidemia provides a chance of further reduction of atherosclerotic vascular complications beyond current therapeutic options. A nicotinic acid (niacin) offers a substantial modification of triglyceride and HDL-cholesterol levels together with beneficial impact on LDL-cholesterol and Lp (a) concentrations. Interacting with GPR109A receptors on the surface of hepatocytes, adipocytes and other tissues, niacin induces numerous metabolic changes, thus, explaining its desirable as well as harmful effects. Niacin administration mostly in combination with a statin was associated with a significant slowing of progression or even regression of atherosclerosis in clinical trials. Major limitation of niacin widespread use- its side effects- can be partly overcome by thorough education of patients. Modern pharmacological forms of extended-release niacin, and particularly, its combination with a prostaglandin D2 receptor antagonist – laropiprant- can enhance its use in everyday practice.

Keywords: niacin, cardiovascular disease, dyslipidemia, HDL-c, Lp (a), laropiprant.