Niacin and cholesterol control: when d4T/stavudine (Zerit) and protease inhibitors worsen cholesterol problems in people with HIV

This note appeared in the Winter 2007 issue of the NYBC newsletter The Supplement, so we’re citing it to add to our ongoing discussion  of dietary supplement strategies for cholesterol control.

Vitamin B3 aka Niacin has long been recognized as effective in managing high cholesterol (high LDL level), and has the added advantage of improving levels of HDL (“good cholesterol”), which is often low in HIV infection (treated or not). The problem: high-dose Niacin can cause unpleasant “flushing and itching.” One approach is to increase the dose slowly to about 1.5 to 3 grams a day over a period of a couple of weeks. This is an alternative that people on antivirals may wish to try, working with their physicians, in order to manage cholesterol problems that can be worsened by certain antivirals – notably d4T/stavudine (Zerit) – and protease inhibitors.

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