From the Research
Inositol nicotinate should not be used as a first-line treatment for individuals with very high triglyceride levels, and its use should be considered only under medical supervision, as prescription medications like fibrates, omega-3 fatty acids, or statins are usually more effective and have stronger evidence supporting their use. This compound, also known as niacin inositol hexanicotinate, is a form of vitamin B3 that may help reduce triglyceride levels by inhibiting the production of very low-density lipoproteins (VLDL) in the liver, which are precursors to triglycerides. According to the most recent study 1, the management of hypertriglyceridemia involves nonpharmacological interventions and initiation of statin therapy, with the addition of fibrates or omega-3 fatty acids in severe cases. Some key points to consider when managing hypertriglyceridemia include:
- Lifestyle modifications, such as weight loss, limiting alcohol, reducing sugar and refined carbohydrate intake, increasing physical activity, and consuming omega-3 rich foods, are essential components of any triglyceride-lowering strategy.
- Prescription medications like fibrates, omega-3 fatty acids, or statins are usually more effective and have stronger evidence supporting their use.
- Inositol nicotinate may interact with other medications and could affect liver function or blood glucose levels, requiring regular monitoring by a healthcare provider. As noted in the study 2, severely elevated triglyceride levels (500 mg per dL or higher) increase the risk of pancreatitis, and the use of fibrates, omega-3 fatty acids, or niacin should be considered to reduce this risk. However, the most recent study 1 suggests that icosapent ethyl is the only US Food and Drug Administration approved medication for CV risk reduction in patients with hypertriglyceridemia, and results from phase 3 trials for other pipeline pharmacotherapies are needed to guide future treatment considerations.