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Effects of Aspirin When Added to the Prostaglandin D 2 Receptor Antagonist Laropiprant on Niacin‐Induced Flushing Symptoms
Author(s) -
Dishy Victor,
Liu Fang,
Ebel David L.,
Atiee George J.,
Royalty Jane,
Reilley Sandra,
Paolini John F.,
Wagner John A.,
Lai Eseng
Publication year - 2009
Publication title -
the journal of clinical pharmacology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.92
H-Index - 116
eISSN - 1552-4604
pISSN - 0091-2700
DOI - 10.1177/0091270009332246
Subject(s) - niacin , medicine , placebo , aspirin , pharmacology , tolerability , crossover study , b vitamins , adverse effect , antagonist , gastroenterology , anesthesia , receptor , alternative medicine , pathology
Niacin is an effective lipid‐modifying therapy whose use has been limited by suboptimal tolerability. The adverse effect of flushing is due to prostaglandin D 2 (PGD 2 )–mediated cutaneous vasodilation. Adjunctive treatment with the PGD 2 receptor antagonist laropiprant significantly reduces the incidence and severity of niacin‐induced flushing. The objective of this study was to assess the effect of aspirin pretreatment on flushing symptoms with extended‐release (ER) niacin/laropiprant in healthy volunteers. A randomized, double‐blind, placebo‐controlled crossover study compared patient‐rated flushing following pretreatment with aspirin 325 mg versus placebo administered 30 minutes before ER niacin 2 g/laropiprant 40 mg. Flushing responses were assessed using participant‐reported overall symptom severity score (OSSS), including individual characteristics of redness, warmth, tingling, or itching. The overall incidence and severity of flushing were comparable for participants receiving aspirin or placebo before ER niacin 2 g/laropiprant 40 mg. The difference in 3‐day average OSSS between treatments was 0.2 (P = .180). Profiles of flushing severity, frequency, and bothersomeness were comparable for the aspirin/ER niacin/laropiprant and ER niacin/laropiprant regimens. All treatments were safe and well tolerated. Coadministration of aspirin 325 mg daily with ER niacin 2 g/laropiprant 40 mg does not further reduce residual flushing symptoms associated with ER niacin 2 g/laropiprant 40 mg alone.