Endur-acin is used to lower blood levels of "bad" cholesterol (low-density lipoprotein, or LDL) and triglycerides, and increase levels of "good" cholesterol (high-density lipoprotein, or HDL).

Niaspan is used to lower the risk of a heart attack in people who have high cholesterol and who have a history of heart attacks. Niaspan can also be used with another cholesterol medicine to slow down the build-up of fatty deposits in your arteries.

Endur-acin may also be used for purposes not listed in this medication guide.

You should not take Endur-acin if you have severe liver disease, a stomach ulcer, or active bleeding.

Follow all directions on your prescription label and read all medication guides or instruction sheets. Use the medicine exactly as directed.

Endur-acin can cause flushing (warmth, itching, redness, or tingly feeling under your skin). These effects should disappear over time as you keep taking the medicine. Flushing may be worse if you drink alcohol or hot beverages shortly after taking this medicine.

Swallow the capsule or tablet whole and do not crush, chew, break, or open it.

Your dose needs may change if you switch to a different brand, strength, or form of this medicine. Avoid medication errors by using only the form and strength your doctor prescribes.

If you stop taking Endur-acin for any length of time, talk with your doctor before starting the medication again. You may need to restart the medication at a lower dose.

This medicine can affect the results of certain medical tests. Tell any doctor who treats you that you are using Endur-acin.

Endur-acin is only part of a complete treatment program that may also include diet, exercise, and weight control. Follow your diet, medication, and exercise routines very closely.

Your doctor may recommend you take aspirin or an NSAID (such as ibuprofen, Advil, or Aleve) to help prevent flushing. Keep using these medicines for as long as your doctor has prescribed.

Store at room temperature away from moisture and heat.

You should not take Endur-acin if you are allergic to it, or if you have:

• severe liver disease;

• a stomach ulcer; or

• active bleeding.

Tell your doctor if you have ever had:

• liver disease;

• kidney problems;

• heart disease, chest pain (angina);

• gout; or

• diabetes.

It is not known whether Endur-acin will harm an unborn baby. You may not be able to use Endur-acin during pregnancy. Tell your doctor right away if you become pregnant.

Do not breastfeed.

Do not give this medicine to a child without medical advice.

Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Avoid drinking alcohol. It may increase your risk of liver damage, and can also worsen the flushing effects of niacin.

Avoid getting up too fast from a sitting or lying position, or you may feel dizzy.

Avoid eating foods high in fat or cholesterol, or Endur-acin will not be as effective.

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Endur-acin may cause serious side effects. Call your doctor at once if you have:

• heart attack symptoms--chest pain or pressure, pain spreading to your jaw or shoulder, nausea, sweating;

• high blood sugar--increased thirst, increased urination, dry mouth, fruity breath odor;

• unexplained muscle pain, tenderness or weakness;

• a light-headed feeling, like you might pass out;

• irregular heartbeats;

• severe warmth or redness under your skin;

• vision problems; or

• jaundice (yellowing of the skin or eyes).

Common side effects of Endur-acin may include:

• flushing (sudden warmth, redness, or tingly feeling);

• upset stomach, nausea, vomiting, diarrhea;

• abnormal liver function tests;

• itching, rash, dry skin;

• cough;

• skin discoloration; or

• headache.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

You should not take colesevelam, colestipol, or cholestyramine within 4 hours before or 4 hours after taking Endur-acin.

Tell your doctor about all your other medicines, especially:

• other medicines to lower cholesterol or triglycerides;

• aspirin;

• blood pressure medicine; or

• a blood thinner--warfarin, Coumadin, Jantoven.

This list is not complete. Other drugs may affect Endur-acin, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.