The Journal of Emergency Medicine
Volume 41, Issue 3 , Pages e65-e68 , September 2011

Niacin Toxicity Resulting from Urine Drug Test Evasion

  • Anne M. Daul, MD

      Affiliations

    • Department of Emergency Medicine, Carolinas Medical Center, Charlotte, North Carolina
    • Corresponding Author InformationCorresponding Address: Anne M. Daul, md, Department of Emergency Medicine, Carolinas Medical Center, 1000 Blythe Blvd., 3rd Floor MEB, Charlotte, NC 28203
    • ,
  • Michael C. Beuhler, MD

      Affiliations

    • Carolinas Poison Center, Charlotte, North Carolina
    • Department of Emergency Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina

Received 4 October 2009 ,Accepted 15 November 2009.

References 

  1. Carlson LA. Nicotinic acid: the broad-spectrum lipid drug (A 50th anniversary review). J Intern Med. 2005;258:94–114
  2. Mittal MK, Florin T, Perrone J, et al. Toxicity from the use of niacin to beat urine drug screening. Ann Emerg Med. 2007;50:587–590
  3. Guyton JR, Bays HE. Safety considerations with niacin therapy. Am J Cardiol. 2007;99:22C–31C
  4. Fischer DJ, Knight LL, Vestal RE. Fulminant hepatic failure following low-dose sustained-release niacin therapy in hospital. West J Med. 1991;155:410–412
  5. Mullin GE, Greenson JK, Mitchell MC. Fulminant hepatic failure after ingestion of sustained-release nicotinic acid. Ann Intern Med. 1989;111:253–254
  6. Etchason JA, Miller TD, Squires RW, et al. Niacin-induced hepatitis: a potential side effect with low-dose time-release niacin. Mayo Clin Proc. 1991;66:23–28
  7. Gharavi AG, Diamond JA, Smith DA, et al. Niacin-induced myopathy. Am J Cardiol. 1994;74:841–842
  8. Jonas M, Graeme-Cook F. Case records of the Massachusetts General Hospital (Weekly clinicopathological exercises. Case 6-2001. A 17-year-old girl with marked jaundice and weight loss). N Engl J Med. 2001;344:591–599
  9. Henry JA, Jeffreys KF, Dawling S. Toxicity and deaths from 3,4-methylenedioxymethamphetamine (“ecstasy”). Lancet. 1992;340:384–387
  10. Fidler H, Dhillon A, Gertner D, Burroughs A. Chronic ecstasy (3,4-methylenedioxymethamphetamine) abuse: a recurrent and unpredictable cause of severe acute hepatitis. J Hepatol. 1996;25:563–566
  11. Brauer RB, Heidecke CD, Beckurtset KTE, et al. Liver transplantation for the treatment of fulminant hepatic failure induced by the ingestion of ecstasy. Transpl Intern. 1997;10:229–233
  12. Beitia G, Cobreros A, Sainz L, et al. Ecstasy-induced toxicity in rat liver. Liver. 2000;20:8–15
  13. O'Brien MB, Silverberg JD, Nguyen TT. Nicotinic acid-induced toxicity associated with cytopenia and decreased levels of thyroxine-binding globulin. Mayo Clin Proc. 1992;67:465–468
  14. Taylor FB, Toh CH, Hoots WK, Wada H, Levi H Scientific Subcommittee on Disseminated Intravascular Coagulation (DIC) of the International Society on Thrombosis and Haemostasis (ISTH). Towards definition, clinical and laboratory criteria, and a scoring system for disseminated intravascular coagulation. Thromb Haemost. 2001;86:1327–1330
  15. Lin TH, Voon WC, Yen HW, et al. Randomized comparative study of the effects of treatment with once-daily, niacin extended-release/lovastatin and with simvastatin on lipid profile and fibrinolytic parameters in Taiwan. Kaohsiung J Med Sci. 2006;22:257–265
  16. Higashi-Okai K, Nagino H, Yamada K, Okai Y. Antioxidant and prooxidant activities of B group vitamins in lipid peroxidation. J UOEH. 2006;28:359–368
  17. Schirren CA, Berghaus TM, Sackmann M. Thrombotic thrombocytopenic purpura after Ecstasy-induced acute liver failure. Ann Intern Med. 1999;130:163

 No reprints are available from the author.

PII: S0736-4679(09)00955-X

doi: 10.1016/j.jemermed.2009.11.029

The Journal of Emergency Medicine
Volume 41, Issue 3 , Pages e65-e68 , September 2011

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