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Niacin, also known as vitamin B3, is a prescription medication used to help reduce high levels of cholesterol and triglycerides, which are types of fats in the blood. It is often utilized alongside a healthy diet and exercise regimen, particularly when other non-drug treatments have not been effective. Niacin is not typically the first-choice treatment but may be prescribed for those with high cholesterol, high triglycerides, a history of heart attacks, or coronary artery disease to lower the risk of further heart issues and slow down plaque buildup in the arteries. This medication works by decreasing the release of fat from tissues and reducing cholesterol production in the liver. It also activates specific pathways that help remove triglycerides from the body, leading to lower "bad" (LDL) cholesterol and triglyceride levels while increasing "good" (HDL) cholesterol levels. By doing so, niacin can help prevent heart attacks, strokes, and reduce the risk of pancreatitis in individuals with severely high triglycerides. Niacin is available in an extended-release form (Niacin ER), which is taken once daily, and a regular form (Niacor), taken three times daily. Some common side effects may include flushing and stomach upset. It is important to consult with a healthcare professional before starting niacin to ensure it is safe and appropriate for you, particularly if combining it with other medications. Additionally, adopting lifestyle changes such as quitting smoking, losing weight if necessary, and maintaining a low-fat diet can enhance the effectiveness of this treatment.