Which hyperlipidemia medication is most likely to cause flushing?

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Multiple Choice

Which hyperlipidemia medication is most likely to cause flushing?

Flushing is a classic side effect of niacin. Niacin lowers triglycerides by inhibiting hepatic VLDL synthesis and raises HDL, with some LDL reduction as well. The flush comes from prostaglandin-mediated vasodilation in the skin, producing warmth, red blotching, and itching shortly after taking the drug. It’s more pronounced with immediate‑release forms and often diminishes with pretreatment using aspirin or by switching to an extended‑release formulation taken with food. The other lipid meds don’t typically produce this flushing pattern. Ezetimibe reduces intestinal cholesterol absorption and does not commonly cause flushing. Statins like simvastatin and rosuvastatin have risks such as myopathy or hepatotoxicity rather than a characteristic flushing reaction.

Flushing is a classic side effect of niacin. Niacin lowers triglycerides by inhibiting hepatic VLDL synthesis and raises HDL, with some LDL reduction as well. The flush comes from prostaglandin-mediated vasodilation in the skin, producing warmth, red blotching, and itching shortly after taking the drug. It’s more pronounced with immediate‑release forms and often diminishes with pretreatment using aspirin or by switching to an extended‑release formulation taken with food.

The other lipid meds don’t typically produce this flushing pattern. Ezetimibe reduces intestinal cholesterol absorption and does not commonly cause flushing. Statins like simvastatin and rosuvastatin have risks such as myopathy or hepatotoxicity rather than a characteristic flushing reaction.

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