Inositol Nicotinate Research Articles

Mechanically induced solvent-free esterification method at room temperature.

Herein, we describe two novel strategies for the synthesis of esters, as achieved under high-speed ball-milling (HSBM) conditions at room temperature. In the presence of I2 and KH2PO2, the reactions afford the desired esterification derivatives in 45% to 91% yields within 20 min of grinding. Meanwhile, using KI and P(OEt)3, esterification products can be obtained in 24% to 85% yields after 60 min of grinding. In addition, the I2/KH2PO2 protocol was successfully extended to the late-stage diversification of natural products showing the robustness of this useful approach. Further application of this method in the synthesis of inositol nicotinate was also discussed.

PCV30 Cost-Effectiveness of Cilostazol, Naftidrofuryl Oxalate, Pentoxifylline and Inositol Nicotinate for the Treatment of Intermittent Claudication in People with Peripheral Arterial Disease in the Uk

PCV30 Cost-Effectiveness of Cilostazol, Naftidrofuryl Oxalate, Pentoxifylline and Inositol Nicotinate for the Treatment of Intermittent Claudication in People with Peripheral Arterial Disease in the Uk

A systematic review and economic evaluation of cilostazol, naftidrofuryl oxalate, pentoxifylline and inositol nicotinate for the treatment of intermittent claudication in people with peripheral arterial disease

A systematic review and economic evaluation of cilostazol, naftidrofuryl oxalate, pentoxifylline and inositol nicotinate for the treatment of intermittent claudication in people with peripheral arterial disease

A systematic review of xuezhikang, an extract from red yeast rice, for coronary heart disease complicated by dyslipidemia.

Objective. This systematic review aims to evaluate the benefit and side effect of Xuezhikang for coronary heart disease (CHD) complicated by dyslipidemia. Methods. All randomized clinical trials (RCTs) with Xuezhikang as a treatment for CHD combined with dyslipidemia were considered for inclusion. Data extraction and analyses and quality assessment were conducted according to the Cochrane standards. Results. We included 22 randomized trials. Xuezhikang showed significant benefit on the incidence of all-cause deaths, CHD deaths, myocardial infarction, and revascularization as compared with placebo based on conventional treatment for CHD. It remarkably lowered total cholesterol (TC), triglyceride (TG), and low-density lipoprotein-cholesterol (LDL-C) as compared with the placebo or inositol nicotinate group, which was similar to statins group. Xuezhikang also raised high-density lipoprotein cholesterol (HDL-C) compared to placebo or no intervention, which was similar to Inositol nicotinate and slightly inferior to statins. The incidence of adverse events did not differ between the Xuezhikang and control group. Conclusions. Xuezhikang showed a comprehensive lipid-regulating effect and was safe and effective in reducing cardiovascular events in CHD patients complicated by dyslipidemia. However, more rigorous trials with high quality are needed to give high level of evidence.

A systematic review and economic evaluation of cilostazol, naftidrofuryl oxalate, pentoxifylline and inositol nicotinate for the treatment of intermittent claudication in people with peripheral arterial disease.

Peripheral arterial disease (PAD) is a condition in which there is blockage or narrowing of the arteries that carry blood to the legs and arms. It is estimated to affect around 4.5% of people aged between 55 and 74 years within the UK. The most common symptom of PAD is intermittent claudication (IC), characterised by pain in the legs on walking that is relieved with rest. To assess the effectiveness and cost-effectiveness of cilostazol, naftidrofuryl oxalate, pentoxifylline and inositol nicotinate, compared with no vasoactive drugs, for IC due to PAD in adults whose symptoms continue despite a period of conventional management. Electronic bibliographic databases were searched during April to June 2010 (MEDLINE, MEDLINE In-Process & Other Non-Indexed Citations, EMBASE, The Cochrane Library databases, Cumulative Index to Nursing and Allied Health Literature, Web of Science, Conference Proceedings Citation Index, BIOSIS Previews). Effectiveness outcomes sought were maximal walking distance (MWD), pain-free walking distance (PFWD), ankle-brachial pressure index, cardiovascular events, mortality, adverse events (AEs) and health-related quality of life (HRQoL). A narrative synthesis was provided for all outcomes and a network meta-analysis was undertaken for the walking distance outcomes. A Markov model was developed to assess the relative cost-effectiveness of the interventions from a NHS perspective over a lifetime. The model has three states: vasoactive drug treatment, no vasoactive drug treatment and death. Each 1-week cycle, patients may continue with the drug, discontinue the drug or die. Regression analysis was undertaken to model the relationship between MWD and utility so that a cost per quality-adjusted life-year (QALY) outcome measure could be presented. Univariate and probabilistic sensitivity analyses were undertaken. All costs and outcomes were discounted at 3.5%. Twenty-six randomised controlled trials were identified that met the inclusion criteria for the clinical effectiveness review. There was evidence that walking distance outcomes were significantly improved by both cilostazol and naftidrofuryl oxalate; the 95% credible intervals for the difference from placebo in the logarithm mean change MWD from baseline were 0.108 to 0.337 and 0.181 to 0.762, respectively. It was not possible to include inositol nicotinate within the meta-analysis of MWD and PFWD owing to the lack of 24-month data; however, the shorter-term data did not suggest a significant effect. AEs were minor for all drugs and included headaches and gastrointestinal difficulties. The incidence of serious adverse events (SAEs), including cardiovascular events and mortality, was not increased by the vasoactive drugs compared with placebo; however, most studies had a relatively short follow-up time to address this outcome. HRQoL data were limited. Two studies of limited quality were identified within the review of cost-effectiveness. The de novo model developed suggests that naftidrofuryl oxalate dominates cilostazol and pentoxifylline and has a cost per QALY gained of around £6070 compared with no vasoactive drug. This result is reasonably robust to changes within the key model assumptions. Inositol nicotinate was not included within the main analysis owing to lack of data. However, it is unlikely to be considered to be cost-effective due to its high acquisition cost (£900 vs £100-500 per year for the other drugs). Naftidrofuryl oxalate and cilostazol both appear to be effective treatments for this patient population, with minimal SAEs. However, naftidrofuryl oxalate is the only treatment that is likely to be considered cost-effective. The long-term effectiveness is uncertain and hence a trial comparing cilostazol, naftidrofuryl oxalate and placebo beyond 24 weeks would be beneficial. Outcomes associated with naftidrofuryl oxalate could also be compared with those associated with supervised exercise programmes and angioplasty.

Chinese herbal medicines for hypercholesterolemia

Hypercholesterolemia is an important key contributory factor for ischemic heart disease and is associated with age, high blood pressure, a family history of hypercholesterolemia, and diabetes. Chinese herbal medicines have been used for a long time as lipid-lowering agents. To assess the effects of Chinese herbal medicines on hypercholesterolemia. We searched the following databases: The Cochrane Library (issue 8, 2010), MEDLINE (until July 2010), EMBASE (until July 2010 ), Chinese BioMedical Database (until July 2010), Traditional Chinese Medical Literature Analysis and Retrieval System (until July 2010), China National Knowledge Infrastructure (until July 2010), Chinese VIP Information (until July 2010), Chinese Academic Conference Papers Database and Chinese Dissertation Database (until July 2010), and Allied and Complementary Medicine Database (until July 2010). We considered randomized controlled clinical trials in hypercholesterolemic participants comparing Chinese herbal medicines with placebo, no treatment, and pharmacological or non-pharmacological interventions. Two review authors independently extracted data and assessed the risk of bias. We resolved any disagreements with this assessment through discussion and a decision was achieved based by consensus. We assessed trials for the risk of bias against key criteria: random sequence generation, allocation concealment, blinding of participants, incomplete outcome data, selective outcome reporting and other sources of bias. We included 22 randomized trials (2130 participants). The mean treatment duration was 2.3 ± 1.3 months (ranging from one to six months). Twenty trials were conducted in China and 18 trials were published in Chinese. Overall, the risk of bias of included trials was high or unclear. Five different herbal medicines were evaluated in the included trials, which compared herbs with conventional medicine in six comparisons (20 trials), or placebo (two trials). There were no outcome data in any of the trials on cardiovascular events and death from any cause. One trial each reported well-being (no significant differences) and economic costs. No serious adverse events were observed. Xuezhikang was the most commonly used herbal formula investigated. A significant effect on total cholesterol (two trial, 254 participants) was shown in favor of Xuezhikang when compared with inositol nicotinate (mean difference (MD) -0.90 mmol/L, 95% confidence interval (CI) -1.13 to -0.68) . Some herbal medicines may have cholesterol-lowering effects. Our findings have to be interpreted with caution due to high or unclear risk of bias of the included trials.

High doses of bifendate elevate serum and hepatic triglyceride levels in rabbits and mice: animal models of acute hypertriglyceridemia1

To investigate the effects of bifendate on serum and hepatic lipids level in rabbits and mice. Animals were administered bifendate [powdered pill suspended in 0.5% sodium carboxymethylcellulose (CMC)] at increasing doses (0.25-1 g/kg, ig). Blood lipid and apolipoprotein levels were measured using commercially available assay kits. The treatment of rabbits with a single dose of bifendate (0.3 g/kg) caused a time-dependent and biphasic change in serum triglyceride (TG) levels, with the value reaching a maximum (3-fold increase compared to the baseline value) between 24 and 36 h post-dosing. When mice were orally treated with bifendate (0.25-1 g/kg), serum TG levels increased by 39%-76% and 14%-39% at 24 and 48 h post-dosing, respectively. When given at daily doses of 0.25 and 1 g/kg for 4 d, bifendate increased serum TG levels (56%-79%), with concomitant elevations in apolipoprotein A-I and apolipoprotein B levels at 24 h after the last dosing. TG levels were also increased (11%-43%) in liver samples of mice receiving single or multiple doses of bifendate. However, bifendate treatment caused slight reductions in serum and hepatic total cholesterol levels (9%-13%). The hypertriglyceridemia induced by bifendate was ameliorated by fenofibrate but not inositol nicotinate treatment in mice. The findings suggest that bifendate treatment at high oral doses can cause an acute elevation in serum and hepatic TG levels.

Raynaud's Phenomenon and the Possible Use of Foods

ABSTRACT: In this article we focus on the possible use of foods to alleviate Raynaud’s phenomenon (RP). RP isevoked, pr edominately, by cold and r esults in a potent v ascular constr iction of the micr ovascular blood v essels inthe hands , thus leading to r educed hand blood flo w and the elev ation of pain sensation. To alleviate RP b y diet, foodcomponents need to be able to pr omote hand skin blood flo w, which may be achiev ed using fish oil, garlic, ginkgobiloba, L-carnitine, or inositol nicotinate, or to increase hand skin temperature, using evening primrose oil, ginkgobiloba, or inositol nicotinate. Although there are a number of studies documenting such improvements with theseingredients, they often are poorly designed. Hence, there is a need for more controlled studies to substantiate theiruse, but also to test alternative foods or target new ones. Therefore, we also discuss some alternate food options andbriefly outline clinical dr ugs for the tr eatment of RP , as their mechanisms of action may also be possible tar gets forfood. It is the intention of this article to address the research needs of this field and to provide a better understandingof alternative options for those with RP.Keywords: Raynaud’s, vascular constriction, dietary intervention, nutraceutical, functional foods

Pharmacotherapy of Raynaud's phenomenon.

Primary Raynaud's phenomenon is common, particularly in younger women, and may be familial. Vasospasm is not confined to the digits and may involve, for example, the tongue and nose, and also visceral organs like the heart, oesophagus or lung and cerebral circulation. Symptoms tend to be milder in primary compared with secondary Raynaud's phenomenon, which is associated with other disorders such as the connective tissue diseases. Indeed, the severity of symptoms often acts as the predictor for the much later onset of the associated systemic disease. Occupational Raynaud's phenomenon is related to the use of vibrating instruments, and a significant proportion of patients may be cured by an early change in job. In those over 60 years of age, Raynaud's phenomenon is commonly a result of atherosclerotic obstructive arterial disease, and screening for and treatment of the risk factors is appropriate. The best-studied mechanisms in Raynaud's phenomenon involve the blood and vascular endothelium. Microcirculatory flow may be impeded by activated platelet clumps, rigid red and white blood cells and damaged endothelium. These platelet clumps, white blood cells and damaged endothelium also release vasoactive/vasoconstrictive compounds which may additionally trigger the clotting cascade and thrombosis. Initial management for mild disease should focus on support and advice regarding avoidance of known precipitating factors, including vasospastic drugs. Cold protection with warming agents, 'Abel' shoes and also electrically heated gloves and socks is effective, but may be too cumbersome and inconvenient for some patients. Simple vasodilators like naftidrofuryl, inositol nicotinate and possibly pentoxifylline (oxpentifylline) are useful in mild disease, with adverse effects like headache and flushing being less problematic. The 'gold standard' of Raynaud's phenomenon treatment is nifedipine, a calcium channel antagonist/blocker. Full dosage, however, can be limited by ankle swelling, headache and flushing, but adverse effects may be reduced by using the 'retard' or long-acting preparations. Adverse effects are also reduced with the newer calcium channel antagonists like diltiazem but at the expense of efficacy. Useful, enhanced benefit is also achieved by combination therapy with vasodilators. Newer treatments include the prostaglandin analogues which are effective but disadvantaged by their parenteral route of administration, and lack of licence in some countries. Oral preparations are, however, being studied and are in the pipeline. Essential fatty acid supplementation is mildly effective, while ketanserin and calcitonin gene-related peptide both look promising. Lumbar sympathectomy retains its important role in the treatment of Raynaud's phenomenon involving the lower limbs. Satisfactory symptomatic relief is now possible for many patients with Raynaud's phenomenon and this should certainly be the aim for all patients seeking medical help.

Protective effects of various drugs on adriamycin (doxorubicin)-induced toxicity and microsomal lipid peroxidation in mice and rats.

The protective effects of clinically used drugs on the toxicity and microsomal lipid peroxidation induced by doxorubicin (adriamycin, ADM), an anthracycline type antitumor agent, were studied in mice and rats. Regarding the effects of anthracyclines (aclarubicin, ACL; daunorubicin, DAU; ADM; epirubicin, EPI; pirarubicin, PIR) on rat liver microsomal lipid peroxidation, ACL had the smallest effect, and effectiveness increased in the order of PIR, ADM, DAU and EPI. The increasing effect of lipid peroxidation induced by these drugs was closely correlated with the decrease in the body weight of mice administered intraperitoneally at a dose of 20 mg/kg and in rats at LD50 of the drugs. The survival times of ADM-administered mice (which were injected 15 mg/kg of ADM twice) treated with the following drugs, expressed as a percent of that of the control group, were 236% for adenosine triphosphate, 224% for coenzyme Q10 (Co Q), 235% for dextran sulfate (DS), 123% for dipyridamole, 121% for flavin adenine dinucleotide, 213% for reduced glutathion, 155% for inositol nicotinate, 157% for nicardipin and 297% for nicomol. The rat heart microsomal lipid peroxidation levels in vivo may be one of the indications of ADM-induced toxicity. The levels treated with DS correlated well with the development of ADM-induced toxicity: mouse survival time, change of body weight and tissue wet weight loss. Another type of drug, such as Co Q, may improve the myocardiac mitochondrial functions compared to those of ADM-administered mice.

Do drugs help intermittent claudication?

Many drugs are promoted for the treatment of intermittent claudication: cinnarizine (Stugeron Forte), cyclandelate (Cyclospasmol), naftidrofuryl (Praxilene), inositol nicotinate (Hexopal) and oxpentifylline (Trental); two other nicotinic acid derivatives, Bradilan and Ronicol, are licensed but not promoted. In 1988 the Committee on Review of Medicines deleted claudication as an indication for isoxsuprine (Duvadilan) from the product licence because evidence of efficacy was insufficient, but the CRM has been very slow to review the efficacy of the other drugs. Is there evidence that any of these drugs improve walking distance more than placebo?1,2,3

The therapeutic efficacy of inositol nicotinate (Hexopal®) in intermittent claudication: a controlled trial

International Journal of Clinical PracticeVolume 42, Issue 9 p. 377-383 Clinical Study The therapeutic efficacy of inositol nicotinate (Hexopal®) in intermittent claudication: a controlled trial J O'Hara MB ChB, J O'Hara MB ChB General Practitioner BrightonSearch for more papers by this authorP N Jolly BSc, MB BS, P N Jolly BSc, MB BS General Practitioner ReadingSearch for more papers by this authorC G Nicol MRCS LRCP, Corresponding Author C G Nicol MRCS LRCP n/[email protected] Medical Department, Winthrop LaboratoriesAddress correspondence to Dr C G Nicol, Medical Department, Winthrop Laboratories, Sterling-Winthrop House, Onslow Street, Guildford, Surrey, GU1 4YS.Search for more papers by this author J O'Hara MB ChB, J O'Hara MB ChB General Practitioner BrightonSearch for more papers by this authorP N Jolly BSc, MB BS, P N Jolly BSc, MB BS General Practitioner ReadingSearch for more papers by this authorC G Nicol MRCS LRCP, Corresponding Author C G Nicol MRCS LRCP n/[email protected] Medical Department, Winthrop LaboratoriesAddress correspondence to Dr C G Nicol, Medical Department, Winthrop Laboratories, Sterling-Winthrop House, Onslow Street, Guildford, Surrey, GU1 4YS.Search for more papers by this author First published: 01 September 1988 https://doi.org/10.1111/j.1742-1241.1988.tb08609.x ® Registered trademark of Winthrop Laboratories. Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Volume42, Issue9September 1988Pages 377-383 RelatedInformation

Does inositol nicotinate (Hexopal) influence intermittent claudication? — a controlled trial

Does inositol nicotinate (Hexopal) influence intermittent claudication? — a controlled trial

Protection against adriamycin (doxorubicin)-induced toxicity in mice by several clinically used drugs.

Protective effects of clinically used drugs against adriamycin (ADM)-induced toxicity were studied in ICR mice. The control mice, which were administered 15 mg/kg of ADM twice, survived 7.48 +/- 1.99 days (mean +/- S.D.). The survival times of mice treated with the following drugs, expressed as a percent of that of the control group, were 293.6% for coenzyme Q10 (Co Q10, 2 mg/kg), 402.2% for dextran sulfate (MDS, 300 mg/kg), 121.6% for flavin adenine dinucleotide (20 mg/kg), 236.3% for adenosine triphosphate disodium (50 mg/kg), 213.7% for reduced glutathione (100 mg/kg), 121.6% for phytonadione (50 mg/kg), 155.2% for inositol nicotinate (Ino-N, 500 mg/kg), 335.5% for nicomol (1000 mg/kg), 157.5% for nicardipine (10 mg/kg) and 123.3% for dipyridamol (50 mg/kg). Anti-hyperlipemic agents such as MDS, nicomol, Ino-N and Co Q10 strongly protected against the ADM-induced toxicity, and the mice administered these drugs lived significantly longer than the control mice. The mechanism of the protective effect was discussed.

Heterogeneity of Biochemical Actions Among Vasodilators

Thirty-four vasodilators were screened in several in vitro biochemical assays related to smooth muscle excitation-contraction coupling, binding to β1-, β2-, and α-adrenergic receptors, inhibition of phosphodiesterase activity, and antagonism of calcium accumulation. Isoproterenol and perhexiline only exhibited binding to β-adrenergic sites. Ergocryptine, tolazoline, and amotriphene only bound to α-adrenergic receptors. Leniquinsin, papaverine, proquazone, dioxyline, hoquizil, quazodine, and theophylline were active only as phosphodiesterase inhibitors. Isoxsuprine, nylidrin, and bencyclane bound to α- and β-receptors. Pentoxifylline bound to β1-sites and inhibited phosphodiesterase. Cyclandelate bound to β2-sites and blocked calcium accumulation. Cinnarizine and flunarizine antagonized calcium accumulation and bound to α-sites. Prazosin bound to α-sites and inhibited phosphodiesterase. Ethaverine and dipyridamole were inhibitors of phosphodiesterase and calcium accumulation. Nafronyl bound to β2- and α-sites and antagonized calcium accumulation. Mebeverine bound to β2- and α-receptors and inhibited phosphodiesterase activity and calcium accumulation. Verapamil bound to α-sites, and blocked phosphodiesterase and calcium accumulation. Quinazosin bound to β2- and α-receptors and antagonized both phosphodiesterase activity and calcium accumulation. Vasodilators that were inactive in all assays included niacin, nicotinyl alcohol, inositol nicotinate, amyl nitrite, sodium nitroprusside, diazoxide, hydralazine, and protoveratrine. Vasodilators should not be considered as a single drug class since they act on various mechanisms related to coupling of neuronal excitation to muscular contractility.

Quantitative thermal imaging to assess inositol nicotinate treatment for Raynaud's syndrome.

The objective assessment of thermography was used to quantify the response to cold stress in the hands of sufferers from Raynaud's Syndrome over a period of 36 weeks while on inositol nicotinate (Hexopal) in a dose of 4 g per day. Objective improvement was observed in the thermal gradient of the hand after cold challenge (RTG) following this sustained treatment. Statistically significant improvements were noted on four of the five subjective assessments. No drug-related adverse reactions were noted.

An Experimentally Controlled Evaluation of the Effect of Inositol Nicotinate upon the Digital Blood Flow in Patients with Raynaud's Phenomenon

The vaso-active effects of inositol nicotinate (Hexopal) were investigated in thirty patients with primary and secondary Raynaud's phenomenon using several non-invasive experimental techniques under controlled conditions. The earlier formed impression that this drug requires a prolonged 'build-up' period was confirmed. Recording the time required to induce Raynaud's phenomenon as well as assessments of total and nutrient digital blood flow showed significant beneficial therapeutic effects upon the skin's microcirculation by inositol nicotinate. This study suggests that the therapeutic effect of this drug is not merely due to vasodilation but that other mechanisms such as enhanced fibrinolysis and lowering of serum lipids may play a significant part in its overall effect. Smokers responded slower than non-smokers, but even elderly patients with longstanding vasospastic disease showed measurably improved digital circulation. Unlike some other drugs in this field inositol nicotinate was found to be effective orally and to be devoid of unwanted side-effects. However, in the majority of patients it failed to abolish their increased vascular spasm although it diminished it significantly in most. It appears to be a safe and well tolerated drug, which, together with other symptomatic measures, merits to be used in the management of vasospastic disease of the extremities even in the presence of partial obliteration of the microcirculation.

Hexopal in Raynaud's disease.

Twenty female patients with primary Raynaud's phenomenon were included in a 9-month open assessment of Hexopal® tablets. Measurements of digital artery blood velocity rates by transcutaneous Doppler techniques, digital artery pressure by micromanometry, and hand blood flow by venous occlusion plethysmography were undertaken at regular intervals throughout the 9 months of the study in fourteen of the patients. Additionally, levels of serum cholesterol and triglycerides and plasma fibrinogen were recorded and a visual analogue assessment was made by the patients of the severity of their condition. In patients with primary Raynaud's phenomenon the blood pressure reductions during reactive hyperaemia were quantitatively more pronounced and prolonged compared to values obtained in adult healthy female subjects. In particular, pressure amplitudes were abolished initially in several cases which later developed progressively towards initial values. Blood flow and velocity rate values in the patients during reactive hyperaemia did not achieve levels previously recorded in normal adult healthy female subjects. Peak flow levels were reduced and the time course of reactive hyperaemia was delayed. Oral treatment with inositol nicotinate (Hexopal) was associated with statistically significant increases in transcutaneous blood velocity at rest and during reactive hyperaemia. There were some increases in hand blood flow, particularly in the group receiving 4 g/day, but the changes did not reach statistical significance. There were appreciable reductions in the time course of reactive hyperaemia phases and early attainment of blood pressure values close to the initial values. Serum cholesterol and triglyceride concentrations and plasma fibrinogen levels showed statistically significant reductions during the first three months of treatment and these reduced levels were sustained for the subsequent six months of the study. Improvements in the patients' visual analogue assessments of the severity of their conditions were statistically significant. The occurrence of significant improvements in digital arterial blood flow rates at rest and during reactive hyperaemia did not occur until the second month of treatment. These findings lend support to the proposal that nicotinic acid derivatives during long-term use may produce improvement in peripheral circulation by a mechanism which differs from the brief vasodilatory effect noted during acute administration.

Quantitative thermographic assessment of inositol nicotinate therapy in Raynaud's phenomena.

The basal temperature of the hands has been measured by quantitative thermography in a group of normal controls and rheumatoid patients exhibiting Raynaud's phenomenon. The thermographic index for both the dorsum of the hand and the fingers was significantly lower in the patients with Raynaud's. Oral treatment with inositol nicotinate (Hexopal) was followed by an initial rise in the thermographic index in both areas. After the initial increase the temperature fell again but then rose after two months treatment. At nine months two subjects on continuous therapy had higher indices than the four who had discontinued therapy. It is suggested that long-term treatment with nicotinate acid derivatives may produce improvement in the peripheral circulation by a different mechanism than the transient effect detected by short-term studies.

Double-Blind Comparison of Bradilan (Tetranicotinoylfructose) Tablets and Hexopal (Inositol Nicotinate) Tablets in the Treatment of Intermittent Claudication

A double-blind comparison of Bradilan ( tetranicotinoylfructose) tablets 250 mg and Hexopal ( inositol nicotinate) 500 mg tablets in the treatment of intermittent claudication in fifty patients showed that, using walking distance as the main parameter, Bradilan tablets were highly significantly more effective ( p < 0.002).