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

Abstract

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.

Niacin: chemical forms, bioavailability, and health effects

“…24 The small amount of data available that suggests IHN does not produce a flushing reaction is consistent with the modest NA plasma response following IHN intake. 23,24,40 Few other adverse effects have been reported in clinical trials studying the use of dosages of IHN up to 4,000 mg/ day. [40][41][42][43] There is debate about whether the bioavailability of NA from IHN is high enough to justify it being considered a form of niacin.…”

“…23,24,40 Few other adverse effects have been reported in clinical trials studying the use of dosages of IHN up to 4,000 mg/ day. [40][41][42][43] There is debate about whether the bioavailability of NA from IHN is high enough to justify it being considered a form of niacin. Some publications support this classification, 17 while others contradict it.…”

Raynaud's Phenomenon and the Possible Use of Foods

“…The conclusions of these studies were as follows. In RP, symptomatic improvements were reported when IH was consumed for 3 (Holti 1979;Sunderland and others 1988) and 9 mo others 1977, 1981;Aylward 1979). Two studies (Aylward 1979;Holti 1979) assessed responses of flow, and increases were reported after 2, 3, and 9 mo of consumption (Aylward 1979;Holti 1979).…”

“…. Table 1 outlines the 5 studies that investigated the effects of IH in RP, and 4 of them can be criticized because they are lacking a study control others 1977, 1981;Aylward 1979;Holti 1979;Sunderland and others 1988). The conclusions of these studies were as follows.…”

“…In RP, symptomatic improvements were reported when IH was consumed for 3 (Holti 1979;Sunderland and others 1988) and 9 mo others 1977, 1981;Aylward 1979). Two studies (Aylward 1979;Holti 1979) assessed responses of flow, and increases were reported after 2, 3, and 9 mo of consumption (Aylward 1979;Holti 1979). Four studies have assessed hand skin temperature responses and they reported little (Holti 1979) or no effect after 12 wk of consumption (Sunderland and others 1988) or an increase after 9 mo of usage others 1977, 1981).…”