默沙东公司(Merck Sharp & Dohme)的烟酸+拉罗皮兰复方控释片（nicotinic acid+ laropiprant，Tredaptive）已在欧盟、冰岛和挪威获准上市，用于对脂质代谢障碍血症和原发性高胆固醇血症患者的LDL-C、HDL-C 和甘油三酯新调脂治疗。
本品含有烟酸和拉罗皮兰。在对4 700多例患者的临床研究中，本品降低低密度胆固醇（LDL-C，即“坏胆固醇”）、升高高密度胆固醇（HDL-C ，即“好胆固醇”），还可减少甘油三酯的含量。高LDL-C，低HDL-C和甘油三酯升高是诱发心脏病发作和休克的危险因素。
本品已获准用于治疗脂肪代谢障碍血症，特别适用于混合型脂肪代谢血症（特征是高LDL-C和甘油三酯、低HDL-C）患者和原发性高胆固醇血症（杂合遗传和非遗传）患者。当单一采用他汀类药物降胆固醇无效时，应添加本品。对不宜采用或患者不能耐受他汀类药物的患者，可单一采用本品治疗。
单独采用本品或与他汀类药物联合用药时，本品 2 g/40 mg服用24周可显著改善血中LDL-C、HDL-C和甘油三酯浓度。开始研究时，本品一日1 g/20 mg；治疗第4周后，本品 2 g/40 mg维持治疗20周。在12～24周的研究中，本品2 g/40 mg较安慰剂显著降低LDL-C浓度（-18%）、升高HDL-C浓度（20%）和降低甘油三酯浓度（-26%）。
本品 2 g/40 mg与辛伐他汀（20 mg或40 mg）联合用药12周降低LDL-C（-48%），升高HDL-C浓度（28%）和降低甘油三酯浓度（-33%）。患者潮红较烟酸控释制剂显著减少。
患者通常对本品耐受性好，不良反应一般是轻度和暂时性的。潮红是本品最常见的不良反应，主要出现在头、颈和上身。其它不良反应是ALT或AST升高，眩晕、头痛、感觉异常（麻木感、刺痛或皮肤灼热）、腹泻、消化不良、恶心、呕吐、红斑（皮肤红）、瘙痒、荨麻疹和潮热等。
Tredaptive
amNicotinic acid and laropiprant modified-release tablets for treating dyslipidaemia, particularly combined mixed dyslipidaemia and primary hypercholesterolaemia.
PHARMACOLOGY
Tredaptive combines nicotinic acid (niacin), a lipid-lowering agent, with laropiprant, a selective antagonist of the prostaglandin D2 receptor subtype 1.1 Laropiprant has no effect on lipid levels, but simply suppresses the flushing caused by nicotinic acid.
CLINICAL STUDIES
In a 24-week trial in 1,216 patients, nicotinic acid (1g/day for four weeks, followed by 2g/day for 20 weeks) given in combination with laropiprant significantly improved lipid profiles compared with placebo and caused markedly less flushing than the same dose of nicotinic acid alone.2
In another trial, the 726 patients randomised to receive nicotinic acid (1g/day for four weeks, followed by 2g/day for 12 weeks) given in combination with laropiprant experienced significantly fewer days of flushing per week during the 16-week treatment period than the 729 patients who were randomised to receive nicotinic acid alone (0.5g/day for four weeks gradually titrated to 2g/day for the final four weeks), despite more rapid nicotinic acid titration.3
