Which lipid-lowering agent can potentially cause flushing as a side effect?

Flushing is a well-known side effect specifically associated with niacin, which is a vitamin B3 derivative. When niacin is administered, it causes the release of prostaglandins, leading to vasodilation and subsequent flushing, especially in the face and neck. This side effect is often described as warmth, redness, and sometimes itching, which tends to occur shortly after taking the medication and may resolve over time as the body adjusts to the treatment.

In contrast, statins, fibrates, and bile acid sequestrants do not typically cause flushing. Statins primarily work by inhibiting HMG-CoA reductase and are more commonly associated with muscle-related side effects or liver enzyme elevation. Fibrates primarily target triglyceride levels and have different side effects, such as gastrointestinal discomfort. Bile acid sequestrants work by binding bile acids in the intestine to promote excretion, and their common side effects include gastrointestinal issues like constipation or bloating, rather than flushing. Thus, among these options, niacin is distinctly noted for the side effect of flushing.