Which of the following is a contraindication for using niacin?

Niacin, also known as vitamin B3, is a lipid-lowering agent known for its ability to improve lipid profiles by lowering triglycerides and LDL cholesterol while raising HDL cholesterol. However, one of the significant contraindications for niacin use is liver disease.

The liver metabolizes niacin, and elevated doses can lead to hepatotoxicity, particularly in individuals with pre-existing liver conditions. This toxicity can manifest as liver dysfunction or failure. Due to the risk of exacerbating liver issues or causing further liver damage, it is essential to avoid using niacin in patients with liver disease.

In contrast, while diabetes, high blood pressure, and heart disease may pose challenges in using niacin due to potential side effects (like increased insulin resistance in diabetes or the risk of flushing), they do not present the same immediate and serious risk as liver disease does. Therefore, assessing liver health is critical before initiating niacin therapy.