COUMADIN is contraindicated in women who are pregnant except in pregnant women with mechanical heart valves, who are at high risk of thromboembolism, and for whom the benefits of COUMADIN may outweigh the risks [see WARNINGS AND PRECAUTIONS ]. COUMADIN can cause fetal harm. Exposure to warfarin during the first trimester of pregnancy caused a pattern of congenital malformations in about 5% of exposed offspring. Because these data were not collected in adequate and well-controlled studies, this incidence of major birth defects is not an adequate basis for comparison to the estimated incidences in the control group or the . general population and may not reflect the incidences observed in practice. Consider the benefits and risks of COUMADIN and possible risks to the fetus when prescribing COUMADIN to a pregnant woman.
Niaspan (KOS Pharmaceuticals) is a prescription form of extended release niacin. A placebo-controlled, double-blind trial in 122 HIV-negative patients with primary dyslipidemia compared Niaspan 1000 and 2000 mg/ day with placebo. Niaspan reduced LDL cholesterol significantly compared with placebo. In addition, triglyceride levels were decreased 21% with the 1000-mg/day dosage and 28% with the 2000-mg/day dosage. Approximately 85% of the patients taking Niaspan had some flushing, but this reaction did not differ in frequency, intensity, or duration between the two dosages. In two patients the aspartate transaminase level (liver enzyme) was more than twice the normal level, and in one the alanine transaminase level was elevated to more than three times normal.