Certified Diabetes Care and Education Specialist (CDCES) Practice Exam

Which medication class is contraindicated for individuals with hepatic dysfunction due to its potential for hepatotoxicity?

1. Statins

2. Niacin

3. Fibrates

4. Biguanides

The correct answer is: Niacin

Niacin, also known as vitamin B3, is a medication class that can lead to hepatotoxicity, primarily when used in high doses for dyslipidemia treatment. This risk makes it contraindicated for individuals with hepatic dysfunction. Hepatic impairment can exacerbate the effects of niacin, leading to elevated liver enzymes and potentially severe liver damage. In contrast, other classes such as statins and fibrates have specific guidelines for their use in patients with liver function concerns, allowing dosages to be adjusted based on liver health. Biguanides, like metformin, while generally used cautiously in hepatic impairment, don’t present the same immediate risk of hepatotoxicity that niacin does. Thus, niacin’s known side effect profile related to liver health makes it the class contraindicated for those with hepatic dysfunction.