Niacin And Niacinamide (Vitamin B3)

Are there any interactions with medications?



Alcohol (Ethanol)
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

Niacin can cause flushing and itchiness. Consuming alcohol along with niacin might make the flushing and itching worse. There is also some concern that consuming alcohol with niacin might increase the chance of having liver damage.



Allopurinol (Zyloprim)
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

Allopurinol (Zyloprim) is used to treat gout. Taking large doses of niacin might worsen gout and decrease the effectiveness of allopurinol (Zyloprim).



Carbamazepine (Tegretol)
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

Carbamazepine (Tegretol) is broken down by the body. There is some concern that niacinamide might decrease how fast the body breaks down carbamazepine (Tegretol). But there is not enough information to know if this is important.



Clonidine (Catapres)
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

Clonidine and niacin both lower blood pressure. Taking niacin with clonidine might cause your blood pressure to become too low.



Medications for diabetes (Antidiabetes drugs)
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

Long-term use of niacin and niacinamide might increase blood sugar. By increasing blood sugar, niacin and niacinamide might decrease the effectiveness of diabetes medications. Monitor your blood sugar closely. The dose of your diabetes medication might need to be changed.

Some medications used for diabetes include glimepiride (Amaryl), glyburide (DiaBeta, Glynase PresTab, Micronase), insulin, pioglitazone (Actos), rosiglitazone (Avandia), metformin (Glucophage), nateglinide (Starlix), repaglinide (Prandin), chlorpropamide (Diabinese), glipizide (Glucotrol), tolbutamide (Orinase), and others.



Medications used for lowering cholesterol (Bile acid sequestrants)
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

Some medications for lowering cholesterol called bile acid sequestrants can decrease how much niacin or niacinamide the body absorbs. This might reduce the effectiveness of niacin or niacinamide. Take niacin or niacinamide and the medications at least 4-6 hours apart.

Some of these medications used for lowering cholesterol include cholestyramine (Questran) and colestipol (Colestid).



Medications used for lowering cholesterol (Statins)
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

Niacin can adversely affect the muscles. Some medications used for lowering cholesterol called statins can also affect the muscles. Taking niacin along with these medications might increase the risk of muscle problems.

Some of these medications used for high cholesterol include rosuvastatin (Crestor), atorvastatin (Lipitor), lovastatin (Mevacor), pravastatin (Pravachol), fluvastatin (Lescol), and simvastatin (Zocor).



Primidone (Mysoline)
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

Primidone (Mysoline) is broken down by the body. There is some concern that niacinamide might decrease how fast the body breaks down primidone (Mysoline). But there is not enough information to know if this is important.



Probenecid
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

Probenecid is used to treat gout. Taking large doses of niacin might worsen gout and decrease the effectiveness of probenecid.



Sulfinpyrazone (Anturane)
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

Sulfinpyrazone (Anturane) is used to treat gout. Taking large doses of niacin might worsen gout and decrease the effectiveness of sulfinpyrazone (Anturane).



Aspirin
Interaction Rating: Minor Be cautious with this combination.
Talk with your health provider.

Aspirin is often used with niacin to reduce the flushing caused by niacin. Taking high doses of aspirin might decrease how fast the body gets rid of niacin. This could cause there to be too much niacin in the body and possibly lead to side effects. But the low doses of aspirin most commonly used for niacin-related flushing don't seem to be a problem.



Nicotine patch (Transdermal nicotine)
Interaction Rating: Minor Be cautious with this combination.
Talk with your health provider.

Niacin can sometimes cause flushing and dizziness. The nicotine patch can also cause flushing and dizziness. Taking niacin or niacinamide and using a nicotine patch can increase the possibility of becoming flushed and dizzy.

Dosing considerations for Niacin And Niacinamide (vitamin B3).

The following doses have been studied in scientific research:

BY MOUTH:
  • For high cholesterol: The effects of niacin are dose-dependent. The biggest increases in HDL and decreases in triglycerides occur at 1200-1500 mg/day. Niacin's greatest effects on LDL occur at 2000-3000 mg/day.
  • To prevent heart disease in people with high cholesterol: Niacin 4 grams daily.
  • For preventing and treating vitamin B3 deficiency: Doses of nicotinic acid and niacinamide are considered equivalent. For mild vitamin B3 deficiency, niacin or niacinamide 50-100 mg per day is used. For pellagra in adults, niacin or niacinamide 300-500 mg daily is given in divided doses. For pellagra in children, niacin or niacinamide 100-300 mg daily is given in divided doses. For Hartnup disease, niacin or niacinamide 50-200 mg daily.
  • For reducing fluid loss caused by cholera toxin: Niacin 2 grams daily.
  • To prevent type 1 diabetes in high-risk children: Sustained-release niacinamide 1.2 grams/m² (body surface area) per day.
  • To slow disease progression of newly diagnosed type 1 diabetes: Niacinamide 25 mg/kg daily.
  • For treating osteoarthritis: Niacinamide 3 grams per day in divided doses.
  • For reduced risk of cataracts: A daily dietary intake of approximately 44 mg of niacin.
  • For preventing Alzheimer's disease: 17-45 mg of niacin from food and multivitamins. Food sources high in niacin include meat, fish, beans, nuts, coffee, and fortified grains and cereals. Note that there is no reliable evidence that taking a stand-alone niacin supplement will help to prevent Alzheimer's disease.
The daily recommended dietary allowances (RDAs) of niacin are: Infants 0-6 months, 2 mg; Infants 7-12 months, 4 mg; Children 1-3 years, 6 mg; Children 4-8 years, 8 mg; Children 9-13 years, 12 mg; Men 14 years and older, 16 mg; Women 14 years and older, 14 mg; Pregnant women, 18 mg; and Lactating women, 17 mg. The maximum daily dose of niacin is: Children 1-3 years, 10 mg; Children 4-8 years, 15 mg; Children 9-13 years, 20 mg; Adults, including Pregnant and Lactating women, 14-18 years, 30 mg; and Adults, including pregnant and breast-feeding women, older than 18 years, 35 mg.


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