Do not confuse niacin with NADH, niacinamide, inositol nicotinate, IP-6, or tryptophan. See the separate listings for these topics.
Prescription forms of niacin are approved by the US Food and Drug Administration (FDA) for high cholesterol and to increase levels of a specific type of good cholesterol, known as HDL. Niacin supplements and prescription products are also taken by mouth for preventing vitamin B3 deficiency and related conditions such as pellagra.
How does it work ?
Niacin is required for the proper function of fats and sugars in the body and to maintain healthy cells. At high doses, niacin might help people with heart disease because of its beneficial effects on clotting. It may also improve levels of a certain type of fat called triglycerides in the blood.
Niacin deficiency can cause a condition called pellagra, which causes skin irritation, diarrhea, and dementia. Pellagra was common in the early twentieth century, but is less common now, since some foods containing flour are now fortified with niacin. Pellagra has been virtually eliminated in western culture.
People with poor diet, alcoholism, and some types of slow-growing tumors called carcinoid tumors might be at risk for niacin deficiency.
Uses & Effectiveness ?
Likely Effective for
- Abnormal levels of cholesterol or blood fats (dyslipidemia). Some niacin products are approved by the U.S. Food and Drug Administration (FDA) as prescriptions for treating abnormal levels of blood fats. These prescription products typically come in high strengths of 500 mg or more. These products improve cholesterol levels, but do not improve heart problems such as heart attacks and strokes. Niacin may be combined with other cholesterol-lowering drugs when diet and single-drug therapy is not enough. Dietary supplement forms of niacin usually come in strengths of 250 mg or less, and don't seem to improve blood fat levels.
- A disease caused by niacin deficiency (pellagra). Niacin is approved by the U.S. Food and Drug Administration (FDA) for this use. However, niacin can cause "flushing" (redness, itching, and tingling). So another product, called niacinamide, is sometimes preferred because it doesn't cause this side effect.
Possibly Effective for
- Abnormal levels of blood fats in people with HIV/AIDS. Taking niacin seems to improve levels of cholesterol and blood fats called triglycerides in patients with this condition.
- A grouping of symptoms that increase the risk of diabetes, heart disease, and stroke (metabolic syndrome). Taking niacin seems to increase levels of high-density lipoprotein (HDL or "good") cholesterol and reduce levels of blood fats called triglycerides in people with metabolic syndrome. Taking the niacin along with a prescription omega-3 fatty acid seems to work even better.
Insufficient Evidence for
- Alzheimer disease. Early research suggests that consuming higher amounts of niacin from food and dietary supplements might lower the risk of getting Alzheimer disease.
- Hardening of the arteries (atherosclerosis). Taking niacin by mouth along with medicines called bile acid sequestrants might reduce worsening of this condition in men. But niacin seems to be no better than the medications called statins. Also, niacin does not prevent heart problems such as a heart attack or stroke.
- Cataracts. People who eat a diet high in niacin might have a reduced chance of developing nuclear cataracts. The effect of taking niacin supplements is unknown.
- An infection of the intestines that causes diarrhea (cholera). Taking niacin by mouth seems to reduce diarrhea in people with cholera.
- Erectile dysfunction (ED). Taking extended-release niacin at bedtime for 12 weeks seems to help men who have ED and high lipid levels maintain an erection during sexual intercourse.
- High levels of phosphate in the blood (hyperphosphatemia). People with kidney failure might have high blood levels of phosphate. Some early research shows that taking niacin can reduce blood levels of phosphate in people with end-stage kidney disease and high levels of blood phosphate. But other research shows that taking niacin does not lower blood phosphate levels in people who are also taking medications used to lower blood phosphate levels.
- High blood pressure. It is unclear if adequate dietary niacin prevents high blood pressure.
- Blockage of the vein in the eye (retinal vein occlusion): Early research shows that taking niacin might improve eyesight in people with this condition.
- Sickle cell disease: Early research shows that taking niacin does not improve the levels of blood fats in people with sickle cell disease.
- Athletic performance.
- Attention deficit-hyperactivity disorder (ADHD).
- An inner ear disorder marked by dizziness, hearing loss, and ringing in the ear (Meniere disease).
- Dizziness (vertigo).
- Motion sickness.
- Other conditions.
A common side effect of niacin is a flushing reaction. This might cause burning, tingling, itching, and redness of the face, arms, and chest, as well as headaches. Starting with small doses of niacin and taking 325 mg of aspirin before each dose of niacin will help reduce the flushing reaction. Usually, this reaction goes away as the body gets used to the medication. Alcohol can make the flushing reaction worse. Avoid large amounts of alcohol while taking niacin.
Other minor side effects of niacin are stomach upset, intestinal gas, dizziness, pain in the mouth, and other problems.
When doses of over 3 grams per day of niacin are taken, more serious side effects can happen. These include liver problems, gout, ulcers of the digestive tract, loss of vision, high blood sugar, irregular heartbeat, and other serious problems.
Special Precautions and Warnings
Children: Niacin is LIKELY SAFE when taken by mouth in the recommended amounts for each age group. But children should avoid taking doses of niacin above the daily upper limits, which are 10 mg for children 1-3 years of age, 15 mg for children 4-8 years of age, 20 mg for children 9-13 years of age, and 30 mg for children 14-18 years of age.
Allergies: Niacin might worsen allergies by causing histamine, the chemical responsible for allergic symptoms, to be released.
Diabetes: Niacin might increase blood sugar. People with diabetes who take niacin should check their blood sugar carefully.
Gallbladder disease: Niacin might make gallbladder disease worse.
Gout: Large amounts of niacin might increase the risk for gout.
Kidney disease: Niacin might accumulate in people with kidney disease. This might cause harm.
Liver disease: Niacin in high doses might increase liver damage. Don't use large amounts if you have liver disease.
Low blood pressure: Niacin in high doses might lower blood pressure and worsen this condition.
Stomach or intestinal ulcers: Niacin might make ulcers worse. Don't use large amounts if you have ulcers.
Surgery: Niacin might interfere with blood sugar control during and after surgery. Stop taking niacin at least 2 weeks before a scheduled surgery.
Fatty deposits around tendons (tendon xanthomas): Niacin might increase the risk of infections in xanthomas.
Thyroid disorders: Thyroxine is a hormone produced by the thyroid gland. Niacin might lower blood levels of thyroxine. This might worsen symptoms of certain thyroid disorders.
Alcohol (ethanol) interacts with NIACIN AND NIACINAMIDE (VITAMIN B3)
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) interacts with NIACIN AND NIACINAMIDE (VITAMIN B3)
Allopurinol (Zyloprim) is used to treat gout. Taking large doses of niacin might worsen gout and decrease the effectiveness of allopurinol (Zyloprim).
Carbamazepine (Tegretol) interacts with NIACIN AND NIACINAMIDE (VITAMIN B3)
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) interacts with NIACIN AND NIACINAMIDE (VITAMIN B3)
Clonidine and niacin both lower blood pressure. Taking both niacin with clonidine might cause your blood pressure to become too low.
Medications for diabetes (Antidiabetes drugs) interacts with NIACIN AND NIACINAMIDE (VITAMIN B3)
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) interacts with NIACIN AND NIACINAMIDE (VITAMIN B3)
Some medication 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 hours apart.
Some of these medications used for high cholesterol include cholestyramine (Questran) and colestipol (Colestid).
Medications used for lowering cholesterol (Statins) interacts with NIACIN AND NIACINAMIDE (VITAMIN B3)
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 for lowering cholesterol might increase the risk of muscle problems.
Some of these medications used for high cholesterol include rosuvastatin (Crestor), atorvastatin (Lipitor), lovastatin (Mevacor), pravastatin (Pravachol), and simvastatin (Zocor).
Primidone (Mysoline) interacts with NIACIN AND NIACINAMIDE (VITAMIN B3)
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 interacts with NIACIN AND NIACINAMIDE (VITAMIN B3)
Probenecid is used to treat gout. Taking large doses of niacin might worsen gout and decrease the effectiveness of probenecid.
Sulfinpyrazone (Anturane) interacts with NIACIN AND NIACINAMIDE (VITAMIN B3)
Sulfinpyrazone (Anturane) is used to treat gout. Taking large doses of niacin might worsen gout and decrease the effectiveness of sulfinpyrazone (Anturane).
Be cautious with this combination
Aspirin interacts with NIACIN AND NIACINAMIDE (VITAMIN B3)
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) interacts with NIACIN AND NIACINAMIDE (VITAMIN B3)
Niacin can sometimes cause flushing and dizziness. The nicotine patch can also cause flushing and dizziness. Taking niacin and/or niacinamide (vitamin B3) and using a nicotine patch can increase the possibility of becoming flushed and dizzy.
Be watchful with this combination
- General: Some dietary supplement products list niacin on the label in niacin equivalents (NE). 1 mg of niacin is the same as 1 mg NE. When niacin is listed on a label as NE, it might include other forms of niacin as well, including niacinamide, inositol nicotinate, and tryptophan. The daily recommended dietary allowances (RDAs) for niacin in adults are 16 mg NE for men, 14 mg NE for women, 18 mg NE for pregnant women, and 17 mg NE for lactating women.
- For high cholesterol:The effects of niacin are dose-dependent. Doses of niacin as low as 50 mg and as high as 12 grams each day have been used. However, the biggest increases in HDL and decreases in triglycerides occur at 1200 to 1500 mg/day. Niacin's greatest effects on LDL occur at 2000 to 3000 mg/day. Niacin is often used with other medications for improving cholesterol levels.
- For preventing and treating vitamin B3 deficiency and related conditions such as pellagra: 300-1000 mg daily in divided doses.
- For treating hardening of the arteries: Doses of niacin have been as high as 12 grams daily. However, a dose of about 1 to 4 grams of niacin daily, alone or along with statins or bile acid sequestrants (a cholesterol-lowering medicine), has been used for up to 6.2 years.
- For reducing fluid loss caused by cholera toxin: 2 grams daily has been used.
- For abnormal blood fat levels due to treatment for HIV/AIDS: Up to 2 grams daily has been used.
- For metabolic syndrome: 2 grams of niacin has been taken daily for 16 weeks. In some cases, niacin 2 grams daily, alone or at this dosage, is taken along with 4 grams of prescription omega-3 ethyl esters (Lovaza, GlaxoSmithKline Pharmaceuticals).
- For preventing and treating vitamin B3 deficiency and related conditions such as pellagra: 60 mg of niacin has been used.
- For preventing and treating vitamin B3 deficiency and related conditions such as pellagra: 60 mg of niacin has been used.
- General: The daily recommended dietary allowances (RDAs) for niacin in children are 2 mg NE for infants 0-6 months of age, 4 mg NE for infants 7-12 months of age, 6 mg NE for children 1-3 years of age, 8 mg NE for children 4-8 years of age, 12 mg NE for children 9-13 years of age, 16 mg NE for boys 14-18 years of age, and 14 mg NE for girls 14-18 years of age.
- For preventing and treating vitamin B3 deficiency and related conditions such as pellagra: 100-300 mg per day of niacin, given in divided doses.
Schwartz ML. Severe reversible hyperglycemia as a consequence of niacin therapy. Arch Int Med 1993;153:2050-2. View abstract.
Scoffone HM, Krajewski M, Zorca S, et al. Effect of extended-release niacin on serum lipids and on endothelial function in adults with sickle cell anemia and low high-density lipoprotein cholesterol levels. Am J Cardiol. 2013 Nov 1;112(9):1499-504. View abstract.
Shakir KM, Kroll S, Aprill BS, Drake AJ 3rd, Eisold JF. Nicotinic acid decreases serum thyroid hormone levels while maintaining a euthyroid state. Mayo Clin Proc. 1995;70(6):556-8. View abstract.
Shearer GC, Pottala JV, Hansen SN, Brandenburg V, Harris WS. Effects of prescription niacin and omega-3 fatty acids on lipids and vascular function in metabolic syndrome: a randomized controlled trial. J Lipid Res. 2012 Nov;53(11):2429-35. View abstract.
Shils ME, Olson JA, Shike M, Ross AC, eds. Modern Nutrition in Health and Disease. 9th ed. Baltimore, MD: Williams & Wilkins, 1999.
Song S, Lee CJ, Oh J, Park S, Kang SM, Lee SH. Effect of Niacin on Carotid Atherosclerosis in Patients at Low-Density Lipoprotein-Cholesterol Goal but High Lipoprotein (a) Level: a 2-Year Follow-Up Study. J Lipid Atheroscler. 2019;8(1):58-66. View abstract.
Spies TD, Grant JM, Stone RE, et al. Recent observations on the treatment of six hundred pellagrins with special emphasis on the use of nicotinic acid in prophylaxis. South Med J 1938;31(12):1231.
Stevens H, Ostlere L, Begent R, et al. Pellagra secondary to 5-fluorouracil. Br J Dermatol 1993;128:578-80. View abstract.
Stone NJ, Robinson JG, Lichtenstein AH, et al. 2013 ACC/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults: a report of the American College of Cardiology/American Heart Association task force on practice guidelines. J Am Coll Cardiol 2014;63(25):2889-934. View abstract.
Stratigos JD, Katsambas A. Pellagra: a still existing disease. Br J Dermatol 1977;96:99-106. View abstract.
Swash M, Roberts AH. Reversible pellagra-like encephalopathy with ethionamide and cycloserine. Tubercle 1972;53:132. View abstract.
Teo KK, Goldstein LB, Chaitman BR, Grant S, Weintraub WS, Anderson DC, Sila CA, Cruz-Flores S, Padley RJ, Kostuk WJ, Boden WE; AIM-HIGH Investigators. Extended-release niacin therapy and risk of ischemic stroke in patients with cardiovascular disease: the Atherothrombosis Intervention in Metabolic Syndrome with low HDL/High Triglycerides: Impact on Global Health Outcome (AIM-HIGH) trial. Stroke. 2013 Oct;44(10):2688-93. View abstract.
Tornvall P, Hamsten A, Johansson J, Carlson LA. Normalisation of the composition of very low density lipoprotein in hypertriglyceridemia by nicotinic acid. Atherosclerosis. 1990;84(2-3):219-27. View abstract.
Turjman N, Cardamone A, Gotterer GS, Hendrix TR. Effect of nicotinic acid on cholera-induced fluid movement and unidirectional sodium fluxes in rabbit jejunum. Johns Hopkins Med J. 1980;147(6):209-11. View abstract.
Urberg M, Zemel MB. Evidence for synergism between chromium and nicotinic acid in the control of glucose tolerance in elderly humans. Metabolism 1987;36:896-9. View abstract.
Vacek JL, Dittmeier G, Chiarelli T, et al. Comparison of lovastatin (20 mg) and nicotinic acid (1.2 g) with either drug alone for type II hyperlipoproteinemia. Am J Cardiol 1995;76:182-4. View abstract.
Vannucchi H, Moreno FS. Interaction of niacin and zinc metabolism in patients with alcoholic pellagra. Am J Clin Nutr 1989;50:364-9. View abstract.
Vega GL, Grundy SM. Lipoprotein responses to treatment with lovastatin, gemfibrozil, and nicotinic acid in normolipidemic patients with hypoalphalipoproteinemia. Arch Intern Med 1994;154:73-82. View abstract.
Vincent JE, Zijlstra FJ. Nicotinic acid inhibits thromboxane synthesis in platelets. Prostaglandins. 1978;15(4):629-36. View abstract.
Whelan AM, Price SO, Fowler SF, Hainer BL. The effect of aspirin on niacin-induced cutaneous reactions. J Fam Pract 1992;34:165-8. View abstract.
Wink J, Giacoppe G, King J. Effect of very-low-dose naicin on high-density lipoprotein in patients undergoing long-term statin therapy. Am Heart J 2002;143:514-8.. View abstract.
Wolfe ML, Vartanian SF, Ross JL, et al. Safety and effectiveness of Niaspan when added sequentially to a statin for treatment of dyslipidemia. Am J Cardiol 2001;87:476-9,A7.. View abstract.
Yates AA, Schlicker SA, Suitor CW. Dietary reference intakes: The new basis for recommendations for calcium and related nutrients, B vitamins, and choline. J Am Diet Assoc 1998;98:699-706. View abstract.
Zema MJ. Gemfibrozil, nicotinic acid and combination therapy in patients with isolated hypoalphalipoproteinemia: a randomized, open-label, crossover study. J Am Coll Cardiol 2000;35:640-6. View abstract.
Hendrix, C. R., Housh, T. J., Mielke, M., Zuniga, J. M., Camic, C. L., Johnson, G. O., Schmidt, R. J., and Housh, D. J. Acute effects of a caffeine-containing supplement on bench press and leg extension strength and time to exhaustion during cycle ergometry. J Strength.Cond.Res 2010;24(3):859-865. View abstract.
Urberg, M., Benyi, J., and John, R. Hypocholesterolemic effects of nicotinic acid and chromium supplementation. J Fam.Pract. 1988;27(6):603-606. View abstract.
Ali EH, McJunkin B, Jubelirer S, Hood W. Niacin induced coagulopathy as a manifestation of occult liver injury. W V Med J. 2013 Jan-Feb;109(1):12-4 View abstract.
American Dietetic Association Website. Available at: www.eatright.org/adap1097.html (Accessed 16 July 1999).
American Society of Health-System Pharmacists. ASHP Therapeutic Position Statement on the safe use of niacin in the management of dyslipidemias. Am J Health Syst Pharm 1997;54:2815-9. View abstract.
Anderson TJ, Grégoire J, Pearson GJ, et al. 2016 Canadian Cardiovascular Society Guidelines for the Management of Dyslipidemia for the Prevention of Cardiovascular Disease in the Adult. Can J Cardiol. 2016;32(11):1263-1282. View abstract.
Andersson RG, Aberg G, Brattsand R, Ericsson E, Lundholm L. Studies on the mechanism of flush induced by nicotinic acid. Acta Pharmacol Toxicol (Copenh). 1977 Jul;41(1):1-10. View abstract.
Anon. Niacinamide Monograph. Alt Med Rev 2002;7:525-9. View abstract.
Aramwit P, Srisawadwong R, Supasyndh O. Effectiveness and safety of extended-release nicotinic acid for reducing serum phosphorus in hemodialysis patients. J Nephrol. 2012 May-Jun;25(3):354-62. View abstract.
Aronov DM, Keenan JM, Akhmedzhanov NM, et al. Clinical trial of wax-matrix sustained-release niacin in a Russian population with hypercholesterolemia. Arch Fam Med. 1996;5(10):567-75. View abstract.
Balasubramanyam A, Coraza I, Smith EO, et al. Combination of niacin and fenofibrate with lifestyle changes improves dyslipidemia and hypoadiponectinemia in HIV patients on antiretroviral therapy: results of "heart positive," a randomized, controlled trial. J Clin Endocrinol Metab. 2011;96(7):2236-47. View abstract.
Bassan M. A case for immediate-release niacin. Heart Lung. 2012 Jan-Feb;41(1):95-8. View abstract.
Bays HE, Dujovne CA. Drug interactions of lipid-altering drugs. Drug Saf 1998;19:355-71. View abstract.
Bender DA, Earl CJ, Lees AJ. Niacin depletion in Parkinsonian patients treated with L-dopa, benserazide and carbidopa. Clinical Sci 1979;56:89-93. . View abstract.
Bender DA, Russell-Jones R. Isoniazid-induced pellagra despite vitamin B6 supplementation (letter). Lancet 1979;2:1125-6. View abstract.
Bingham LG, Verma SB. A photodistributed rash. (Self-Assessment examination of the American Academy of Dermatology). J Am Acad Dermatol 2005;52:929-32.
Blankenhorn DH, Nessim SA, Johnson RL, et al. Beneficial effects of combined colestipol-niacin therapy on coronary atherosclerosis and coronary venous bypass grafts. JAMA. 1987;257(23):3233-40. View abstract.
Brooks-Hill RW, Bishop ME, Vellend H. Pellagra-like encephalopathy complicating a multiple drug regimen for the treatment of pulmonary infection due to Mycobacterium avium-intracellulare (letter). Am Rev Resp Dis 1985;131:476. View abstract.
Brown BG, Bardsley J, Poulin D, et al. Moderate dose, three-drug therapy with niacin, lovastatin, and colestipol to reduce low-density lipoprotein cholesterol <100 mg/dl in patients with hyperlipidemia and coronary artery disease. Am J Cardiol. 1997;80(2):111-5. View abstract.
Brown BG, Zhao XQ, Chait A, et al. Simvastatin and niacin, antioxidant vitamins, or the combination for the prevention of coronary disease. N Engl J Med 2001;345:1583-93. View abstract.
Brown G, Albers JJ, Fisher LD, et al. Regression of coronary artery disease as a result of intensive lipid-lowering therapy in men with high levels of apolipoprotein B. N Engl J Med. 1990;323(19):1289-98. View abstract.
Brown WV. Niacin for lipid disorders. Indications, effectiveness, and safety. Postgrad Med. 1995 Aug;98(2):185-9, 192-3. View abstract.
Brunner G, Yang EY, Kumar A, et al. The effect of lipid modification on peripheral artery disease after endovascular intervention trial (ELIMIT). Atherosclerosis. 2013 Dec;213(2):371-7. View abstract.
Canner PL, Berge KG, Wenger NK, et al. Fifteen year mortality in Coronary Drug Project patients: long-term benefit with niacin. J Am Coll Cardiol 1986;8:1245-55. View abstract.
Capuzzi DM, Guyton JR, Morgan JM, et al. Efficacy and safety of an extended-release niacin (Niaspan): a long-term study. Am J Cardiol 1998;82:74-81;disc. 85U-6U. View abstract.
Carlson LA, Rosenhamer G. Reduction of mortality in the Stockholm Ischaemic Heart Disease Secondary Prevention Study by combined treatment with clofibrate and nicotinic acid. Acta Med Scand. 1988;223(5):405-18. View abstract.
Cases S, Smith SJ, Zheng YW, et al. Identification of a gene encoding an acyl CoA:diacylglycerol acyltransferase, a key enzyme in triacylglycerol synthesis. Proc Natl Acad Sci U S A. 1998;95(22):13018-23. View abstract.
Cashin-Hemphill L, Spencer CA, Nicoloff JT, et al. Alterations in serum thyroid hormonal indices with colestipol-niacin therapy. Ann Intern Med. 1987;107(3):324-9. View abstract.
Charland SL, Malone DC. Prediction of cardiovascular event risk reduction from lipid changes associated with high potency dyslipidemia therapy. Curr Med Res Opin. 2010;26(2):365-75. View abstract.
Chesney CM, Elam MB, Herd JA, et al. Effect of niacin, warfarin, and antioxidant therapy on coagulation parameters in patients with peripheral arterial disease in the Arterial Disease Multiple Intervention Trial (ADMIT). Am Heart J 2000;140:631-6.. View abstract.
Cheung MC, Zhao XQ, Chait A, et al. Antioxidant supplements block the response of HDL to simvastatin-niacin therapy in patients with coronary artery disease and low HDL. Arterioscler Thromb Vasc Biol 2001;21:1320-6. View abstract.
Crouse JR III. New developments in the use of niacin for treatment of hyperlipidemia: new considerations in the use of an old drug. Coron Artery Dis 1996;7:321-6. View abstract.
Cumming RG, Mitchell P, Smith W. Diet and cataract: the Blue Mountains Eye Study. Ophthalmology 2000;10:450-6. View abstract.
Darvay A, Basarab T, McGregor JM, Russell-Jones R. Isoniazid induced pellagra despite pyridoxine supplementation. Clin Exp Dermatol 1999;24:167-9. View abstract.
Datta S, Das DK, Engelman RM, et al. Enhanced myocardial preservation by nicotinic acid, an antilipolytic compound: mechanism of action. Basic Res Cardiol. 1989;84(1):63-76. View abstract.
Davidson MH, Rooney M, Pollock E, Drucker J, Choy Y. Effect of colesevelam and niacin on low-density lipoprotein cholesterol and glycemic control in subjects with dyslipidemia and impaired fasting glucose. J Clin Lipidol. 2013 Sep-Oct;7(5):423-32. View abstract.
Dearing BD, Lavie CJ, Lohmann TP, Genton E. Niacin-induced clotting factor synthesis deficiency with coagulopathy. Arch Intern Med. 1992;152(4):861-3. View abstract.
Ding RW, Kolbe K, Merz B, et al. Pharmacokinetics of nicotinic acid-salicylic acid interaction. Clin Pharmacol Ther 1989;46:642-7. View abstract.
Drinka PJ. Alterations in thyroid and hepatic function tests associated with preparations of sustained-release niacin. Mayo Clin Proc. 1992;67(12):1206. View abstract.
Dubé MP, Wu JW, Aberg JA, et al. Safety and efficacy of extended-release niacin for the treatment of dyslipidaemia in patients with HIV infection: AIDS Clinical Trials Group Study A5148. Antivir Ther. 2006;11(8):1081-9. View abstract.
Duggal JK, Singh M, Attri N, et al. Effect of niacin therapy on cardiovascular outcomes in patients with coronary artery disease. J Cardiovasc Pharmacol Ther. 2010;15(2):158-66. View abstract.
Dunn RT, Ford MA, Rindone JP, Kwiecinski FA. Low-Dose Aspirin and Ibuprofen Reduce the Cutaneous Reactions Following Niacin Administration. Am J Ther. 1995;2(7):478-480. View abstract.
Elam MB, Hunninghake DB, Davis KB, et al. Effect of niacin on lipid and lipoprotein levels and glycemic control in patients with diabetes and peripheral arterial disease: the ADMIT study: A randomized trial. Arterial Disease Multiple Intervention Trial. JAMA. 2000;284(10):1263-70. View abstract.
Etchason JA, Miller TD, Squires RW, et al. Niacin-induced hepatitis: a potential side effect with low-dose time-release niacin. Mayo Clin Proc. 1991;66(1):23-8. View abstract.
Figge HL, Figge J, Souney PF, et al. Comparison of excretion of nicotinuric acid after ingestion of two controlled release nicotinic acid preparations in man. J Clin Pharmacol. 1988 Dec;28(12):1136-40. View abstract.
Figge HL, Figge J, Souney PF, et al. Nicotinic acid: a review of its clinical use in the treatment of lipid disorders. Pharmacotherapy 1988;8:287-94. View abstract.
Food and Nutrition Board, Institute of Medicine. Dietary Reference Intakes for Thiamin, Riboflavin, Niacin, Vitamin B6, Folate, Vitamin B12, Pantothenic Acid, Biotin, and Choline (2000). Washington, DC: National Academy Press, 2000. Available at: https://books.nap.edu/books/0309065542/html/.
Fraunfelder FW, Fraunfelder FT, Illingworth DR. Adverse ocular effects associated with niacin therapy. Br J Ophthalmol 1995;79:54-56.
Gadegbeku CA, Dhandayuthapani A, Shrayyef MZ, Egan BM. Hemodynamic effects of nicotinic acid infusion in normotensive and hypertensive subjects. Am J Hypertens. 2003;16(1):67-71. View abstract.
Ganji SH, Tavintharan S, Zhu D, Xing Y, Kamanna VS, Kashyap ML. Niacin noncompetitively inhibits DGAT2 but not DGAT1 activity in HepG2 cells. J Lipid Res. 2004;45(10):1835-45. View abstract.
Garg A, Grundy SM. Nicotinic acid as therapy for dyslipidemia in non-insulin-dependent diabetes mellitus. JAMA 1990;264:723-6. View abstract.
Garg R, Malinow MR, Pettinger M, et al. Niacin treatment increases plasma homocysteine levels. Am Heart J 1999;138:1082-7. View abstract.
Garnett WR. Interactions with hydroxymethylglutaryl-coenzyme A reductase inhibitors. Am J Health Syst Pharm. 1995;52(15):1639-45. View abstract.
Gaynon MW, Paulus YM, Rahimy E, Alexander JL, Mansour SE. Effect of oral niacin on central retinal vein occlusion. Graefes Arch Clin Exp Ophthalmol. 2017 Jun;255(6):1085-92. View abstract.
Gerber MT, Mondy KE, Yarasheski KE, et al. Niacin in HIV-infected individuals with hyperlipidemia receiving potent antiretroviral therapy. Clin Infect Dis. 2004;39(3):419-25. View abstract.
Gharavi AG, Diamond JA, Smith DA, Phillips RA. Niacin-induced myopathy. Am J Cardiol. 1994;74(8):841-2. View abstract.
Gibbons LW, Gonzalez V, Gordon N, Grundy S. The prevalence of side effects with regular and sustained-release nicotinic acid. Am J Med 1995;99:378-85. View abstract.
Gillman MA, Sandyk R. Nicotinic acid deficiency induced by sodium valproate (letter). S Afr Med J 1984;65:986. View abstract.
Goldberg A, Alagona P Jr, Capuzzi DM, et al. Multiple-dose efficacy and safety of an extended-release form of niacin in the management of hyperlipidemia. Am J Cardiol. 2000;85(9):1100-5. View abstract.
Goldberg AC. A meta-analysis of randomized controlled studies on the effects of extended-release niacin in women. Am J Cardiol. 2004;94(1):121-4. View abstract.
Goldie C, Taylor AJ, Nguyen P, McCoy C, Zhao XQ, Preiss D. Niacin therapy and the risk of new-onset diabetes: a meta-analysis of randomized controlled trials. Heart. 2016 Feb;102(3):198-203. View abstract.
Gray DR, Morgan T, Chretien SD, Kashyap ML. Efficacy and safety of controlled-release niacin in dyslipoproteinemic veterans. Ann Intern Med 1994;121:252-8. View abstract.
Guyton JR, Blazing MA, Hagar J, et al. Extended-release niacin vs gemfibrozil for the treatment of low levels of high-density lipoprotein cholesterol. Niaspan-Gemfibrozil Study Group. Arch Intern Med 2000;160:1177-84. View abstract.
Guyton JR, Fazio S, Adewale AJ, Jensen E, Tomassini JE, Shah A, Tershakovec AM. Effect of extended-release niacin on new-onset diabetes among hyperlipidemic patients treated with ezetimibe/simvastatin in a randomized controlled trial. Diabetes Care. 2012 Apr;35(4):857-60. View abstract.
Guyton JR, Goldberg AC, Kreisberg RA, et al. Effectiveness of once-nightly dosing of extended-release niacin alone and in combination for hypercholesterolemia. Am J Cardiol 1998;82:737-43. View abstract.
Hardman JG, Limbird LL, Molinoff PB, eds. Goodman and Gillman's The Pharmacological Basis of Therapeutics, 9th ed. New York, NY: McGraw-Hill, 1996.
Hendricks WM. Pellagra and pellagralike dermatoses: etiology, differential diagnosis, dermatopathology, and treatment. Semin Dermatol 1991;10:282-92. View abstract.
Henkin Y, Johnson KC, Segrest JP. Rechallenge with crystalline niacin after drug-induced hepatitis from sustained-release niacin. JAMA. 1990;264(2):241-3. View abstract.
Henkin Y, Oberman A, Hurst DC, Segrest JP. Niacin revisited: clinical observations on an important but underutilized drug. Am J Med. 1991;91(3):239-46. View abstract.
Hoskin PJ, Stratford MR, Saunders MI, et al. Administration of nicotinamide during chart: pharmacokinetics, dose escalation, and clinical toxicity. Int J Radiat Oncol Biol Phys 1995;32:1111-9. View abstract.
Illingworth DR, Stein EA, Mitchel YB, et al. Comparative effects of lovastatin and niacin in primary hypercholesterolemia. A prospective trial. Arch Intern Med 1994;154:1586-95. View abstract.
Ioannides-Demos LL, Christophidis N, et al. Dosing implications of a clinical interaction between grapefruit juice and cyclosporine and metabolite concentrations in patients with autoimmune diseases. J Rheumatol 1997;24:49-54. View abstract.
Ishii N, Nishihara Y. Pellagra encephalopathy among tuberculous patients: its relation to isoniazid therapy. J Neurol Neurosurg Psychiatry 1985;48:628-34. View abstract.
Ito MK. Advances in the understanding and management of dyslipidemia: using niacin-based therapies. Am J Health-Syst Pharm 2003;60(suppl 2):s15-21. View abstract.
Jarrett P, Duffill M, Oakley A, Smith A. Pellagra, azathioprine and inflammatory bowel disease. Clin Exp Dermatol 1997;22:44-5. View abstract.
Jenkins DJA, Spence JD, Giovannucci EL, et al. Supplemental vitamins and minerals for CVD prevention and treatment. J Am Coll Cardiol 2018;71(22):2570-84. View abstract.
Jin FY, Kamanna VS, Kashyap ML. Niacin decreases removal of high-density lipoprotein apolipoprotein A-I but not cholesterol ester by Hep G2 cells. Implication for reverse cholesterol transport. Arterioscler Thromb Vasc Biol. 1997;17(10):2020-8. View abstract.
Johansson JO, Egberg N, Asplund-Carlson A, Carlson LA. Nicotinic acid treatment shifts the fibrinolytic balance favourably and decreases plasma fibrinogen in hypertriglyceridaemic men. J Cardiovasc Risk 1997;4:165-71. View abstract.
Jungnickel PW, Maloley PA, Vander Tuin EL, et al. Effect of two aspirin pretreatment regimens on niacin-induced cutaneous reactions. J Gen Intern Med 1997;12:591-6. View abstract.
Kahn SE, Beard JC, Schwartz MW, et al. Increased B-cell secretory capacity as mechanism for islet adaptation to nicotinic acid-induced insulin resistance. Diabetes 1989;38:562-8. View abstract.
Karpe F, Frayn KN. The nicotinic acid receptor--a new mechanism for an old drug. Lancet. 2004;363(9424):1892-4. View abstract.
Karthikeyan K, Thappa DM. Pellagra and skin. Int J Dermatol 2002;41:476-81. View abstract.
Kaur S, Goraya JS, Thami GP, Kanwar AJ. Pellagrous dermatitis induced by phenytoin (letter). Pediatr Derm 2002;19:93. View abstract.
Keene D, Price C, Shun-Shin MJ, Francis DP. Effect on cardiovascular risk of high density lipoprotein targeted drug treatments niacin, fibrates, and CETP inhibitors: meta-analysis of randomised controlled trials including 117,411 patients. BMJ. 2014 Jul 18;349:g4379. View abstract.
Kei A, Liberopoulos EN, Mikhailidis DP, Elisaf M. Comparison of switch to the highest dose of rosuvastatin vs. add-on nicotinic acid vs. add-on fenofibrate for mixed dyslipidaemia. Int J Clin Pract. 2013 May;67(5):412-9. View abstract.
Knodel LC, Talbert RL. Adverse effects of hypolipidaemic drugs. Med Toxicol 1987;2:10-32. View abstract.
Knopp RH, Alagona P, Davidson M, et al. Equivalent efficacy of a time-release form of niacin (Niaspan) given once-a-night versus plain niacin in the management of hyperlipidemia. Metabolism 1998;47:1097-104. View abstract.
Knopp RH. Clinical profiles of plain versus sustained-release niacin (Niaspan) and the physiologic rationale for nighttime dosing. Am J Cardiol 1998;82:24U-28U;discussion 39U-41U. View abstract.
Lakey WC, Greyshock N, Guyton JR. Adverse reactions of Achilles tendon xanthomas in three hypercholesterolemic patients after treatment intensification with niacin and bile acid sequestrants. J Clin Lipidol. 2013 Mar-Apr;7(2):178-81. View abstract.
Lal SM, Hewett JE, Petroski GF, et al. Effects of nicotinic acid and lovastatin in renal transplant patients: a prospective, randomized, open-labeled crossover trial. Am J Kidney Dis 1995;25:616-22. View abstract.
Lavigne PM, Karas RH. The current state of niacin in cardiovascular disease prevention: a systematic review and meta-regression. J Am Coll Cardiol. 2013 Jan 29;61(4):440-6. View abstract.
Leighton RF, Gordon NF, Small GS, et al. Dental and gingival pain as side effects of niacin therapy. Chest 1998;114:1472-4. View abstract.
Litin SC, Anderson CF. Nicotinic acid-associated myopathy: a report of three cases. Am J Med. 1989;86(4):481-3. View abstract.
Litin SC, Anderson CF. Nicotinic acid-associated myopathy: a report of three cases. Am J Med. 1989;86(4):481-3.View abstract.
Lloyd-Jones DM, Morris PB, Ballantyne CM, et al. 2016 ACC Expert consensus decision rathway on the role of non-statin therapies for LDL-cholesterol lowering in the management of atherosclerotic cardiovascular disease risk: a report of the American College of Cardiology task force on clinical expert consensus documents. J Am Coll of Cardiol 2016;68(1):92-125. View abstract.
Loebl T, Raskin S. A novel case report: acute manic psychotic episode after treatment with niacin. J Neuropsychiatry Clin Neurosci. 2013 Fall;25(4):E14. View abstract.
Ludwig GD, White DC. Pellagra induced by 6-mercaptopurine. Clin Res 1960;8:212.
Lyon VB, Fairley JA. Anticonvulsant-induced pellagra. J Am Acad Dermatol 2002;46:597-9. View abstract.
Mack WJ, Selzer RH, Hodis HN, et al. One-year reduction and longitudinal analysis of carotid intima-media thickness associated with colestipol/niacin therapy. Stroke. 1993;24(12):1779-83. View abstract.
Maes BD, Hiele MI, Geypens BJ, et al. Pharmacological modulation of gastric emptying rate of solids as measured by the carbon labelled octanoic acid breath test: influence of erythromycin and propantheline. Gut 1994;35(3):333-7. View abstract.
Malfait P, Moren A, Dillon JC, et al. An outbreak of pellagra related to changes in dietary niacin among Mozambican refugees in Malawi. Int J Epidemiol. 1993;22(3):504-11. View abstract.
McKenney J. New perspectives on the use of niacin in the treatment of lipid disorders. Arch Intern Med 2004;164:697-705. View abstract.
McKenney JM, Proctor JD, Harris S, Chinchili VM. A comparison of the efficacy and toxic effects of sustained- vs immediate-release niacin in hypercholesterolemic patients. JAMA 1994;271:672-7. View abstract.
Menon RM, Adams MH, González MA, Tolbert DS, Leu JH, Cefali EA. Plasma and urine pharmacokinetics of niacin and its metabolites from an extended-release niacin formulation. Int J Clin Pharmacol Ther. 2007;45(8):448-54. View abstract.
Miralbell R, Mornex F, Greiner R, et al. Accelerated radiotherapy, carbogen, and nicotinamide in glioblastoma multiforme: report of European Organization for Research and Treatment of Cancer trial 22933. J Clin Oncol 1999;17:3143-9. View abstract.
Montserrat-de la Paz S, Lopez S, Bermudez B, et al. Effects of immediate-release niacin and dietary fatty acids on acute insulin and lipid status in individuals with metabolic syndrome. J Sci Food Agric 2018;98(6):2194-200. View abstract.
Morgan JM, Capuzzi DM, Baksh RI, et al. Effects of extended-release niacin on lipoprotein subclass distribution. Am J Cardiol. 2003;91(12):1432-6. View abstract.
Morgan JM, Capuzzi DM, Guyton JR, et al. Treatment Effect of Niaspan, a Controlled-release Niacin, in Patients With Hypercholesterolemia: A Placebo-controlled Trial. J Cardiovasc Pharmacol Ther. 1996;1(3):195-202. View abstract.
Morris MC, Evans DA, Bianias JL, et al. Dietary niacin and the risk of incident Alzheimer's disease and of cognitive decline. J Neurol Neurosurg Psychiatry 2004;75:1093-99. View abstract.
Mrochek JE, Jolley RL, Young DS, Turner WJ. Metabolic response of humans to ingestion of nicotinic acid and nicotinamide. Clin Chem. 1976;22(11):1821-7. View abstract.
Nahata MC. Chloramphenicol. In: Evans WE, Schentag JJ, Jusko WJ (eds). Applied Pharmacokinetics: Principles of Therapeutic Drug Monitoring. 3rd ed., Vancouver, WA: Applied Therapeutics, Inc., 1992.
National Cholesterol Education Program. Cholesterol Lowering in the Patient with Coronary Heart Disease. 1997. Available at: <a href="https://www.vidyya.com/pdfs/1225cholesterol.pdf" target="_blank">https://www.vidyya.com/pdfs/1225cholesterol.pdf</a>. (Accessed 26 May 2016).
Neuvonen PJ, Roivas L, Laine K, Sundholm O. The bioavailability of sustained release nicotinic acid formulations. Br J Clin Pharmacol. 1991;32(4):473-6. View abstract.
Ng CF, Lee CP, Ho AL, Lee VW. Effect of niacin on erectile function in men suffering erectile dysfunction and dyslipidemia. J Sex Med. 2011;8(10):2883-93. View abstract.
Niaspan [package insert]. Barcelona, Spain: AbbVie LTD; 2015.
NIH News. NIH stops clinical trial on combination cholesterol treatment. May 26, 2011. https://www.nih.gov/news/health/may2011/nhlbi-26.htm. (Accessed 3 June 2011).
O'Brien T, Silverberg JD, Nguyen TT. Nicotinic acid-induced toxicity associated with cytopenia and decreased levels of thyroxine-binding globulin. Mayo Clin Proc. 1992;67(5):465-8. View abstract.
O'REILLY PO, CALLBECK MJ, HOFFER A. Sustained-release nicotinic acid (nicospan); effect on (1) cholesterol levels and (2) leukocytes. Can Med Assoc J. 1959;80(5):359-62. View abstract.
Papa CM. Niacinamide and acanthosis nigricans (letter). Arch Dermatol 1984;120:1281. View abstract.
Park YK, Sempos CT, Barton CN, et al. Effectiveness of food fortification in the United States: the case of pellagra. Am J Public Health 2000;90:727-38. View abstract.
Philpott AC, Hubacek J, Sun YC, Hillard D, Anderson TJ. Niacin improves lipid profile but not endothelial function in patients with coronary artery disease on high dose statin therapy. Atherosclerosis. 2013 Feb;226(2):453-8. View abstract.
PL Detail-Document, Niacin Plus Statin to Reduce Cardiovascular Risk: AIM-HIGH Study. Pharmacist's Letter/Prescriber's Letter. July 2011.
PL Detail-Document, Role of Non-Statins for Dyslipidemia. Pharmacist's Letter/Prescriber's Letter. June 2016;32(6):320601.
Pozzilli P, Browne PD, Kolb H. Meta-analysis of nicotinamide treatment in patients with recent-onset IDDM. The Nicotinamide Trialists. Diabetes Care 1996;19:1357-63. View abstract.
Product information: Niaspan. Kos Pharmaceuticals. Cranbury, NJ. 2005. Available at www.niaspan.com/professional/content/pdfs/productinfo.pdf. (Accessed 3 March 2006).
Rabbani GH, Butler T, Bardhan PK, Islam A. Reduction of fluid-loss in cholera by nicotinic acid: a randomized controlled trial. Lancet 1983;2:1439-42. View abstract.
Rader JI, Calvert RJ, Hathcock JN. Hepatic toxicity of unmodified and time-release preparations of niacin. Am J Med 1992;92:77-81. View abstract.
Raising HDL and Niacin Use. Pharmacist's Letter/Prescriber's Letter 2004;20(5):200504.
Reaven P, Witztum JL. Lovastatin, nicotinic acid and rhabdomyolysis (letter). Ann Int Med 1988;109:597-8. View abstract.
Reimund E. Sleep deprivation-induced dermatitis: further support of nicotinic acid depletion in sleep deprivation. Med Hypotheses 1991;36:371-3. View abstract.
Sahebkar A, Reiner Z, Simental-Mendia LE, Ferretti G, Cicero AF. Effect of extended-release niacin on plasma lipoprotein(a) levels: A systematic review and meta-analysis of randomized placebo-controlled trials. Metabolism. 2016 Nov;65(11):1664-78. View abstract.
Sampathkumar K, Selvam M, Sooraj YS, Gowthaman S, Ajeshkumar RN. Extended release nicotinic acid - a novel oral agent for phosphate control. Int Urol Nephrol. 2006;38(1):171-4. View abstract.
Schandelmaier S, Briel M, Saccilotto R, Olu KK, Arpagaus A, Hemkens LG, Nordmann AJ. Niacin for primary and secondary prevention of cardiovascular events. Cochrane Database Syst Rev. 2017 Jun 14;6:CD009744. View abstract.
Schwab RA, Bachhuber BH. Delirium and lactic acidosis caused by ethanol and niacin coingestion. Am J Emerg Med 1991;9:363-5. View abstract.
Zhang Z, Liu M, Zhou C, et al. Evaluation of Dietary Niacin and New-Onset Hypertension Among Chinese Adults. JAMA Netw Open. 2021;4(1):e2031669. View abstract.
Zhao XQ, Brown BG, Hillger L, et al. Effects of intensive lipid-lowering therapy on the coronary arteries of asymptomatic subjects with elevated apolipoprotein B. Circulation 1993;88:2744-53. View abstract.
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