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Niacin And Niacinamide (Vitamin B3)

IN THIS ARTICLE

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).



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.



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

Taking niacin along with gemfibrozil might cause muscle damage in some people. Use with caution.



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

Use of high doses of niacin (about 3-4 grams daily) might increase blood sugar. By increasing blood sugar, niacin 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 for high blood pressure (Antihypertensive drugs)
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

Using niacin with drugs that lower blood pressure may increase the effects of these drugs and may lower blood pressure too much.

Some medications for high blood pressure include captopril (Capoten), enalapril (Vasotec), losartan (Cozaar), valsartan (Diovan), diltiazem (Cardizem), amlodipine (Norvasc), hydrochlorothiazide (HydroDIURIL), furosemide (Lasix), and many others.



Medications that can harm the liver (Hepatotoxic drugs)
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

Niacin might harm the liver. Sustained-release niacin preparations seem to have the greatest risk. Taking niacin along with medication that might also harm the liver can increase the risk of liver damage. Do not take niacin if you are taking a medication that can harm the liver.

Some medications that can harm the liver include acetaminophen (Tylenol and others), amiodarone (Cordarone), carbamazepine (Tegretol), isoniazid (INH), methotrexate (Rheumatrex), methyldopa (Aldomet), fluconazole (Diflucan), itraconazole (Sporanox), erythromycin (Erythrocin, Ilosone, others), phenytoin (Dilantin), lovastatin (Mevacor), pravastatin (Pravachol), simvastatin (Zocor), and many others.



Medications that slow blood clotting (Anticoagulant / Antiplatelet drugs)
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

Niacin might slow blood clotting. Taking niacin along with medications that also slow clotting might increase the chances of bruising and bleeding.

Some medications that slow blood clotting include aspirin, clopidogrel (Plavix), dalteparin (Fragmin), enoxaparin (Lovenox), heparin, indomethacin (Indocin), ticlopidine (Ticlid), warfarin (Coumadin), 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 the body absorbs. This might reduce the effectiveness of niacin. Take niacin 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).



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).



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

The body naturally produces thyroid hormones. Niacin might decrease thyroid hormone levels. Taking niacin with thyroid hormone pills might decrease the effects and side effects of thyroid hormone.



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. However, 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.

The following doses have been studied in scientific research:

ADULTS

BY MOUTH:
  • For high cholesterol: The effects of niacin are dose-dependent. Doses of niacin have been as low as 50 mg and as high as 12 grams each day have been used. However,But tThe most common doses are between 1-3 grams daily.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. Niacin may be 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, dose of about 1000-4200 mg1-4 grams of niacin daily, alone or along with statins or bile acid sequestrantscholesterol-lowering medicine, has beenis most commonly 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 it is taken Niacin 2 grams daily, alone or at this dosage along with 4 grams of prescription omega-3 ethyl esters (Lovaza, GlaxoSmithKline Pharmaceuticals)
BY IV:
  • For preventing and treating vitamin B3 deficiency and related conditions such as pellagra: 60 mg of niacin has been used.
AS A SHOT:
  • For preventing and treating vitamin B3 deficiency and related conditions such as pellagra: 60 mg of niacin has been used.
CHILDREN

BY MOUTH:
  • For preventing and treating vitamin B3 deficiency and related conditions such as pellagra: 100-300 mg per day of niacin, given in divided doses.
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 tolerable upper level (UL) for 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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Report Problems to the Food and Drug Administration

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.



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