What is it?
Niacin is used for high cholesterol. It is also used along with other treatments for circulation problems, migraine headache, dizziness, and to reduce the diarrhea associated with cholera. Niacin is also used for preventing positive urine drug screens in people who take illegal drugs.
Niacinamide is used for treating diabetes and two skin conditions called bullous pemphigoid and granuloma annulare.
Niacin or niacinamide is used for preventing vitamin B3 deficiency and related conditions such as pellagra. Each of these forms of vitamin B3 is used for schizophrenia, hallucinations due to drugs, Alzheimer’s disease and age-related loss of thinking skills, chronic brain syndrome, depression, motion sickness, alcohol dependence, and fluid collection (edema).
Some people use niacin or niacinamide for acne, leprosy, attention deficit-hyperactivity disorder (ADHD), memory loss, arthritis, preventing premenstrual headache, improving digestion, protecting against toxins and pollutants, reducing the effects of aging, lowering blood pressure, improving circulation, promoting relaxation, improving orgasm, and preventing cataracts.
Niacinamide is applied to the skin for treating a skin condition called inflammatory acne vulgaris.
How effective is it?
Natural Medicines Comprehensive Database rates effectiveness based on scientific evidence according to the following scale: Effective, Likely Effective, Possibly Effective, Possibly Ineffective, Likely Ineffective, Ineffective, and Insufficient Evidence to Rate.
The effectiveness ratings for NIACIN AND NIACINAMIDE (VITAMIN B3) are as follows:
Likely effective for...
- High cholesterol. Only niacin seems to lower cholesterol, not niacinamide. Some niacin products are FDA-approved prescription products for treating high cholesterol. These prescription niacin products typically come in high strengths of 500 mg or higher. Dietary supplement forms of niacin usually come in strengths of 250 mg or less. Since very high doses of niacin are required for high cholesterol, dietary supplement niacin usually isn’t appropriate.
- Treatment and prevention of niacin deficiency, and certain conditions related to niacin deficiency such as pellagra. Both niacin and niacinamide are approved by the U.S. Food and Drug Administration (FDA) for these uses. Niacinamide is sometimes preferred because it doesn’t cause “flushing,” (redness, itching and tingling), a side effect of niacin treatment.
Possibly effective for...
- Osteoarthritis. Taking niacinamide seems to improve joint flexibility and reduce pain and swelling. Some people who take niacinamide might be able to cut down on standard painkilling medications.
- Alzheimer’s disease. People who consume higher amounts of niacin from food and multivitamin sources seem to have a lower risk of getting Alzheimer’s disease than people who consume less niacin. But there is no evidence that taking a stand-alone niacin supplement helps to prevent Alzheimer’s disease.
- Hardening of the arteries (atherosclerosis).
- Reducing the risk of a second heart attack in men with heart or circulatory disorders.
- Diarrhea from an infection called cholera.
- Diabetes, types 1 and 2.
- Prevention and treatment of cataracts, an eye condition.
Insufficient evidence to rate effectiveness for...
- Attention deficit-hyperactivity disorder (ADHD). There is conflicting evidence regarding the usefulness of niacinamide in combination with other vitamins for the treatment of ADHD.
- Migraine headache.
- Motion sickness.
- Alcohol dependence.
- Improving orgasm.
- Other conditions.
How does it work?
Niacin and niacinamide are required for the proper function of fats and sugars in the body and to maintain healthy cells. At high doses, niacin and niacinamide can have different effects. 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. Niacinamide has no beneficial effects on fats and should not be used for treating high cholesterol or high fat levels 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 foods 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.
Are there safety concerns?
Other minor side effects of niacin and niacinamide 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. Similar side effects can happen with large doses of niacinamide.
Some concern has been raised about stroke risk in people taking niacin. In one large study, people who took high doses of niacin had a two-fold greater risk of stroke compared to those not taking niacin. But it is unclear if this outcome was due to niacin or some other unknown factor. Previous research has not identified any stroke risk related to taking niacin. Most experts believe that it is too soon to jump to any conclusions about niacin and strokes.
Niacinamide is POSSIBLY SAFE when used appropriately in children.
Special precautions & warnings:Pregnancy and breast-feeding: Niacin and niacinamide are LIKELY SAFE for pregnant and breast-feeding women when taken in the recommended amounts. The recommended amount of niacin for pregnant or breast-feeding women is 30 mg per day for women under 18 years of age, and 35 mg for women over 18.
Allergies: Niacin and niacinamide can make allergies more severe because they cause histamine, the chemical responsible for allergic symptoms, to be released. .
Heart disease/unstable angina: Large amounts of niacin and niacinamide can increase the risk of irregular heartbeat. Use with caution.
Diabetes: Niacin and niacinamide might increase blood sugar. People with diabetes who take niacin or niacinamide should check their blood sugar carefully.
Gallbladder disease: Niacin and niacinamide might make gallbladder disease worse.
Gout: Large amounts of niacin or niacinamide might bring on gout.
Low blood pressure: Don’t take niacin or niacinamide if you have low blood pressure. Your blood pressure might drop too much.
Liver disease: Niacin or niacinamide might increase liver damage. Don’t use them if you have liver disease.
Kidney disease: Niacin might accumulate in people with kidney disease and cause harm. Don’t use them if you have kidney disease.
Stomach or intestinal ulcers: Niacin or niacinamide might make ulcers worse. Don’t use them if you have ulcers.
Surgery: Niacin and niacinamide might interfere with blood sugar control during and after surgery. Stop taking niacin or niacinamide at least 2 weeks before a scheduled surgery.
Are there interactions with medications?
- Alcohol (Ethanol)
- 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)
- Allopurinol (Zyloprim) is used to treat gout. Taking large doses of niacin might worsen gout and decrease the effectiveness of allopurinol (Zyloprim).
- Carbamazepine (Tegretol)
- 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)
- 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)
- 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)
- 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)
- 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)
- 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 is used to treat gout. Taking large doses of niacin might worsen gout and decrease the effectiveness of probenecid.
- Sulfinpyrazone (Anturane)
- Sulfinpyrazone (Anturane) is used to treat gout. Taking large doses of niacin might worsen gout and decrease the effectiveness of sulfinpyrazone (Anturane).
- 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)
- 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.
Are there interactions with herbs and supplements?
- A combination of niacin and the prescription drug simvastatin (Zocor) raises HDL (high density lipoprotein) cholesterol ("good cholesterol") in people with coronary heart disease and low HDL levels. But taking niacin along with combinations of antioxidants (selenium, vitamin C, vitamin E, and beta-carotene) seems to blunt this rise in HDL. It is not known whether this effect happens in people who don't have coronary heart disease.
- Taking niacin and chromium together might lower blood sugar. If you have diabetes and take chromium and niacin supplements together, monitor your blood sugar to make sure it doesn't get too low.
- Herbs and supplements that might harm the liver
- Niacin, especially in higher doses can cause liver damage. Taking niacin along with other herbs or supplements that might harm the liver could increase this risk. Some of these products include androstenedione, borage leaf, chaparral, comfrey, dehydroepiandrosterone (DHEA), germander, kava, pennyroyal oil, red yeast, and others.
- Kombucha tea
- There is some concern that kombucha tea might decrease niacin absorption. But this needs to be studied more.
- The body can make niacin. People who are malnourished and have niacin deficiency, such as chronic alcoholics, make extra niacin if they take zinc. There might be an increased risk of niacin-related side effects such as flushing and itching if niacin and zinc are taken together.
Are there interactions with foods?
- Hot drinks
- Niacin can cause flushing and itching. These effects might be increased if niacin is taken with a hot drink.
What dose is used?
- 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.
To learn more about how this article was written, please see the Natural Medicines Comprehensive Database methodology.
- FDA statement on the AIM-HIGH trial. http://www.fda.gov/Drugs/DrugSafety/ PostmarketDrugSafetyInformationforPatientsand Providers/ucm256841.htm. (Accessed 3 June 2011).
- NIH News. NIH stops clinical trial on combination cholesterol treatment. May 26, 2011. http://www.nih.gov/news/health/may2011/nhlbi-26.htm. (Accessed 3 June 2011).
- PL Detail-Document, Niacin Plus Statin to Reduce Cardiovascular Risk: AIM-HIGH Study. Pharmacist's Letter/Prescriber's Letter. July 2011.
- Karthikeyan K, Thappa DM. Pellagra and skin. Int J Dermatol 2002;41:476-81. View abstract.
- Hendricks WM. Pellagra and pellagralike dermatoses: etiology, differential diagnosis, dermatopathology, and treatment. Semin Dermatol 1991;10:282-92. 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.
- 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.
- Jorgensen J. Pellagra probably due to pyrazinamide: development during combined chemotherapy of tuberculosis. Int J Dermatol 1983;22:44-5. 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.
- Lyon VB, Fairley JA. Anticonvulsant-induced pellagra. J Am Acad Dermatol 2002;46:597-9. View abstract.
- Kaur S, Goraya JS, Thami GP, Kanwar AJ. Pellagrous dermatitis induced by phenytoin (letter). Pediatr Derm 2002;19:93. View abstract.
- Wood B, Rademaker M, Oakley A, Wallace J. Pellagra in a woman using alternative remedies. Australas J Dermatol 1998;39:42-4. View abstract.
- Bender DA, Russell-Jones R. Isoniazid-induced pellagra despite vitamin B6 supplementation (letter). Lancet 1979;2:1125-6. View abstract.
- Stevens H, Ostlere L, Begent R, et al. Pellagra secondary to 5-fluorouracil. Br J Dermatol 1993;128:578-80. View abstract.
- Swash M, Roberts AH. Reversible pellagra-like encephalopathy with ethionamide and cycloserine. Tubercle 1972;53:132. 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.
- 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.
- Ludwig GD, White DC. Pellagra induced by 6-mercaptopurine. Clin Res 1960;8:212.
- Stratigos JD, Katsambas A. Pellagra: a still existing disease. Br J Dermatol 1977;96:99-106. 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.
- Visalli N, Cavallo MG, Signore A, et al. A multi-centre randomized trial of two different doses of nicotinamide in patients with recent-onset type 1 diabetes (the IMDIAB VI). Diabetes Metab Res Rev 1999;15:181-5. View abstract.
- Product information: Niaspan. Kos Pharmaceuticals. Cranbury, NJ. 2005. Available at www.niaspan.com/professional/content/pdfs/productinfo.pdf. (Accessed 3 March 2006).
- Schwab RA, Bachhuber BH. Delirium and lactic acidosis caused by ethanol and niacin coingestion. Am J Emerg Med 1991;9:363-5. 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.
- Reaven P, Witztum JL. Lovastatin, nicotinic acid and rhabdomyolysis (letter). Ann Int Med 1988;109:597-8. View abstract.
- Rockwell KA. Potential interaction between niacin and transdermal nicotine (letter). Ann Pharmacother 1993;27:1283-4. View abstract.
- Bourgeois BF, Dodson WE, Ferrendelli JA. Interactions between primidone, carbamazepine, and nicotinamide. Neurology 1982;32:1122-6. View abstract.
- Gillman MA, Sandyk R. Nicotinic acid deficiency induced by sodium valproate (letter). S Afr Med J 1984;65:986. View abstract.
- Papa CM. Niacinamide and acanthosis nigricans (letter). Arch Dermatol 1984;120:1281. View abstract.
- Winter SL, Boyer JL. Hepatic toxicity from large doses of vitamin B3 (nicotinamide). N Engl J Med 1973;289:1180-2. 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.
- McKenney J. New perspectives on the use of niacin in the treatment of lipid disorders. Arch Intern Med 2004;164:697-705. View abstract.
- Raising HDL and Niacin Use. Pharmacist's Letter/Prescriber's Letter 2004;20:200504.
- 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.
- Fatigante L, Ducci F, Cartei F, et al. Carbogen and nicotinamide combined with unconventional radiotherapy in glioblastoma multiforme: a new modality treatment. Int J Radiat Oncol Biol Phys 1997;37:499-504. 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.
- Anon. Niacinamide Monograph. Alt Med Rev 2002;7:525-9. View abstract.
- Schwartz ML. Severe reversible hyperglycemia as a consequence of niacin therapy. Arch Int Med 1993;153:2050-2. 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.
- 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.
- 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.
- Bays HE, Dujovne CA. Drug interactions of lipid-altering drugs. Drug Saf 1998;19:355-71. 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.
- 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.
- 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.
- Haslam RH, Dalby JT, Rademaker AW. Effects of megavitamin therapy on children with attention deficit disorders. Pediatrics 1984;74:103-11.. 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.
- 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.
- Brown BG, Zhao XQ, Chait A. Simvastatin and niacin, antioxidant vitamins, or the combination for the prevention of coronary disease. N Engl J Med 2001;345:1583-93. View abstract.
- Cumming RG, Mitchell P, Smith W. Diet and cataract: the Blue Mountains Eye Study. Ophthalmology 2000;10:450-6. View abstract.
- Kuroki F, Iida M, Tominaga M, et al. Multiple vitamin status in Crohn's disease. Correlation with disease activity. Dig Dis Sci 1993;38:1614-8. 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 . Washington, DC: National Academy Press, 2000. Available at: http://books.nap.edu/books/0309065542/html/.
- Shalita AR, Smith JG, Parish LC, et al. Topical nicotinamide compared with clindamycin gel in the treatment of inflammatory acne vulgaris. Int J Dermatol 1995;34:434-7. View abstract.
- American Dietetic Association Website. Available at: www.eatright.org/adap1097.html (Accessed 16 July 1999).
- 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.
- 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.
- 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.
- 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.
- 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.
- McCarty MF, Russell AL. Niacinamide therapy for osteoarthritis--does it inhibit nitric oxide synthase induction by interleukin 1 in chondrocytes? Med Hypotheses 1999;53:350-60. View abstract.
- Jonas WB, Rapoza CP, Blair WF. The effect of niacinamide on osteoarthritis: a pilot study. Inflamm Res 1996;45:330-4. View abstract.
- Polo V, Saibene A, Pontiroli AE. Nicotinamide improves insulin secretion and metabolic control in lean type 2 diabetic patients with secondary failure to sulphonylureas. Acta Diabetol 1998;35:61-4. View abstract.
- Greenbaum CJ, Kahn SE, Palmer JP. Nicotinamide's effects on glucose metabolism in subjects at risk for IDDM. Diabetes 1996;45:1631-4. View abstract.
- 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.
- Pozzilli P, Visalli N, Signore A, et al. Double blind trial of nicotinamide in recent-onset IDDM (the IMDIAB III study). Diabetologia 1995;38:848-52. View abstract.
- Visalli N, Cavallo MG, Signore A, et al. A multi-centre randomized trial of two different doses of nicotinamide in patients with recent-onset type 1 diabetes (the IMDIAB VI). Diabetes Metab Res Rev 1999;15:181-5. View abstract.
- Pozzilli P, Visalli N, Cavallo MG, et al. Vitamin E and nicotinamide have similar effects in maintaining residual beta cell function in recent onset insulin-dependent diabetes. Eur J Endocrinol 1997;137:234-9. View abstract.
- Reimers JI, Andersen HU, Pociot F. [Nicotinamide and prevention of insulin-dependent diabetes mellitus. Rationale, effects, toxicology and clinical experiences. ENDIT Group]. Ugeskr Laeger 1994;156:461-5. View abstract.
- Lampeter EF, Klinghammer A, Scherbaum WA, et al. The Deutsche Nicotinamide Intervention Study: an attempt to prevent type 1 diabetes. DENIS Group. Diabetes 1998;47:980-4. View abstract.
- Elliott RB, Pilcher CC, Fergusson DM, Stewart AW. A population based strategy to prevent insulin-dependent diabetes using nicotinamide. J Pediatr Endocrinol Metab 1996;9:501-9. View abstract.
- Gale EA. Theory and practice of nicotinamide trials in pre-type 1 diabetes. J Pediatr Endocrinol Metab 1996;9:375-9. View abstract.
- Kolb H, Burkart V. Nicotinamide in type 1 diabetes. Mechanism of action revisited. Diabetes Care 1999;22:B16-20. 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.
- Briend A, Nath SK, Heyman M, Desjeux JF. Comparative effects of nicotinic acid and nicotinamide on cholera toxin-induced secretion in rabbit ileum. J Diarrhoeal Dis Res 1993;11:97-100. View abstract.
- 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.
- National Cholesterol Education Program. Cholesterol Lowering in the Patient with Coronary Heart Disease. 1997. Available at: http://www.nhlbi.nih.gov/health/prof/heart/chol/chol_low.pdf.
- Darvay A, Basarab T, McGregor JM, Russell-Jones R. Isoniazid induced pellagra despite pyridoxine supplementation. Clin Exp Dermatol 1999;24:167-9. 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.
- 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.
- Garg A, Grundy SM. Nicotinic acid as therapy for dyslipidemia in non-insulin-dependent diabetes mellitus. JAMA 1990;264:723-6. 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.
- 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.
- 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.
- 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.
- 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.
- 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.
- 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.
- 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.
- 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.
- 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.
- 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.
- 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.
- 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.
- 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.
- Knodel LC, Talbert RL. Adverse effects of hypolipidaemic drugs. Med Toxicol 1987;2:10-32. View abstract.
- Brenner A. The effects of megadoses of selected B complex vitamins on children with hyperkinesis: controlled studies with long-term follow-up. J Learn Disabil 1982;15:258-64. View abstract.
- Shils ME, Olson JA, Shike M, Ross AC, eds. Modern Nutrition in Health and Disease. 9th ed. Baltimore, MD: Williams & Wilkins, 1999.
- Garg R, Malinow M, Pettinger M. Niacin treatment increases plasma homocyst(e)ine levels. Am Heart J 1999;138:1082-7. 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.
- Hardman JG, Limbird LL, Molinoff PB, eds. Goodman and Gillman's The Pharmacological Basis of Therapeutics, 9th ed. New York, NY: McGraw-Hill, 1996.
- Garg R, Malinow MR, Pettinger M, et al. Niacin treatment increases plasma homocysteine levels. Am Heart J 1999;138:1082-7. View abstract.
- McKevoy GK, ed. AHFS Drug Information. Bethesda, MD: American Society of Health-System Pharmacists, 1998.