What is niacin (nicotinic acid)?
Niacin, also called nicotinic acid, is a B vitamin (vitamin B3). It occurs naturally in
plants and animals, and is also added to many foods as a vitamin supplement. Niacin is also
present in many multiple vitamins and nutritional supplements.
Niacin is used to treat and prevent a lack of natural niacin in the body, and to lower
cholesterol and triglycerides (types of fat) in the blood. It is also used to lower the risk of heart
attack in people with high cholesterol who have already had a heart attack. Niacin is sometimes
used to treat coronary artery disease (also called atherosclerosis).
Niacin may also be used for purposes other than those listed in this medication guide.
What should I discuss with my healthcare provider before taking niacin (nicotinic acid)?
Do not take this medication if you are allergic to niacin, or if you have severe liver
disease, a stomach ulcer, or active bleeding.
Before taking niacin, tell your doctor if you are allergic to any drugs, or if you have:
If you have any of these conditions, you may not be able to use niacin,
or you may need dosage adjustments or special tests during treatment.
FDA pregnancy category C. Niacin may be harmful to an unborn baby when the
medication is taken at doses to treat high cholesterol or other conditions. Tell your doctor if you
are pregnant or plan to become pregnant during treatment.
Niacin can pass into breast milk and may harm a nursing baby. Do not use this
medication without telling your doctor if you are breast-feeding a baby.
How should I take niacin (nicotinic acid)?
Take this medication exactly as it was prescribed for you. Do not take the medication in
larger amounts, or take it for longer than recommended by your doctor. Follow the directions on
your prescription label.
Niacin is sometimes taken at bedtime with a low-fat snack. Follow your doctor's
instructions.
Niacin can cause certain side effects, such as flushing (warmth, itching, redness, or tingly
feeling under your skin). These effects can be made worse if you drink alcohol or hot beverages
shortly after you take niacin. These effects should disappear over time as you keep taking the
medication.
Take niacin with a full glass of cold or cool water. Taking the medication with a hot
drink may increase your risk of side effects such as flushing.
Do not crush, chew, break, or open an extended-release tablet or capsule. Swallow
the pill whole. It is specially made to release medicine slowly in the body. Breaking or opening
the pill would cause too much of the drug to be released at one time.
Niacin extended-release tablets and capsules contain higher strengths of the medicine
than the regular niacin tablets. Take only the dose that is correct for the type of niacin tablet or
capsule you are using.
Niacin can cause you to have unusual results with certain medical tests (urine tests). Tell
any doctor who treats you that you are using niacin.
If you stop taking niacin for any length of time, talk with your doctor before starting the
medication again. You may need to restart the medication at a lower dose.
Niacin is only part of a complete program of treatment that may also include diet,
exercise, weight control, and other medications. Follow your diet, medication, and exercise
routines very closely.
To be sure this medication is not causing harmful effects, your blood will need to be
tested on a regular basis. Your kidney or liver function may also need to be tested. Do not miss
any scheduled appointments.
Store niacin at room temperature away from moisture and heat.
What happens if I miss a dose of niacin (nicotinic acid)?
Take the missed dose as soon as you remember. Be sure to take the missed dose with
food if you normally take your niacin dose with a meal or snack.
If it is almost time for your next dose, skip the missed dose and take the medicine at your
next regularly scheduled time.
Do not
take extra medicine to make up the
missed dose.
Where can I get more information about niacin (nicotinic acid)?
Your pharmacist has information about niacin (nicotinic acid) written for health professionals that you may read.
What are the possible side effects of niacin (nicotinic acid)?
Get emergency medical help if you have any of these
signs of an allergic
reaction:
hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
Call your doctor at once if you have any of these serious side effects:
-
feeling light-headed, fainting;
-
fast, pounding, or uneven heart beats;
-
feeling short of breath;
-
swelling;
-
jaundice (yellowing of your skin or eyes); or
-
muscle pain, tenderness, or weakness with fever or flu
symptoms and dark colored urine.
If you are diabetic, tell your doctor about any changes in your
blood sugar levels.
Less serious side effects of niacin include:
-
mild dizziness;
-
warmth, redness, or tingly feeling under your skin;
-
itching, dry skin;
-
sweating or chills;
-
nausea, diarrhea, belching, gas;
-
muscle pain, leg cramps; or
-
sleep problems (insomnia).
This is not a complete list of side effects and others may occur. Tell
your doctor about any unusual or bothersome side effect. You may report side effects to FDA at 1-800-FDA-1088.
What is the most important information I should know about niacin (nicotinic acid)?
Do not take this medication if you are allergic to niacin, or if you have severe liver
disease, a stomach ulcer, or active bleeding.
Niacin can cause certain side effects, such as flushing (warmth, itching, redness, or tingly
feeling under your skin). These effects can be made worse if you drink alcohol or hot beverages
shortly after you take niacin. These effects should disappear over time as you keep taking the
medication.
Avoid getting up too fast from a sitting or lying position, or you may feel dizzy. Get up
slowly and steady yourself to prevent a fall.
Avoid taking colestipol (Colestid) or cholestyramine (Locholest, Prevalite, Questran) at
the same time you take niacin. If you take either of these other medications, take them at least 4
to 6 hours before or after you take niacin.
Niacin is only part of a complete program of treatment that may also include diet,
exercise, weight control, and other medications. Follow your diet, medication, and exercise
routines very closely.
What should I avoid while taking niacin (nicotinic acid)?
Avoid drinking hot beverages shortly after taking niacin. Hot drinks can worsen niacin's
flushing effect (warmth, itching, redness, or tingly feeling under your skin).
Avoid drinking alcohol while taking niacin. Alcohol may increase your risk of liver
damage, and can also worsen the flushing effects of niacin.
Avoid taking colestipol (Colestid) or cholestyramine (Locholest, Prevalite, Questran) at
the same time you take niacin. If you take either of these other medications, take them at least 4
to 6 hours before or after you take niacin.
Avoid getting up too fast from a sitting or lying position, or you may feel dizzy. Get up
slowly and steady yourself to prevent a fall.
What other drugs will affect niacin (nicotinic acid)?
Tell your doctor about all other cholesterol-lowering drugs you are taking with niacin,
especially atorvastatin (Lipitor), fluvastatin (Lescol), lovastatin (Mevacor), pravastatin
(Pravachol), or simvastatin (Zocor).
Before taking niacin, tell your doctor if you are also using any of the following drugs:
-
a blood thinner such as warfarin (Coumadin);
-
multivitamins or mineral supplements that contain niacin;
-
blood pressure or heart medications such as amlodipine
(Norvasc), diltiazem (Tiazac, Cartia, Cardizem), felodipine (Plendil), nicardipine (Cardene),
nifedipine (Procardia, Adalat), nimodipine (Nimotop), nisoldipine (Sular), or verapamil (Calan,
Covera, Isoptin, Verelan); or
-
heart medications such as doxazosin (Cardura), isosorbide
(Dilatrate, Imdur, Isordil, Monoket, Sorbitrate), nitroglycerin (Nitro-Bid, Nitro-Dur, Nitrostat),
prazosin (Minipress), or terazosin (Hytrin).
This list is not complete and there may be other drugs that can interact
with niacin. Tell your doctor about all the prescription and over-the-counter medications you
use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors.
Do not start using a new medication without telling your doctor.
What happens if I have an overdose of niacin (nicotinic acid)?