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Niacin Brand Names
Niacor | Niaspan | Nicomide-T | Slo-Niacin
What is Niacin
Niacin (nicotinic acid or 3-pyridinecarboxylic acid) is a B-complex vitamin.
Good dietary sources of niacin are animal proteins, beans, green vegetables, liver, mushrooms, peanuts, whole wheat, and unpolished rice. Niacin is also present in cereal grains but is largely bound to plant proteins, and thus is poorly absorbed after ingestion.
Niacin is one of the substances used in the enrichment of refined flour, and our dietary intake of pre-formed niacin comes primarily from enriched grains. However, the body’s niacin requirement is also met by the biosynthesis of niacin from tryptophan, an amino acid.
For example, milk and eggs do not contain niacin, but do contain large amounts of tryptophan from which niacin is derived.
Each 60 mg of excess tryptophan (after protein synthesis) is converted to approximately 1 mg of niacin. Synthesis of the vitamin from tryptophan in proteins supplies roughly half the niacin requirement in man.
Iron-deficiency or inadequate pyridoxine or riboflavin status will decrease the conversion of tryptophan to niacin and may contribute to deficiency, due to an interdependence of coenzymes in the niacin production pathway.
A late and serious manifestation of niacin deficiency is pellagra, a clinical symptom complex principally affecting the GI tract, skin, and CNS, producing symptoms of diarrhea, dermatitis, and dementia, respectively.
Pellagra may result from a niacin- and protein-deficient diet, isoniazid therapy, or certain diseases that result in poor utilization of tryptophan.
Pellagra was the only vitamin-deficiency disease to ever reach epidemic proportions in the US; pellagra is rare today in industrialized countries due to the enrichment of refined flours.
Indications
- atherosclerosis
- hyperlipoproteinemia
- hypertriglyceridemia
- myocardial infarction prophylaxis
- nutritional supplementation
- pellagra
- peripheral vascular disease (PVD)
- tinnitus
For the treatment of clinical manifestations of pellagra
Side Effects
- abdominal pain
- anaphylactoid reactions
- angina
- angioedema
- asthenia
- atrial fibrillation
- blurred vision
- bullous rash
- chills
- cough
- diabetes mellitus
- diaphoresis
- diarrhea
- dizziness
- dyspepsia
- dyspnea
- edema
- elevated hepatic enzymes
- eructation
- fatigue
- flatulence
- flushing
- gout
- headache
- hepatic failure
- hepatic necrosis
- hepatitis
- hyperglycemia
- hyperuricemia
- hypophosphatemia
- hypotension
- insomnia
- jaundice
- laryngeal edema
- laryngospasm
- macular edema
- maculopapular rash
- muscle cramps
- myalgia
- myasthenia
- myopathy
- nausea
- orthostatic hypotension
- palpitations
- paresthesias
- peptic ulcer
- peripheral edema
- peripheral vasodilation
- pruritus
- rash
- renal tubular obstruction
- rhabdomyolysis
- sinus tachycardia
- skin hyperpigmentation
- syncope
- thrombocytopenia
- urticaria
- vesicular rash
- vomiting
- weakness
- xerosis
Monitoring Parameters
- blood glucose
- LFTs
- serum uric acid
Contraindications
- acute myocardial infarction
- alcoholism
- angina
- anticoagulant therapy
- bleeding
- breast-feeding
- children
- coagulopathy
- diabetes mellitus
- driving or operating machinery
- gallbladder disease
- geriatric
- gout
- hepatic disease
- hypophosphatemia
- hypotension
- infants
- neonates
- orthostatic hypotension
- peptic ulcer disease
- pregnancy
- renal disease
- renal failure
- renal impairment
- rhabdomyolysis
- surgery
- thrombocytopenia
Patients who have a known hypersensitivity to niacin or any product component should not be given the drug.
Interactions
- Acarbose
- Acetohexamide
- Albiglutide
- Alogliptin
- Alogliptin; Metformin
- Alogliptin; Pioglitazone
- Alpha-blockers
- Alpha-glucosidase Inhibitors
- Amlodipine; Atorvastatin
- Angiotensin II receptor antagonists
- Angiotensin-converting enzyme inhibitors
- Aspirin, ASA; Pravastatin
- Atorvastatin
- Atorvastatin; Ezetimibe
- Beta-blockers
- Bile acid sequestrants
- Calcium-channel blockers
- Canagliflozin
- Canagliflozin; Metformin
- Carbamazepine
- Central-acting adrenergic agents
- Cerivastatin
- Chlorpropamide
- Dapagliflozin
- Dapagliflozin; Metformin
- Dapagliflozin; Saxagliptin
- Dulaglutide
- Empagliflozin
- Empagliflozin; Linagliptin
- Empagliflozin; Linagliptin; Metformin
- Empagliflozin; Metformin
- Eplerenone
- Epoprostenol
- Ertugliflozin; Metformin
- Ertugliflozin; Sitagliptin
- Ethanol
- Exenatide
- Ezetimibe; Simvastatin
- Fluvastatin
- Glimepiride
- Glimepiride; Pioglitazone
- Glimepiride; Rosiglitazone
- Glipizide
- Glipizide; Metformin
- Glyburide
- Glyburide; Metformin
- Iloprost
- Incretin Mimetics
- Insulin Degludec; Liraglutide
- Insulin Glargine; Lixisenatide
- Insulins
- Linagliptin
- Linagliptin; Metformin
- Liraglutide
- Lixisenatide
- Loop diuretics
- Lovastatin
- Lovastatin; Niacin
- Mecamylamine
- Metformin
- Metformin; Pioglitazone
- Metformin; Repaglinide
- Metformin; Rosiglitazone
- Metformin; Saxagliptin
- Metformin; Sitagliptin
- Miglitol
- Nateglinide
- Niacin; Simvastatin
- Pitavastatin
- Potassium-sparing diuretics
- Pramlintide
- Pravastatin
- Red Yeast Rice
- Repaglinide
- Reserpine
- Rosuvastatin
- Saxagliptin
- Semaglutide
- Simvastatin
- Simvastatin; Sitagliptin
- Sitagliptin
- Sulfonylureas
- Telbivudine
- Thiazide diuretics
- Thiazolidinediones
- Tolazamide
- Tolbutamide
- Treprostinil
- Vasodilators
- Warfarin
