Niacin Interactions

Niacin can have possible interaction with other medications or drugs you may be taking. If you are currently taking any of the following, you should talk with your doctor before taking Niacin.

Blood thinners
Niacin can potentially increase the effect of these medications, increasing the risk of bleeding.

Alpha blockers and blood pressure medications
Niacin can increase the effectiveness of medications taken to lower blood pressure.

Statins 
Some studies indicate taking niacin with simvastatin (Zocor) appears to slow down the progression of heart disease. However, the combination may also increase the likelihood for serious side effects, such as muscle inflammation or liver damage. If you are taking a statin, consult with your doctor before taking any Niacin supplement.


Cholesterol-lowering medications 
Niacin binds the cholesterol lowering medications known as bile-acid sequestrants and may make them less effective. Bile-acid sequestrants include colestipol (Colestid), colesevelam (Welchol), and cholestyramine (Questran). Take niacin and these medications at different times of the day (not together).

Tetracycline 
Don't take Niacin at teh same time as the antibiotic tetracycline, Niacin can interfere with absorption and effectiveness. All vitamin B complex supplements should be taken at different times from tetracycline.  Niacin in the morning, tetracycline in the evening for example.

Anti-seizure medications
Phenytoin (Dilantin) and valproic acid (Depakote) have been associated with Niacin deficiency in some people. Taking Niacin with carbamazepine (Tegretol) or mysoline (Primidone) may increase levels of these medications in the body.
  Diabetes medications
Niacin has the potential to increase blood sugar levels. People taking medications used to treat high blood glucose levels should closely monitor blood sugar levels when taking Niacin.

Nicotine patches 
Using nicotine patches while taking Niacin can increase the potential of experiencing a Niacin flush.


Isoniazid (INH)
INH is a medicine used to treat tuberculosis and can cause Niacin deficiency.

Some medications can lower Niacin levels:

• Fluorouracil 
• Cycloserine (Seromycin) 
• Mercaptopurine (Purinethol) 
• Azathioprine (Imuran) 
• Levodopa and carbidopa 
• Chloramphenicol (Chloromycetin)

 If you're taking one of these medication, discus the need for a Niacin supplement with your doctor.

Niacin Side Effects

Studies have show Niacin (nicotinic acid, AKA Bitamin B3) to be a very effective supplement for improving your cholesterol profile by increasing high density lipoproteins (HDL) and lower very low density lipoproteins (VLDL) and low density lipoproteins (LDL). This can reduce the risk of heart attack or stroke.

Niacin also help the body convert food into energy, use fats and proteins, promote healthy skin, hair, eyes and liver, and assist the function of the nervous system. Niacin is water soluble, meaning the body doesn't store it and must get it from the diet.

Niacin, however, is not without its side effects. The most common side effect is called niacin flush, which is a burning, tingling sensation in the skin, mainly in the and upper chest. The skin may also become very flushed. There are things you can do to help prevent or reduce the niacin flush.

At very high doses (2,000mg daily or more), niacin can be associated with liver damage and stomach ulcers. If you are using high dose Niacin for cholesterol control, make sure you get your liver function checked on a regular basis. 

If you have a history of kidney disease, liver disease, or stomach ulcers, consult with your doctor before taking Niacin. Same goes if you have diabetes or gallbladder disease.

Niacin can make gout and diabetes worse.

In some people, Niacin has been know to cause a drop on blood pressure. If you already have low blood pressure, consult with your doctor before taking Niacin.

Serious side effects of Niacin include:

• feeling light headed or dizzy, as though you might pass out
• irregular heart beats, or a fast, pounding heart rate
• shortness of breath or difficulty breathing
• swelling, especially in the facial area
• jaundice (yellowing of hte skin or eyes)
• muscle pain, tenderness, or weakness with fever
• dark urine

If you have any of the above side effects, you should seek a doctor's assistance.

Niacin can have less serious side effects as well:

• mild dizziness or feeling light-headed
• warmth, redness, or tingly feeling
• itching, sweating or chills
• nausea, diarrhea, belching, gas
• muscle pain and leg cramps
• insomnia

Talking Niacin with food and plenty of liquid can help prevent some of these less serious side effects.

Don't let the above scare you away. Niacin is a very good supplement, and is the best out there for raising HDL and lowering triglycerides. Most people tolerate it fine.

How to Stop the Niacin Flush

If you've ever taken Niacin, then you've probably experienced the Niacin flush. Although not dangerous, it can be so uncomfortable for some people that they stop taking Niacin, missing out on all the benefits Niacin has.There are some things you can do to limit the flush, or prevent it all together. Niacin is such a great supplement, especially because of it's ability to help improve a person's cholesterol profile.

First, a word about no-flush Niacin. You've probably heard of this, but what you probably haven't heard is the no-flush Niacin is not actually Niacin (nicotinic acid), but is instead an isomer of Niacin called inositol hexanicotinate. Inositol hexanicotinate does not impart the same benefits for your cholesterol, so taking it would be useless for that purpose.

Some things you can do to help prevent or reduce the Niacin flush

1. Start with lower doses and work your way up. Start with very small amounts of niacin and gradually increase. One method might be to start with a 25mg three times a day, such as with each meal. The next day, try 50mg at breakfast, 25mg at lunch and 25mg at supper. The day after that, take 50mg with breakfast, 50mg with lunch, and 25mg at supper. The next day, 50mg at each meal. Then 75mg, 50mg and 50mg, then 75mg, 65mg, 50mg, and so on.The most effective benefits from Niacin for cholesterol usually start around 1,500mg a day, which would be 500mg with each meal. Work with your doctor to figure out what daily dose works best for you. I, personally, take 2,000mg a day - 1,000mg in the morning and 1,000mg in the evening. I still get the flush, but I'm used to it now and it no longer bothers me.
   
2. Niacin supplements are available in regular and a timed-release form. Timed-release versions of Niacin are supposed to help people avoid the flush effect. The problem with most time-release Niacin supplements is that they have been associated with liver problems.The time-release forms of nicotinic acid formulated in a way that the niacin is slowly released as the tablet travels through the intestines. Unfortunately, this means the liver is constantly processing niacin, and, for some individuals, this can cause liver issues. Be aware that if you take time-release Niacin, your doses should be approximately half what you would take with a quick release version. Also know that a time-release version of Niacin may only delay the flush, not prevent it!
3. Try taking a 325mg dose of aspirin (1 tablet) 15 to 30 minutes before you take your Niacin. Studies have indicated taking an aspirin before taking the Niacin can decrease the flushing and itching. Know that this doesn't work for everyone and while it might reduce the effects of the flush, it probably won't completely prevent it.
4. Take Niacin on a full stomach or with a meal. This can lessen or even prevent the flush completely, mainly because it slows the absorption of Niacin. Be aware though that sometimes taking Niacin with a meal might only delay the flush effect, causing it to occur much later. So don't panic if you start experiencing the flush and hour or even longer after taking the Niacin on a full stomach.
5. Drink a lot of water. Some people claim that drinking 12 - 16 ounces of water when taking your Niacin dose can help prevent or limit the flush. personally, this method has been hit or miss for me, so I can't attest to it's effectiveness.
6. A new study appearing in the online edition January 29, 2009 of the British Journal of Pharmacology reveals that the supplement quercetin is a very efficient flush-blocker when teamed with niacin. Quercetin is a common bioflavonoid found in apples, buckwheat, tea and onions. It is associated with protection from cancer, and blocks the release of histamine, making it an ideal allergy blocker. In the experiment, the quercetin was injected, so it remains to be seen if oral dosing will have the same benefits, but it's worth a try if you're taking niacin and are bothered by flushing. Two 500 mg capsules of quercetin an hour or so before niacin dosing might work.

Ultimately, there might be nothing you can do to completely prevent the Niacin flush, but although the saying "no pain, no gain" isn't always true, in this case it might be.The health benefits Niacin offers might be worth enduring it's most notorious side effect.

Niacin Flush

Research has established that niacin can improve your cholesterol profile by increasing high density lipoproteins (HDL - the good cholesterol) and lowering very low density lipoproteins (VLDL) and low density lipoproteins (LDL), both of which are considered the "bad" cholesterol and can contribute to cardiovascular disease. Some additional benefits of Niacin have also been discovered: it has been shown to reduce anxiety and depression, help you relax, and contribute to better sleep.

Anyone who's take a substantial dose of Niacin (nicotinic acid, not inositol hexanicotinate), usually in the range of 500mg or more, has probably experienced what is called the "Niacin flush". The Niacin flush is a warm, sometimes itchy or prickly feeling that comes over the skin with 10 - 30 minutes after taking a Niacin dose. The feeling is often accompanied by a noticeable red flushing of the skin, especially of the face, upper chest, and shoulders, although it can include the whole body. In some cases, the flush can be very uncomfortable, and may even be accompanied by a increased heart rate, sweating, extreme itching, and dizziness.

It can last a few minutes, or up to 30 minutes or even longer, depending on the dose, an individual's sensitivity, whether or not it's taken on an empty stomach, and other factors.When a person first starts taking Niacin, the flush is typically more pronounced and can accompany even small doses.

What causes the Niacin flush?

Niacin causes blood vessels on the surface of the skin, called capillaries, to dilate (expand in size). This allows more blood flow to the surface of the skin, which is what causes the blushing or reddening. This increased blood flow helps these cells get rid of waste products. In response to these waste products entering the blood stream, the body then produces histamine. It's this histamine that causes the tingly, itchy feeling.

While the flush response to high-dose Niacin may be alarming, it is completely harmless. In fact,  niacin is sometimes recommended to help with circulation in conditions like Raynaud's syndrome.

But even though it's harmless, it can be uncomfortable and distracting. And people might very well be wondering why you're walking around glowing like you just got a bad sunburn! There are a few things you can try to help prevent the Niacin flush.