The Who, What, Where, When and Sometimes, Why.

Niacinamide

Niacin and Niacinamide Vitamin B3

What is it?

 

There are two forms of vitamin B3. One form is niacin, the other is niacinamide. Niacinamide is found in many foods including yeast, meat, fish, milk, eggs, green vegetables, beans, and cereal grains. Niacinamide is also found in many vitamin B complex supplements with other B vitamins. Niacinamide can also be formed in the body from dietary niacin.

Do not confuse niacinamide with niacin, NADH, nicotinamide riboside, inositol nicotinate, or tryptophan. See the separate listings for these topics.

Niacinamide is taken by mouth for preventing vitamin B3 deficiency and related conditions such as pellagra. It is also taken by mouth for acne, diabetes, oral cancer, osteoarthritis, and many other conditions. However, there is no good scientific evidence to support these uses. 

Niacinamide is also applied to the skin for acne, eczema, and other skin conditions. There is also no good evidence to support these uses.

 

Natural Medicines 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 Niacinamide are as follows:

Likely Effective for…

  • A disease cause by niacin deficiency  (pellagra ). Niacinamide is approved by the U.S. Food and Drug Administration (FDA) for these uses. Niacinamide is sometimes preferred over niacin because it does not cause “flushing,” (redness, itching and tingling), a side effect of niacin treatment.

Possibly Effective for…

  • Acne. Early research shows that taking tablets containing niacinamide and other ingredients for 8 weeks improves skin appearance in people with acne. Other research shows that applying a cream containing niacinamide improves the appearance of skin in people with acne.
  • Diabetes. Some research shows that taking niacinamide might help prevent the loss of insulin production in children and adults at risk for type 1 diabetes. It might also prevent the loss of insulin production and reduce the dose of insulin needed by children recently diagnosed with type 1 diabetes. However, niacinamide does not seem to prevent the development of type 1 diabetes in at-risk children. In people with type 2 diabetes, niacinamide seems to help protect insulin production and improve blood sugar control.
  • High levels of phosphate in the blood (hyperphosphatemia). High blood levels of phosphate can be caused by reduced kidney function. In people with kidney failure who are on hemodialysis and have high levels of blood phosphate, taking niacinamide seems to help decrease phosphate levels when taken with or without phosphate binders.
  • Head and neck cancer. Research shows that taking niacinamide while receiving radiotherapy and a type of treatment called carbogen might help control tumor growth and increase survival in some people with cancer of the larynx. Taking niacinamide while receiving radiotherapy and carbogen seems to benefit people with cancer of the larynx who are also anemic. It also seems to help people who have tumors that are deprived of oxygen.
  • Skin cancer. Taking niacinamide seems to help prevent new skin cancer or precancerous spots (actinic keratosis) from forming in people with a history of skin cancer or actinic keratosis.
  • Osteoarthritis. Taking niacinamide seems to improve joint flexibility and reduce pain and swelling in people with osteoarthritis. Also, some people with osteoarthritis who take niacinamide might need to take fewer pain medications.

Possibly Ineffective for…

  • Brain tumor. Early research shows that treating people with surgically removed brain tumors with niacinamide, radiotherapy, and carbogen does not improve survival compared to radiotherapy or radiotherapy and carbogen.
  • Bladder cancer. Treating people with bladder cancer with niacinamide, radiotherapy, and carbogen does not appear to decrease tumor growth or improve survival compared to radiotherapy or radiotherapy and carbogen.

Insufficient Evidence to Rate Effectiveness for…

  • An eye disease that leads to vision loss in older adults (age-related macular degeneration or AMD). Early research suggests that taking niacinamide, vitamin E, and lutein for a year improves how well the retina works in people with age-related vision loss due to retina damage.
  • Aging skin. Early research shows that taking niacinamide, vitamin E, and lutein for almost a year improves how well the retina works in people with age-related vision loss due to retina damage.
  • Eczema (atopic dermatitis). Early research shows that applying cream containing 2% niacinamide decreases water loss and improves hydration, and reduces redness and scaling, in people with eczema.
  • Attention deficit-hyperactivity disorder (ADHD). There is conflicting evidence regarding the usefulness of niacinamide in combination with other vitamins for the treatment of ADHD.
  • Skin redness caused by injury or irritation (erythema). Early research shows that applying a cream containing niacinamide reduces skin redness, dryness, and itching caused by the acne medication isotretinoin.
  • Long-term kidney disease (chronic kidney disease or CKD). Early research shows that taking niacinamide does not help reduce itchiness in people with kidney disease.
  • Dark skin patches on the face (melasma). Early research shows that applying moisturizer containing 5% niacinamide or 2% niacinamide with 2% tranexamic acid for 4-8 weeks helps lighten skin in people with darkened patches of skin.
  • Cancer that starts in white blood cells (non-Hodgkin lymphoma). Early research shows that taking niacinamide as part of treatment with a drug called vorinostat might help people with lymphoma go in to remission.
  • A skin condition that causes redness on the face (rosacea). Early research shows that taking tablets containing niacinamide and other ingredients for 8 weeks improves skin appearance in people with rosacea.
  • Rough, scaly skin on the scalp and face (seborrheic dermatitis). Early research shows that applying a cream containing 4% niacinamide can reduce redness and scaling of the skin in people with seborrheic dermatitis.
  • Alcoholism.
  • Alzheimer disease .
  • Arthritis.
  • Decline in memory and thinking skills that occur normally with age.
  • Depression.
  • High blood pressure.
  • Motion sickness.
  • Premenstrual syndrome (PMS).
  • Other conditions.

More evidence is needed to rate niacinamide for these uses.

Niacinamide can be made from niacin in the body. Niacin is converted to niacinamide when it is taken in amounts greater than what is needed by the body. Niacinamide is easily dissolved in water and is well-absorbed when taken by mouth.

Niacinamide is required for the proper function of fats and sugars in the body and to maintain healthy cells.

Unlike niacin, niacinamide has no beneficial effects on fats and should not be used for treating high cholesterol or high fat levels in the blood.

When taken by mouth: Niacinamide is LIKELY SAFE for most adults . Unlike niacin, niacinamide does not cause flushing. However, niacinamide might cause minor side effects such as stomach upset, gas, dizziness, rash, itching, and other problems .

When doses of over 3 grams per day of niacinamide are taken, more serious side effects can happen. These include liver problems or high blood sugar.

When applied to the skin: Niacinamide is POSSIBLY SAFE . Niacinamide cream might cause mild burning, itching, or redness.

Special Precautions & Warnings:

Pregnancy and breast-feeding: Niacinamide is 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 years of age.

Children: Niacinamide is POSSIBLY SAFE when taken by mouth in the recommended amounts for children. 

Allergies: Niacinamide can make allergies more severe because they cause histamine, the chemical responsible for allergic symptoms, to be released.

Diabetes: Niacinamide might increase blood sugar. People with diabetes who take niacinamide should check their blood sugar carefully.

Gallbladder disease: Niacinamide might make gallbladder disease worse.

Gout: Large amounts of niacinamide might bring on gout.

Kidney dialysis: Taking niacinamide seems to increase the risk of low blood-platelet levels in people with kidney failure who are on dialysis. 

Liver disease: Niacinamide might increase liver damage. Don’t use it if you have liver disease.

Stomach or intestinal ulcers: Niacinamide might make ulcers worse. Don’t use it if you have ulcers.

Surgery: Niacinamide might interfere with blood sugar control during and after surgery. Stop taking niacinamide at least 2 weeks before a scheduled surgery.

Carbamazepine (Tegretol)

Interaction Rating = Moderate Be cautious with this combination. Talk to your health provider.

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.

Medications that can harm the liver (Hepatotoxic drugs)

Interaction Rating = Moderate Be cautious with this combination. Talk to your health provider.

Niacinamide might harm the liver, especially when used in high doses. Taking niacinamide along with medication that might also harm the liver can increase the risk of liver damage. Do not take niacinamide 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 to your health provider.

Niacinamide might slow blood clotting. Taking niacinamide 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.

Primidone (Mysoline)

Interaction Rating = Moderate Be cautious with this combination.
Talk with your health provider.

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.

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.

There are no known interactions with foods.

 

ADULT

BY MOUTH:

  • For preventing and treating vitamin B3 deficiency and pellagra: For mild vitamin B3 deficiency, 50-100 mg per day of niacinamide is used. For pellagra, 300-500 mg per day of niacinamide is given in divided doses.
  • To slow disease progression of newly diagnosed type 1 diabetes: 25 mg/kg of niacinamide is used daily.
  • For treating type 2 diabetes: 0.5 grams of niacinamide three times daily for 6 months has been used.
  • For treating osteoarthritis: 3 grams of niacinamide per day in divided doses for 12 weeks.

CHILDREN

BY MOUTH:

  • For pellagra: 100-300 mg of niacinamide is given daily in divided doses.
  • To prevent type 1 diabetes in high-risk children: 1.2 grams/m² (body surface area) of sustained-release niacinamide is used daily.
  • To slow disease progression of newly diagnosed type 1 diabetes: Niacinamide 25 mg/kg daily.

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 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.

 

3-Pyridine Carboxamide, Amide de l’Acide Nicotinique, B Complex Vitamin, Complexe de Vitamines B, Niacinamida, Nicamid, Nicosedine, Nicotinamide, Nicotinic Acid Amide, Nicotylamidum, Vitamin B3, Vitamina B3, Vitamine B3.


 

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