A 2010 review had concluded that niacin was effective as a mono-therapy, but a 2017 review incorporating twice as many trials concluded that prescription niacin, while affecting lipid levels, did not reduce all-cause mortality, cardiovascular mortality, myocardial infarctions, nor fatal or non-fatal strokes. Despite the proven lipid changes, niacin has not been found useful for decreasing the risk of cardiovascular disease in those already on a statin. Immediate-release doses can be as high as 3,000 mg/day sustained-release as high as 2,000 mg/day. Initial prescription amounts are 500 mg/day, increased over time until a therapeutic effect is achieved. There are two forms: immediate-release and sustained-release niacin. Amounts far in excess of the recommended dietary intake for vitamin functions will lower blood triglycerides and low density lipoprotein cholesterol (LDL-C), and raise blood high density lipoprotein cholesterol (HDL-C, often referred to as "good" cholesterol). Niacin is also a prescription medication. Nicotinamide is recommended as a treatment for niacin deficiency because it can be administered in remedial amounts without causing the flushing, considered an adverse effect. Although niacin and nicotinamide are identical in their vitamin activity, nicotinamide does not have the same pharmacological, lipid-modifying effects or side effects as niacin, i.e., when niacin takes on the -amide group, it does not reduce cholesterol nor cause flushing. The amide derivative nicotinamide (niacinamide) is a component of the coenzymes nicotinamide adenine dinucleotide (NAD) and nicotinamide adenine dinucleotide phosphate (NADP+). Many countries mandate its addition to wheat flour or other food grains, thereby reducing the risk of pellagra. Signs and symptoms of pellagra include skin and mouth lesions, anemia, headaches, and tiredness. Niacin as a dietary supplement is used to treat pellagra, a disease caused by niacin deficiency. Niacin is obtained in the diet from a variety of whole and processed foods, with highest contents in fortified packaged foods, meat, poultry, red fish such as tuna and salmon, lesser amounts in nuts, legumes and seeds. It can be manufactured by plants and animals from the amino acid tryptophan. You may report side effects to the FDA at 1-80.Niacin, also known as nicotinic acid, is an organic compound and a form of vitamin B 3, an essential human nutrient. If you notice any other effects, check with your healthcare professional.Ĭall your doctor for medical advice about side effects. Other side effects not listed may also occur in some patients. Reddish purple lines on the arms, face, legs, trunk, or groin Large, flat, blue or purplish patches in the skin Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them: Incidence not knownĪbnormal fat deposits on the face, neck, and trunk Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. These side effects may go away during treatment as your body adjusts to the medicine. Some side effects may occur that usually do not need medical attention. Vomiting of material that looks like coffee grounds Swelling of the face, fingers, feet, abdominal or stomach area, or lower legs Sores, ulcers, or white spots on the lips or tongue or inside the mouth Puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue Pains in the stomach, side, or abdomen, possibly radiating to the back Pain or swelling in the arms or legs without any injury Numbness or tingling in the hands, feet, or lips Check with your doctor immediately if any of the following side effects occur: Incidence not knownįeeling of constant movement of self or surroundings
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