Nicotinic Acid (Nicotinic Acid (Niacin, Vitamin B3))
Complete patient guide for uses, dosage, side effects, and safety information
Prescription RequiredQuick Facts
What Is Nicotinic Acid Used For?
Nicotinic acid, also known as niacin or vitamin B3, is a naturally occurring vitamin that can be used as medicine to improve blood fat levels and treat vitamin deficiency.
Primary Uses
Nicotinic acid is used to treat high levels of cholesterol and triglycerides (fat-like substances in the blood) and pellagra, a rare nicotinic acid deficiency. Pellagra symptoms include loss of appetite, tiredness, weakness, diarrhea, skin problems, and mental changes.
How It Works
Nicotinic acid works by reducing the amount of ‘bad’ cholesterol and triglycerides made by your liver. It helps lower LDL (bad) cholesterol that can block blood vessels and may increase HDL (good) cholesterol that helps remove bad cholesterol from blood vessels.
Good to know: Nicotinic acid is not addictive and occurs naturally in food as vitamin B3.
How to Take Nicotinic Acid
Follow your doctor’s or pharmacist’s instructions carefully, as your dose depends on your condition and other medications you may be taking.
Dosage Instructions
For pellagra: One tablet twice a day. For high cholesterol and triglycerides: Initially one tablet three times a day, increased by one tablet every four days to a maximum of 12-18 tablets daily as directed by your doctor. Swallow tablets whole with water – do not chew them. Take after meals.
What If You Miss a Dose?
Take the missed dose as soon as you remember, then return to your regular schedule. Do not take a double dose to make up for the missed one, as this may increase side effects.
Important: Never double your dose to make up for a missed one – this increases your risk of side effects.
Available Tablet Strengths
Side Effects
Like all medications, this medicine can cause side effects. Most are mild and temporary, but some require medical attention.
Common Side Effects
These side effects occur relatively frequently and usually don’t require emergency care:
- Skin flushing (warmth, redness, itching or tingling on face, neck, chest and back)
- Irregular or rapid heartbeat
- Headache
- Dizziness
- Itching or rash
- Dry or scaly skin, boils
- Darkening or thickening of skin
- Nausea, vomiting
- Diarrhea
- Heartburn or gas
- Nervousness
Seek immediate medical attention if you experience:
- Yellowing of skin and/or eyes
- Shortness of breath
- Signs of gout (painful swollen joints)
- Difficulty seeing
- Fainting
- Dizziness when standing up
- Allergic reaction (swelling of face, lips, mouth, throat or neck causing difficulty swallowing or breathing)
Important Warnings
There are several important conditions and situations where nicotinic acid should not be used or requires special caution.
Who Should Not Take Nicotinic Acid
Do not take if you are allergic to nicotinic acid or any ingredients, have significant liver problems, bleeding from any artery, recent heart attack, or if the medication is expired or damaged.
Medical Conditions to Discuss
Tell your doctor if you have liver disease, heart attack, heart/gallbladder/kidney/liver problems, bleeding problems, glaucoma, stomach ulcer, diabetes, or gout. Your doctor may need to do blood tests to check your liver function.
Pregnancy and Breastfeeding
Do not take nicotinic acid if you are pregnant or breastfeeding. It may affect your developing baby during pregnancy and passes into breast milk, potentially affecting your baby.
Safety in Children: Do not give nicotinic acid to children – safety and effectiveness have not been established in this age group.
Drug Interactions
Several medications can interact with nicotinic acid and affect how it works. Always tell your doctor about all medicines you’re taking.
- Blood pressure medications
- Insulin or diabetes medications
- Aspirin
- Statins (cholesterol medications like pravastatin, simvastatin)
- Colestipol (cholesterol medication)
- Nicotine patches
- Isoniazid (tuberculosis medication)
- Clonidine (blood pressure and migraine medication)
Alcohol & Driving
Alcohol and hot drinks should be avoided while taking nicotinic acid as they can worsen side effects.
Alcohol
Avoid alcohol and hot drinks when taking nicotinic acid. These can increase side effects such as flushing and itching.
Storage
Store tablets in the original bottle in a cool, dry place below 30°C. Keep away from moisture, heat, and sunlight. Do not store in bathrooms, near sinks, in cars, or on windowsills. Keep out of reach of children – a locked cupboard at least 1.5 meters above ground is recommended.
Overdose Information
If you think you or someone else has taken too much nicotinic acid, seek urgent medical attention immediately. Contact the Poisons Information Centre (13 11 26 in Australia), your doctor, or go to the nearest hospital emergency department. Overdose symptoms may include red or itchy skin, vomiting, diarrhea, stomach discomfort or cramps, or fainting.
Frequently Asked Questions
Nicotinic acid helps control cholesterol and triglyceride levels, but it does not cure the condition. You must continue taking it as directed to keep levels controlled. For flushing side effects, most patients find episodes become less frequent and milder within a few weeks of starting therapy.
Yes, you should take nicotinic acid after meals. This is the recommended way to take the medication.
No, nicotinic acid is not addictive. It is vitamin B3 that occurs naturally in food.
Do not stop taking nicotinic acid or lower the dosage without checking with your doctor or pharmacist. If you stop taking it, your cholesterol and triglyceride levels may become out of control again.
No, you should avoid alcohol and hot drinks when taking nicotinic acid. These can increase side effects such as flushing and itching.
Flushing (warmth, redness, itching or tingling typically on the face, neck, chest and back) is the most common side effect. For most patients, flushing episodes become less frequent and milder within a few weeks after starting therapy, or may stop altogether.
Take the missed dose as soon as you remember, then return to your regular schedule. Do not take a double dose to make up for the missed one, as this may increase your chance of side effects.
Important Disclaimer
This information is intended for general educational purposes only and should not be considered medical advice. Always consult your healthcare provider or pharmacist before starting, stopping, or changing any medication.
If you think you may have a medical emergency, call your doctor or emergency services immediately.