Niacinamide - What is it & How to use

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.

Effectiveness

Natural Medicines Comprehensive Database 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…

  • Treatment and prevention of niacin deficiency, and certain conditions related to niacin deficiency such as 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 dysfunction who have high levels of blood phosphate, taking niacinamide seems to help decrease phosphate levels when taken with or without phosphate binders.
  • Cancer of the larynx. 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.
  • Non-melanoma skin cancers (NMSC). 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 less painkilling 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…

  • Age-related vision loss due to retina damage. 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. 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.
  • Itchy skin in people with kidney disease (chronic kidney disease-associated pruritus). Early research shows that taking niacinamide does not help reduce itchiness in people with kidney disease.
  • Patches of skin that have darkened. 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.
  • A type of cancer of white blood cells called 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 called rosacea. Early research shows that taking tablets containing niacinamide and other ingredients for 8 weeks improves skin appearance in people with rosacea.
  • A skin condition called 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.
  • Alcohol dependence.
  • Alzheimer’s disease and age-related mental decline.
  • Arthritis.
  • Depression.
  • High blood pressure.
  • Motion sickness.
  • Premenstrual headache.
  • Other conditions.

More evidence is needed to rate niacin and niacinamide for these uses.

Dose

The following doses have been studied in scientific research:

ADULTS

BY MOUTH:

  • For acne: Tablets containing 750 mg of niacinamide, 25 mg of zinc, 1.5 mg of copper, and 500 mcg of folic acid (Nicomide) once or twice daily have been used. Also, 1-4 tablets containing niacinamide, azelaic acid, zinc, vitamin B6, copper, and folic acid (NicAzel, Elorac Inc., Vernon Hills, IL) have been taken daily.
  • For vitamin B3 deficiency symptoms such as pellagra: 300-500 mg per day of niacinamide is given in divided doses.
  • For diabetes: Niacinamide 1.2 grams/m2 (body surface area) or 25-50 mg/kg is used daily for slowing progression of type 1 diabetes. Also, 0.5 grams of niacinamide three times daily is used to slow the progression of type 2 diabetes.
  • For high levels of phosphate in the blood (hyperphosphatemia): Niacinamide from 500 mg up to 1.75 grams daily in divided doses is used for 8-12 weeks.
  • For cancer of the larynx: 60 mg/kg of niacinamide is given 1-1.5 hours before inhaling carbogen (2% carbon dioxide and 98% oxygen) before and during radiotherapy.
  • For skin cancers other than melanoma: 500 mg of niacinamide once or twice daily for 4-12 months.
  • For treating osteoarthritis: 3 grams of niacinamide per day in divided doses for 12 weeks.

ON THE SKIN:

  • Acne: A gel containing 4% niacinamide twice daily.

CHILDREN

  • Acne: In children at least 12 years of age, 1-4 tablets containing niacinamide, azelaic acid, zinc, vitamin B6, copper, and folic acid (NicAzel, Elorac Inc., Vernon Hills, IL) are taken daily.
  • For pellagra: 100-300 mg of niacinamide is given daily in divided doses.
  • For type 1 diabetes: 1.2 grams/m2 (body surface area) or 25-50 mg/kg of niacinamide is used daily for slowing progression of or preventing type 1 diabetes.

The daily recommended dietary allowances (RDAs) niacinamide 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 tolerable upper level (UL) of niacinamide 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.

Safety Concerns

Niacinamide is LIKELY SAFE for most adults when taken by mouth. Unlike niacin, niacinamide does not cause flushing. However, niacinamide might cause minor adverse effects such as stomach upset, intestinal gas, dizziness, rash, itching, and other problems. When applied on the skin, niacinamide cream might cause mild burning, itching, or redness.

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.

Niacinamide is POSSIBLY SAFE when taken by mouth and appropriately in children or when applied to the skin of adults.

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.

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.

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.

Interaction with medication

Moderate
Be cautious with this combination.
Carbamazepine (Tegretol)
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)
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)
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)
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.

* The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.