Niacin
Also known as nad precursor, niacinamide, nicotinamide, nicotinic acid
Key takeaways
- Niacin monotherapy or as an add-on to statins does not significantly reduce cardiovascular events in large populations (PMID: 28616955).
- Nicotinamide may be effective in the chemoprophylaxis of skin cancer and actinic keratoses (PMID: 35134311).
- A terminal metabolite of niacin may actually promote vascular inflammation and increase CVD risk (PMID: 38374343).
What the research shows
AI-synthesized from 241 peer-reviewed sources · Updated 2025
Niacin (Vitamin B3) and its derivatives are primarily used to manage lipid profiles by lowering LDL and triglycerides while increasing HDL. While effective for lipid modification, recent high-quality evidence suggests limited benefit in reducing major cardiovascular events when added to statin therapy.
By condition
Cholesterol/Cardiovascular Risk
Moderate
Niacin effectively modifies lipid levels, but large meta-analyses and RCTs show inconsistent or insufficient evidence for reducing primary or secondary cardiovascular events.
Skin Health/Acne
Moderate
Topical nicotinamide is used for acne treatment, and oral nicotinamide shows potential for chemoprophylaxis in skin cancer and actinic keratoses.
Glucose and Lipid Metabolism
Weak
Recent evidence on nicotinamide mononucleotide suggests some efficacy in improving glucose and lipid metabolism in adults.
Effective doses
Specific dose ranges were not provided in the provided abstracts; typically administered as nicotinic acid for lipids or nicotinamide for skin/metabolic health.
Safety & interactions
Potential for vascular inflammation associated with certain metabolites; use should be monitored in patients with established cardiovascular disease.
Limitations
There is a conflict between niacin's ability to improve lipid biomarkers and its failure to consistently improve clinical cardiovascular outcomes in large-scale trials.
Dietary Reference Intakes
Source: IOM/NAM · Dietary Reference Intakes: Niacin (Vitamin B3, NE)
| Measure | Value | Description |
|---|
Top-rated Niacin products
Ranked by safety score and evidence coverage
Drug–supplement interactions
28 documented interactions
| Drug | Severity | Mechanism | Evidence |
|---|---|---|---|
| Simvastatin | Critical | Interaction identified from DDInter 2.0 database. Specific drugs: Simvastatin | ddinter-verified |
| Acetohexamide | Moderate | Interaction identified from DDInter 2.0 database. Specific drugs: Acetohexamide | ddinter-verified |
| Albiglutide | Moderate | Interaction identified from DDInter 2.0 database. Specific drugs: Albiglutide | ddinter-verified |
| Alcohol | Moderate | Interaction identified from DDInter 2.0 database. Specific drugs: Ethanol, Ethan | ddinter-verified |
| Antidiabetic Drugs | Moderate | Niacin can increase insulin resistance and raise blood glucose levels, counterac | well-established |
| Asparaginase Escherichia coli | Moderate | Interaction identified from DDInter 2.0 database. Specific drugs: Asparaginase E | ddinter-verified |
| Brentuximab vedotin | Moderate | Interaction identified from DDInter 2.0 database. Specific drugs: Brentuximab ve | ddinter-verified |
| Ertugliflozin | Moderate | Interaction identified from DDInter 2.0 database. Specific drugs: Ertugliflozin | ddinter-verified |
| Insulin aspart (aspart protamine) | Moderate | Interaction identified from DDInter 2.0 database. Specific drugs: Insulin aspart | ddinter-verified |
| Insulin aspart (aspart) | Moderate | Interaction identified from DDInter 2.0 database. Specific drugs: Insulin aspart | ddinter-verified |
How it's sold
Data aggregated from 1,378 product labels
Research evidence
Showing top 10 of 241 sources, sorted by quality
BACKGROUND: Nicotinic acid (niacin) is known to decrease LDL-cholesterol, and triglycerides, and increase HDL-cholesterol levels. The evidence of benefits with niacin monotherapy or add-on to statin-based therapy is controversial. OBJECTIVE…
**Dormuth et al., 2013** | BMJ | Meta Analysis Dormuth Colin R, Hemmelgarn Brenda R, ... Ernst Pierre. Use of high potency statins and rates of admission for acute kidney injury: multicenter, retrospective observational analysis of administ…
OBJECTIVE: To investigate the effects on cardiovascular outcomes of drug interventions that increase high density lipoprotein levels. DESIGN: Meta-analysis. STUDIES REVIEWED: Therapeutic benefit of niacin, fibrates, and cholesteryl ester tr…
Despite intensive preventive cardiovascular disease (CVD) efforts, substantial residual CVD risk remains even for individuals receiving all guideline-recommended interventions. Niacin is an essential micronutrient fortified in food staples,…
**Liu et al., 2010** | Nat Genet | Meta Analysis Liu Jason Z, Tozzi Federica, ... Marchini Jonathan. Meta-analysis and imputation refines the association of 15q25 with smoking quantity. Nat Genet. 2010-May;42(5):436-40. doi:10.1038/ng.572 S…
**Unknown et al., 2010** | Nat Genet | Meta Analysis . Genome-wide meta-analyses identify multiple loci associated with smoking behavior. Nat Genet. 2010-May;42(5):441-7. doi:10.1038/ng.571 Consistent but indirect evidence has implicated ge…
**Hughes et al., 2014** | Cochrane Database Syst Rev | Meta Analysis Hughes John R, Stead Lindsay F, ... Lancaster Tim. Antidepressants for smoking cessation. Cochrane Database Syst Rev. 2014-Jan-08;2014(1):CD000031. doi:10.1002/14651858.CD…
BACKGROUND: Acne is an inflammatory disorder with a high global burden. It is common in adolescents and primarily affects sebaceous gland-rich areas. The clinical benefit of the topical acne treatments azelaic acid, salicylic acid, nicotina…
IMPORTANCE: Niacin remains a therapeutic option for patients with cardiovascular disease, but recent studies have called into question the effectiveness of other drugs that increase high-density lipoprotein cholesterol levels. OBJECTIVE: To…
**Silverman et al., 2016** | JAMA | Meta Analysis Silverman Michael G, Ference Brian A, ... Sabatine Marc S. Association Between Lowering LDL-C and Cardiovascular Risk Reduction Among Different Therapeutic Interventions: A Systematic Review…
Frequently asked questions
What is Niacin and what is it primarily used for?
Niacin, also known as Vitamin B3, is primarily used to manage lipid profiles by lowering LDL cholesterol and triglycerides while increasing HDL. While it effectively modifies these lipid levels, recent high-quality evidence suggests it has limited benefit in reducing major cardiovascular events when added to statin therapy. It is also used in topical forms for skin health.
Does Niacin help with acne or skin cancer prevention?
There is moderate evidence supporting the use of topical nicotinamide for acne treatment. Additionally, oral nicotinamide shows potential for chemoprophylaxis in skin cancer and actinic keratoses. However, research is mixed regarding its broader metabolic benefits, with only weak evidence for improving glucose and lipid metabolism via nicotinamide mononucleotide.
What is the recommended daily intake of Niacin?
According to the Institute of Medicine, the Recommended Dietary Allowance (RDA) for males aged 19-50 is 16 mg NE/day. Specific effective dose ranges for therapeutic purposes were not provided in the available evidence, though it is typically administered as nicotinic acid for lipids or nicotinamide for skin and metabolic health.
What are the safety risks and side effects of taking Niacin?
Niacin use should be monitored in patients with established cardiovascular disease because a terminal metabolite may promote vascular inflammation and increase CVD risk. While generally safe at dietary levels, high doses can cause vascular inflammation. Consumers should consult a healthcare provider to monitor for these potential adverse effects.
Does Niacin interact with diabetes or blood-thinning medications?
Yes, Niacin has moderate interactions with antidiabetic drugs as it can increase insulin resistance and raise blood glucose levels, counteracting diabetes management. It also has minor interactions with anticoagulants, as high doses may have mild antiplatelet effects that could increase bleeding risk. People on these medications should consult their doctor before use.
Is it safe to take Niacin with Statins?
Combining Niacin with statins carries a moderate risk because they synergistically increase the risk of myopathy, especially at Niacin doses greater than 1g/day. This interaction is well-established, so individuals taking statins should be cautious. Always consult a healthcare provider before combining these supplements with prescription medications.
Who should avoid taking Niacin supplements?
Patients with established cardiovascular disease should avoid or closely monitor Niacin use due to potential vascular inflammation. Individuals taking antidiabetic drugs or anticoagulants should also exercise caution due to risks of increased blood glucose and bleeding. Pregnant individuals or those on multiple medications should consult a healthcare provider before starting supplementation.