Niacin (nicotinic acid)
Niacin, or nicotinic acid, is vitamin B3 and can also be used as a prescription lipid-modifying drug at much higher doses than nutritional requirements. It should not be confused with nicotinamide, which has different pharmacologic effects, or with over-the-counter supplements used without lipid monitoring.
At a glance
Quick facts
- Drug class
- Vitamin B3; lipid-modifying drug at pharmacologic doses
- Main uses
- Treatment/prevention of niacin deficiency; selected dyslipidaemia indications at prescription doses when clinically appropriate
- Route
- Oral
- WHO ATC
- C10AD02
- Key safety
- Flushing, itching, gastrointestinal upset, liver injury, hyperglycaemia and hyperuricaemia; extended-release and immediate-release products are not dose-for-dose interchangeable.
- Monitoring
- Liver tests, glucose, uric acid, lipid response, product formulation and other lipid-lowering medicines.
Names & terminology
How this medicine may be named or searched
- Canonical page name
- Niacin (nicotinic acid)
- INN / generic name
- Nicotinic acid
- Aliases / salts
- niacin · nicotinic acid · vitamin B3
- Russian support entity
- nicotinic-acid.ru — entity relationship only, not a clinical source
Structured drug profile
Drug profile
What is Niacin (nicotinic acid)?
Niacin, or nicotinic acid, is vitamin B3 and can also be used as a prescription lipid-modifying drug at much higher doses than nutritional requirements. It should not be confused with nicotinamide, which has different pharmacologic effects, or with over-the-counter supplements used without lipid monitoring.
What is Niacin (nicotinic acid) used for?
Treatment/prevention of niacin deficiency; selected dyslipidaemia indications at prescription doses when clinically appropriate. The exact approved indication depends on the product, route and country. [1]
How it works
Acts as vitamin B3 at nutritional doses; at pharmacologic doses it modifies hepatic lipid metabolism and lowers triglycerides and LDL while raising HDL, though cardiovascular benefit depends on treatment context.
Forms and formulations
Immediate-release and extended-release tablets; supplement forms also exist. Different formulations may have different indications, strengths, excipients and instructions and should not be assumed interchangeable.
Country / market layer
Availability and formulations by market
Brand names, strengths, prescription status and approved uses vary by jurisdiction. Check the exact national product record before relying on a formulation.
Availability depends on the active ingredient, route and formulation; not every medicine in this reference has a current UK product.
U.S. authorization and formulation availability may differ substantially from Europe and other markets.
How it is used
Prescription niacin should be taken exactly as the formulation label specifies. Immediate-release and extended-release products have different schedules and safety profiles. Switching formulations without medical supervision can substantially change exposure and liver risk.
For prescription treatment, use the patient-specific regimen rather than copying a dose from another person or another formulation.
Side effects
Flushing, warmth, itching and headache are common, especially early in treatment. Higher therapeutic doses can also cause gastrointestinal effects, raise blood glucose and uric acid, and injure the liver.
Important warnings and monitoring
Seek medical assessment for jaundice, dark urine, severe weakness, unexplained muscle pain or significant glucose deterioration. People with active liver disease, significant gout or heavy alcohol use need careful review before pharmacologic-dose niacin.
Monitoring context: Liver tests, glucose, uric acid, lipid response, product formulation and other lipid-lowering medicines.
Interactions
Statins and other lipid medicines can increase muscle-toxicity risk in some combinations. Alcohol can worsen flushing and liver risk. Bile-acid sequestrants can interfere with absorption if taken too close together.
Pregnancy and breastfeeding
Nutritional vitamin requirements and prescription lipid-lowering doses are very different. Pharmacologic-dose niacin in pregnancy should only be used after specialist assessment of indication and alternatives.
Overdose and accidental extra doses
Excessive doses can cause marked flushing, low blood pressure, gastrointestinal symptoms, metabolic disturbance and liver toxicity. Significant overdose requires poison-centre or emergency advice.
Practical clinical context
The most important distinction is between the medicine entity and a specific marketed product. Strength, salt, route, modified-release design, age authorization and prescription status can change between products. When safety or dosing decisions matter, use the exact package leaflet, prescribing information or national regulator record for the product actually being used.
This page deliberately separates general evidence from the project’s Russian-language support site nicotinic-acid.ru; that site identifies the cross-language entity but is not treated as an authority for clinical claims.
Common questions
Frequently asked questions
Yes. Nicotinic acid is another name for niacin, though nicotinamide is a different vitamin B3 form.
Nicotinic acid can trigger prostaglandin-mediated dilation of skin blood vessels, causing warmth, redness and itching.
No. Prescription lipid-lowering regimens use specific niacin formulations and doses with medical monitoring.
Yes. Pharmacologic doses can worsen glucose control in some people.
High-dose niacin, especially certain formulations, can cause hepatotoxicity.
Sources
Clinical statements in this reference are based on named public-health, regulatory or guideline sources. Product-specific labeling remains authoritative for exact indications, dosing and contraindications.
This medicine reference is evidence-based and is awaiting clinician review. It is not a substitute for personalized medical advice.