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Niacinamide

What is it?

There are two forms of vitamin B3 - niacin and niacinamide. Niacinamide is found in many foods including yeast, meat, fish, milk, eggs, green vegetables, beans, and cereal grains. Niacinamide is also found in many vitamin B complex supplements with other B vitamins. Niacinamide can also be formed in the body from dietary niacin.

Do not confuse niacinamide with niacin, NADH, nicotinamide riboside, inositol nicotinate, or tryptophan. See the separate listings for these topics.

Niacinamide is used to prevent vitamin B3 deficiency and related conditions such as pellagra. It is also used for acne, diabetes, oral cancer, osteoarthritis, and many other conditions, but there is no good scientific evidence to support these uses.

How effective is it?

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...

  • A disease cause by niacin deficiency (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). In people who need hemodialysis due to kidney failure and have high levels of blood phosphate, taking niacinamide seems to help decrease phosphate levels.
  • Nonmelanoma skin cancer. Taking niacinamide seems to help prevent new skin cancer or precancerous spots (actinic keratosis) from forming in people with a history of nonmelanoma 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 fewer pain 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.

Insufficient evidence to rate effectiveness for...

  • An eye disease that leads to vision loss in older adults (age-related macular degeneration or AMD). 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 applying cream containing 5% niacinamide to the face improves blotchiness, wrinkles, elasticity, and redness in women with aging skin due to sun damage.
  • Eczema (atopic dermatitis). 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.
  • Skin redness caused by injury or irritation (erythema). Early research shows that applying a cream containing niacinamide reduces skin redness, dryness, and itching caused by the acne medication isotretinoin.
  • Dark skin patches on the face (melasma). 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.
  • Cancer that starts in white blood cells (non-Hodgkin 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.
  • Itching. Early research shows that taking niacinamide does not reduce itchiness in people with kidney failure.
  • Rough, scaly skin on the scalp and face (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.
  • A skin condition that causes redness on the face (rosacea).
  • Bladder cancer.
  • Decline in memory and thinking skills that occur normally with age.
  • Depression.
  • Head and neck cancer.
  • Premenstrual syndrome (PMS).
  • Other conditions.
More evidence is needed to rate niacinamide for these uses.

How does it work?

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.

Are there safety concerns?

When taken by mouth: Niacinamide is LIKELY SAFE for most adults when taken in the recommended amounts. Unlike niacin, niacinamide does not cause flushing. However, niacinamide might cause minor side effects such as stomach upset, gas, dizziness, rash, itching, and other problems. To reduce the risk of these side effects, adults should avoid taking niacinamide in doses greater than 35 mg per day.

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.

When applied to the skin: Niacinamide is POSSIBLY SAFE. Niacinamide cream might cause mild burning, itching, or redness.

Special precautions & warnings:

Pregnancy and breast-feeding: Niacinamide is LIKELY SAFE for pregnant and breast-feeding women when taken in the recommended amounts. The maximum 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 per day for women over 18 years of age.

Children: Niacinamide is LIKELY SAFE when taken by mouth in the recommended amounts for each age group. But children should avoid taking doses of niacinamide above the daily upper limits, which are 10 mg for children 1-3 years of age, 15 mg for children 4-8 years of age, 20 mg for children 9-13 years of age, and 30 mg for children 14-18 years of age.

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.

Kidney dialysis: Taking niacinamide seems to increase the risk of low blood-platelet levels in people with kidney failure who are on dialysis.

Stomach or intestinal ulcers: Niacinamide might make ulcers worse. Don't use it if you have ulcers.

Are there interactions with medications?

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 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.

Are there interactions with herbs and supplements?

Herbs and supplements that might slow blood clotting
Niacinamide might slow blood clotting. Using niacinamide along with other herbs and supplements that also slow blood clotting might increase the risk of bleeding in some people. Some other herbs of this type include angelica, clove, danshen, garlic, ginger, Panax ginseng, and others.

Are there interactions with foods?

There are no known interactions with foods.

What dose is used?

The following doses have been studied in scientific research:

ADULTS

BY MOUTH:
  • General: Some dietary supplement products might not list niacinamide separately on the label. Instead, it might be listed under niacin. Niacin is measured in niacin equivalents (NE). A dose of 1 mg of niacinamide is the same as 1 mg NE. The daily recommended dietary allowances (RDAs) for niacinamide in adults are 16 mg NE for men, 14 mg NE for women, 18 mg NE for pregnant women, and 17 mg NE for lactating women.
  • 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 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

  • General: The daily recommended dietary allowances (RDAs) for niacinamide in children are 2 mg for infants 0-6 months of age, 4 mg NE for infants 7-12 months of age, 6 mg NE for children 1-3 years of age, 8 mg NE for children 4-8 years of age, 12 mg NE for children 9-13 years of age, 16 mg NE for men 14-18 years of age, and 14 mg NE for women 14-18 years of age.
  • For 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.

Other names

3-Pyridine Carboxamide, 3-Pyridinecarboxamide, Amide de l'Acide Nicotinique, B Complex Vitamin, Complexe de Vitamines B, Niacinamida, Nicamid, Nicosedine, Nicotinamide, Nicotinic Acid Amide, Nicotylamidum, Pyridine-3-carboxamide, Vitamin B3, Vitamina B3, Vitamine B3.

Methodology

To learn more about how this article was written, please see the Natural Medicines Comprehensive Database methodology.

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Last reviewed - 04/22/2021