What is it?
Do not confuse niacinamide with niacin, NADH, nicotinamide riboside, inositol nicotinate, or tryptophan. See the separate listings for these topics.
Niacinamide is taken by mouth for preventing vitamin B3 deficiency and related conditions such as pellagra. It is also taken by mouth for acne, diabetes, oral cancer, osteoarthritis, and many other conditions. However, there is no good scientific evidence to support these uses.
Niacinamide is also applied to the skin for acne, eczema, and other skin conditions. There is also no good 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). High blood levels of phosphate can be caused by reduced kidney function. In people with kidney failure who are on hemodialysis and have high levels of blood phosphate, taking niacinamide seems to help decrease phosphate levels when taken with or without phosphate binders.
- Head and neck cancer. 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.
- Skin cancer. 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 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.
- 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...
- 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.
- Long-term kidney disease (chronic kidney disease or CKD). Early research shows that taking niacinamide does not help reduce itchiness in people with kidney disease.
- 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.
- A skin condition that causes redness on the face (rosacea). Early research shows that taking tablets containing niacinamide and other ingredients for 8 weeks improves skin appearance in people with rosacea.
- 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.
- Alzheimer disease.
- Decline in memory and thinking skills that occur normally with age.
- High blood pressure.
- Motion sickness.
- Premenstrual syndrome (PMS).
- Other conditions.
How does it work?
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 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.
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.
Kidney dialysis: Taking niacinamide seems to increase the risk of low blood-platelet levels in people with kidney failure who are on dialysis.
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.
Are there interactions with medications?
- 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.
Are there interactions with herbs and supplements?
- Herbs and supplements that might harm the liver
- Niacinamide may cause liver damage, especially when used in higher doses. Taking niacinamide along with other herbs or supplements that might harm the liver could increase this risk. Some of these products include androstenedione, borage leaf, chaparral, comfrey, dehydroepiandrosterone (DHEA), germander, kava, pennyroyal oil, red yeast, and others.
- 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?
- 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 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.
- Acne: A gel containing 4% niacinamide twice daily.
- 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.
To learn more about how this article was written, please see the Natural Medicines Comprehensive Database methodology.
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