Niacin - Hydrochlorothiazide, Spironolactone Interaction
Herbal: Niacin
Also Known As: 3-Pyridinecarboxylic Acid, Vitamin B3
Drug: Hydrochlorothiazide, Spironolactone
Brand names:
Spirozine, Aldactazide, Aldactide 25, Aldactide 50
Medical Content Editor Dr. Brian Staiger, PharmD
Last updated
May 11, 2025
Interaction Details
Hydrochlorothiazide, Spironolactone is classified as belonging to the following category: Antihypertensive Drugs
Theoretically, niacin may increase the risk of hypotension when used with antihypertensive drugs.
The vasodilating effects of niacin can cause hypotension. Furthermore, some clinical evidence suggests that a one-hour infusion of niacin can reduce systolic, diastolic, and mean blood pressure in hypertensive patients. This effect is not observed in normotensive patients.
Interaction Rating
Likelihood of Occurrence
PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists
References
- American Society of Health-System Pharmacists. ASHP Therapeutic Position Statement on the safe use of niacin in the management of dyslipidemias. Am J Health Syst Pharm 1997;54:2815-9.
- McKenney J. New perspectives on the use of niacin in the treatment of lipid disorders. Arch Intern Med 2004;164:697-705.
- Gadegbeku CA, Dhandayuthapani A, Shrayyef MZ, Egan BM. Hemodynamic effects of nicotinic acid infusion in normotensive and hypertensive subjects. Am J Hypertens. 2003;16(1):67-71.
- Aramwit P, Srisawadwong R, Supasyndh O. Effectiveness and safety of extended-release nicotinic acid for reducing serum phosphorus in hemodialysis patients. J Nephrol. 2012 May-Jun;25(3):354-62.
Niacin Overview
Niacin, also known as vitamin B3, is a water-soluble vitamin found in a variety of foods, including meat, poultry, fish, and fortified grains.
It plays a variety of roles in the body, including in the metabolism of carbohydrates, fats, and proteins. It is also necessary for the production of energy in the body and in the synthesis of different hormones.
Niacin deficiency is rare in developed countries, however, supplementation has been shown to have several positive benefits. For example, it can reduce the risk of diabetic neuropathy (i.e., nerve pain) and has been shown effective for treating some types of high cholesterol (extended-release niacin is used as a prescription drug in the United States for this purpose).
There is a multitude of niacin forms available as dietary supplements, including NADH, niacinamide, and nicotinamide riboside, all with different properties.
Niacin - More Interactions
Niacin interacts with 698 drugs
Interaction Rating Key
These severity listings are for informational use only. Never start, stop or otherwise change your therapy before speaking with your provider.
| Major | The combined use of these agents is strongly discouraged as serious side effects or other negative outcomes could occur. |
| Moderate | Use cautiously under the care of a healthcare professional or avoid this combination. A significant interaction or negative outcome could occur. |
| Minor | Be aware that there is a chance of an interaction. Watch for warning signs of a potential interaction. |
| Unknown | No interactions have been reported or no interaction data is currently available. |
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Parts of this content are provided by the Therapeutic Research Center, LLC.
DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.
© 2021 Therapeutic Research Center, LLC
Drug descriptions are provided by MedlinePlus.
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In addition to being a clinical pharmacist specializing in pharmacotherapy, Dr. Brian Staiger is a registered herbalist through the American Herbalist Guild. He has combined his passion for pharmacy practice with the study of medical ethnobotany to improve patient care. Feel free to reach out about any of your herbal or medication questions!
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