Niacin + Tolcapone
Tolcapone brand name: Tasmar.
Niacin has a moderate interaction with Tolcapone. Theoretically, concomitant use of niacin and hepatotoxic drugs might increase the risk of hepatotoxicity.
Read the full interaction reportNiacin and Tolcapone
Here is the interaction we found between these two, with the evidence behind it.
HEPATOTOXIC DRUGS
Why this applies to Tolcapone
Tolcapone falls under HEPATOTOXIC DRUGS — the group Niacin interacts with.
Niacin has been associated with cases of liver toxicity, especially when used in pharmacologic doses. Sustained-release niacin preparations appear to be associated with a higher risk of hepatotoxicity than immediate-release niacin.
Interaction 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.
Here's the thing to know about tolcapone: it already carries a well-known warning about liver injury, which is why your doctor checks your liver enzymes with regular blood tests while you take it. Niacin, especially in high cholesterol-lowering doses (and particularly sustained-release forms), can also stress the liver. So the worry here is simply additive, two things that can each be hard on the liver being used together.
I want to be honest that this is a theoretical concern based on how each one behaves, not strong proof of harm. Everyday food and a regular B3 multivitamin amount are very unlikely to matter. But before adding any high-dose niacin supplement, please check with your doctor or pharmacist so your liver monitoring stays on track.
- 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. DOI
- Bays HE, Dujovne CA. Drug interactions of lipid-altering drugs. Drug Saf 1998;19:355-71. PubMed
- Rader JI, Calvert RJ, Hathcock JN. Hepatic toxicity of unmodified and time-release preparations of niacin. Am J Med 1992;92:77-81. PubMed
- Etchason JA, Miller TD, Squires RW, et al. Niacin-induced hepatitis: a potential side effect with low-dose time-release niacin. Mayo Clin Proc. 1991;66(1):23-8. PubMed
- Henkin Y, Johnson KC, Segrest JP. Rechallenge with crystalline niacin after drug-induced hepatitis from sustained-release niacin. JAMA. 1990;264(2):241-3. DOI
- Henkin Y, Oberman A, Hurst DC, Segrest JP. Niacin revisited: clinical observations on an important but underutilized drug. Am J Med. 1991;91(3):239-46. PubMed
- Bassan M. A case for immediate-release niacin. Heart Lung. 2012 Jan-Feb;41(1):95-8. PubMed
- Nawaz N, Mistretta T, Karime C, Lewis J, Wolf E. Cholestatic Drug-Induced Liver Injury in a Patient Taking High-Dose Niacin for Hyperlipidemia. J Investig Med High Impact Case Rep 2024;12:23247096231224349. PubMed
What These Ratings Mean
Every interaction above is graded three ways — here’s the key to each label.
Clinically significant. Avoid the combination, or use only under close professional supervision.
Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.
Generally not serious. Be aware of it and mention it to your pharmacist.
- LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
- ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
- 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.
- UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
- AHigh-quality meta-analysis (quantitative systematic review).
- BCase-control study.
- CConsensus.
- DAnecdotal evidence.
These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.
Niacin Also Interacts With Other Medications
Niacin has 726 moderate known drug interactions in our database — the Tolcapone one above is one of them. If you take anything else, check it against the full list below.
Check Another of Your Medications Against Niacin
We haven’t checked that one against Niacin yet — ask our pharmacists directly.
Covers the 2,830 medications we’ve checked against Niacin. Pick one to open its full report.
See Every Supplement That Interacts With Tolcapone
This page covers Niacin only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Tolcapone page lists 58 supplements it has a documented interaction with, worst first, each one explained.
The most serious there right now: Activated Charcoal (major), Beer (major), Siberian Cocklebur (major), Wine (major) and Ashwagandha (moderate).
By severity: 4 major · 45 moderate · 9 minor.
Taking Niacin as Part of a Dietary Supplement Product? Check It for Interactions
We hold 933 real supplement products containing Niacin, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Niacin. Your product may carry other ingredients that interact with Tolcapone too, on top of Niacin — and those would not show on this page. Find your product and we’ll check every ingredient on its label:
Where Niacin and Tolcapone Sit Against Everything Else
Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.
#231 of 1,452 supplements looked up here in the last 7 days
#2,463 of 2,830 medications looked up here in the last 7 days
Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.
About Niacin
What is Niacin?
- High cholesterol
- Vitamin B3 deficiency (pellagra)
- Heart health support
- General energy and metabolism
Niacin (vitamin B3) is an essential nutrient your body needs for energy and metabolism, and deficiency is uncommon in most developed countries. Prescription-strength niacin has been used to adjust cholesterol levels, but high doses can cause flushing and other side effects and should only be taken under medical supervision. Always talk with a pharmacist or doctor before using high-dose niacin supplements.
About Tolcapone
What Is Tolcapone Used For?
Brand name: Tasmar
Tolcapone tablets (sold as Tasmar and as generic tolcapone) are used as an add-on therapy to levodopa/carbidopa for idiopathic Parkinson's disease — meaning Parkinson's that arises on its own, not from another cause. It is intended for patients who are experiencing symptom fluctuations and are not responding well to, or are not good candidates for, other add-on treatments.
Because of the serious risk of liver failure, tolcapone is reserved for patients who need additional symptom control and must be stopped within 3 weeks if it is not producing a clear benefit.
Other Drugs & Niacin
Browse every other medication we’ve checked against Niacin — both the ones with a known interaction and the ones without. Select any drug for the full detail.
No drugs match “”.
726 interactions
- Diclofenac Sodium ›
- Diltiazem ›
- Nifedipine ›
- Ibuprofen ›
- Aspirin ›
- Insulin (rdna) ›
- Naproxen ›
- Doxycycline ›
- Minocycline ›
- Propranolol ›
- Tetracycline ›
- Levothyroxine ›
- Amoxicillin ›
- Hydrochlorothiazide ›
- Testosterone ›
- Verapamil ›
- Fenofibrate ›
- Levonorgestrel ›
- Quinidine ›
- Cyclosporine ›
- Glyburide ›
- Insulin (pork) ›
- Methyltestosterone ›
- Ciprofloxacin ›
- Nicotine ›
- Phenytoin ›
- Allopurinol ›
- Carbamazepine ›
- Diclofenac Potassium ›
- Dipyridamole ›
- Hydralazine ›
- Insulin (human) ›
- Acetaminophen ›
- Conjugated Estrogens ›
- Ketoprofen ›
- Methotrexate ›
- Nitrofurantoin ›
- Ofloxacin ›
- Propoxyphene ›
- Rifampin ›
- Testosterone Undecanoate ›
- Trichlormethiazide ›
- Acarbose ›
- Bendroflumethiazide ›
- Bivalirudin ›
- Dapsone ›
- Doxycycline Hyclate ›
- Duloxetine ›
- Eltrombopag ›
- Insulin Glargine ›
- Interferon Alfa-2b ›
- Interferon Beta-1b ›
- Isoniazid ›
- Itraconazole ›
- Levofloxacin ›
- Levothyroxine Sodium ›
- Liotrix ›
- Lisinopril ›
- Metolazone ›
- Minoxidil ›
Showing 60 of 726 moderate interactions — see all 726 on the Niacin page.
No interaction 2,103 drugs checked — show the list
We also checked Niacin against these medications and found no known interaction in our sources. Open any page to confirm.
- Methylphenidate ›
- Sertraline ›
- Ivermectin ›
- Escitalopram ›
- Tadalafil ›
- Docusate ›
- Valacyclovir ›
- Abemaciclib ›
- Hydroxyurea ›
- Methamphetamine ›
- Sumatriptan ›
- Prednisone ›
- Bupropion ›
- Lisdexamfetamine ›
- Acyclovir ›
- Bendamustine ›
- Amitriptyline ›
- Lamotrigine ›
- Fluoxetine ›
- Amphetamine ›
- Gabapentin ›
- Pregabalin ›
- Azithromycin ›
- Dextroamphetamine ›
- Isotretinoin ›
- Clonazepam ›
- Omeprazole ›
- Methylene Blue ›
- Quetiapine ›
- Letrozole ›
- Buspirone ›
- Citalopram ›
- Diazepam ›
- Cyclopentolate ›
- Cephalexin ›
- Roxithromycin ›
- Acetaminophen, Dextromethorphan, Doxylamine ›
- Pegunigalsidase Alfa-iwxj ›
- Daptomycin ›
- Finasteride ›
- Estrogen ›
- Mirtazapine ›
- Hexobarbitone ›
- Dexmethylphenidate ›
- Levetiracetam ›
- Alprazolam ›
- Factor 7a ›
- Bromocriptine ›
- Dutasteride ›
- Aripiprazole ›
- Carbidopa, Levodopa ›
- Mitomycin ›
- Levodopa ›
- Phentermine, Topiramate ›
- Ezetimibe ›
- Dexamethasone ›
- Cefaclor ›
- Venlafaxine ›
- Phenylephrine ›
- Vancomycin ›
Showing the 60 most looked-up of 2,103 medications checked with no known interaction — see the full Niacin list.
Sources & How We Checked
Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.
- Natural Medicines (Therapeutic Research Center) — Evidence-graded clinical reference for vitamins, herbs and supplements — the basis for our interaction data.
- MedlinePlus, U.S. National Library of Medicine — NIH consumer drug information, used for the medication overviews.
- NIH Dietary Supplement Label Database (DSLD) — Official supplement product labels.
Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.
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
Taking Niacin and Tolcapone Together: Common Questions
Can you take Niacin with Tolcapone?
How serious is the Niacin and Tolcapone interaction?
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