Drug & supplement interaction

Niacinamide + Dalteparin

Dalteparin brand name: Fragmin.

Moderate Interaction
The bottom line Moderate

Niacinamide has a moderate interaction with Dalteparin. Theoretically, niacinamide may have additive effects when used with anticoagulant or antiplatelet drugs, especially in patients on hemodialysis.

Read the full interaction report
SeverityModerate
LikelihoodUnlikely
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Niacinamide and Dalteparin

Here is the interaction we found between these two, with the evidence behind it.

Moderate

ANTICOAGULANT/ANTIPLATELET DRUGS

Why this applies to Dalteparin

Dalteparin falls under ANTICOAGULANT/ANTIPLATELET DRUGS — the group Niacinamide interacts with.

Theoretically, niacinamide may have additive effects when used with anticoagulant or antiplatelet drugs, especially in patients on hemodialysis.
Several cases of thrombocytopenia have been reported for hemodialysis patients treated with niacinamide 1 gram daily. Hemodialysis patients receiving niacinamide had almost a three-fold higher risk of developing thrombocytopenia when compared with those receiving placebo.
Severity Moderate Likelihood Unlikely Evidence D

Interaction has been demonstrated in animal or in lab research but has been shown not to occur in humans..

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the gist for Dalteparin (Fragmin), which is a blood thinner you inject to prevent and treat clots. The concern with niacinamide (a form of vitamin B3) is mostly theoretical. At higher supplement doses, it could in theory add to the blood-thinning effect, which might raise the chance of bruising or bleeding. This is not a strongly proven interaction, and the evidence behind it is anecdotal.

The one real-world signal worth knowing about: in people on hemodialysis taking about 1 gram of niacinamide daily, there were reports of lower platelet counts (thrombocytopenia), which can make bleeding easier. Everyday vitamin amounts are unlikely to cause trouble. If you're on dialysis or thinking about high-dose niacinamide, check with your pharmacist or doctor first.

References
  1. Rottembourg JB, Launay-Vacher V, Massard J. Thrombocytopenia induced by nicotinamide in hemodialysis patients. Kidney Int. 2005;68(6):2911-2. PubMed
  2. Zhang Y, Ma T, Zhang P. Efficacy and safety of nicotinamide on phosphorus metabolism in hemodialysis patients: A systematic review and meta-analysis. Medicine (Baltimore). 2018;97(41):e12731. PubMed

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • 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.
Evidence the quality of the studies behind the rating (graded A–D)
  • 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.

Keep it in perspective

Niacinamide Also Interacts With Other Medications

Niacinamide has 123 moderate known drug interactions in our database — the Dalteparin one above is one of them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Niacinamide

Covers the 2,830 medications we’ve checked against Niacinamide. Pick one to open its full report.

Everything else you take

See Every Supplement That Interacts With Dalteparin

This page covers Niacinamide only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Dalteparin page lists 218 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Danshen (major), Piracetam (major), Aconite (moderate) and Allspice (moderate).

By severity: 3 major · 190 moderate · 25 minor.

From our pharmacist’s overview on the Dalteparin page

“Dalteparin (Fragmin) is an injectable blood thinner used to prevent and treat dangerous clots, which is exactly why this list warrants real vigilance, and nearly all 218 ingredients on it thin the blood too. They are herbs and extracts with clot-inhibiting or antiplatelet effects of their own, so stacking them on dalteparin can push bl…”

Reviewed by 2 · Jul 18, 2026

Open the Dalteparin interaction page

One more smart check

Taking Niacinamide as Part of a Dietary Supplement Product? Check It for Interactions

We hold 552 real supplement products containing Niacinamide, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Niacinamide. Your product may carry other ingredients that interact with Dalteparin too, on top of Niacinamide — and those would not show on this page. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Niacinamide and Dalteparin 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.

Supplement Niacinamide
Top 25%

#302 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Dalteparin
Top half

#859 of 2,830 medications looked up here in the last 7 days

29 days ago today

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.

Supplement

About Niacinamide

What is Niacinamide?

  • Acne and skin health
  • Pellagra (niacin deficiency)
  • Anti-aging and skin tone
  • Rosacea
  • Protecting against certain skin cancers

Niacinamide (also called nicotinamide) is a form of vitamin B3 used in supplements and skin-care products. It is well established for preventing and treating vitamin B3 deficiency, and there is moderate evidence for some skin uses, but many popular claims are still being studied. It is generally well tolerated at usual doses, but high amounts should be discussed with your doctor or pharmacist.

Read the full Niacinamide monograph & all interactions
Medication

About Dalteparin Injection

What Is Dalteparin Injection Used For?

Brand name: Fragmin

Fragmin (dalteparin) injection is used to prevent blood clots (deep vein thrombosis, or DVT) in people having hip replacement or abdominal surgery, and in hospitalized patients who are largely immobile due to acute illness. It is also used to reduce ischemic complications — meaning clot-related events — in people with unstable angina or a type of heart attack called non-Q-wave MI, when given alongside aspirin.

Fragmin is approved for the extended treatment of symptomatic venous thromboembolism (VTE — blood clots in the veins or lungs) in adults with cancer, to reduce the chance of clots coming back, for up to six months. It is also approved to treat symptomatic VTE in pediatric patients from birth (at least 35 weeks gestational age) onward. Fragmin is not intended for the acute (immediate emergency) treatment of VTE.

See full Dalteparin Injection drug information
Keep checking

Other Drugs & Niacinamide

Browse every other medication we’ve checked against Niacinamide — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
123Moderate
0Minor
2,706No known interaction
Moderate

123 interactions

Showing 60 of 123 moderate interactions — see all 123 on the Niacinamide page.

No interaction 2,706 drugs checked — show the list
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

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

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Pharmacist Counseling Corner

Taking Niacinamide and Dalteparin Together: Common Questions

Can you take Niacinamide with Dalteparin?
There is a moderate interaction, so it may be acceptable with monitoring or timing changes — but check with your pharmacist first. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Niacinamide and Dalteparin interaction?
We rate it Moderate. This combination may require monitoring, a dose adjustment, or separating the times you take each one. Consult your pharmacist before using them together.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Still Have a Question About Dalteparin and Niacinamide?

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.