Niacin 500 mg Ingredients & Drug Interactions
by Major
What is this page for?
First and foremost: checking Niacin 500 mg against your medications. The heart of this page is the interaction checker and the full interaction report — how this product’s ingredients may interact with prescription and over-the-counter medicines you may be taking.
Around that, we add a pharmacist’s high-level view of the product as a whole — what’s inside, the evidence for its stated use, how transparent the label is, and what safety data exists — so you can see the full picture in one place. It’s educational information from our licensed clinical databases and the clinical staff at HelloPharmacist — not medical advice — and we don’t sell or endorse products. Our editorial policy
Niacin 500 mg is a dietary supplement by Major with 1 active ingredient. Its ingredients are commonly taken for high cholesterol, vitamin b3 deficiency (pellagra), heart health support.Based on those ingredients, 727 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Niacin. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against Niacin 500 mg by Major
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HelloPharmacist Scorecard of Niacin 500 mg by Major
Our pharmacy team’s full take, with four database checks built into the cards below — a summary of what is known, not a grade of the product itself.
What’s inside
Full disclosure
This product contains one active ingredient: niacin (also called nicotinic acid), a B vitamin at 500 mg per dose. Niacin plays a role in energy metabolism and is used to treat pellagra, a vitamin deficiency disease, and may help with cholesterol and blood sugar problems in certain situations.
The inactive ingredients are dicalcium phosphate, microcrystalline cellulose, stearic acid, magnesium stearate, hypromellose, titanium dioxide, magnesium silicate, triacetin, mineral oil, and sodium lauryl sulfate. These are fillers, binders, and coating materials that hold the tablet together and help it dissolve.
Does it work?
Strong evidence
Niacin is likely effective for treating pellagra, the deficiency disease caused by lack of this vitamin. For other uses — including cholesterol problems related to HIV/AIDS and metabolic syndrome — the evidence is considered possibly effective, meaning there's some support but more study is needed.
At the 500 mg dose in this product, you're getting a supplemental amount beyond what you'd get from food. Whether it'll work for your specific goal depends on what you're taking it for and your individual situation — talk it over with your doctor or pharmacist.
How safe is it?
Well-documented data
The niacin found in food is safe. This supplement at 500 mg is a moderate dose that can generally be well tolerated when you take it as directed, but high-dose niacin carries real risks.
The most common side effect is flushing — a hot, tingling sensation in the face and upper body that up to 70% of people may experience, especially at higher doses used for cholesterol treatment. You may also notice stomach upset, nausea, or heartburn, usually worse with time-release forms; taking it with food or an antacid can help.
Rare but serious effects include liver damage, especially with sustained-release niacin, muscle pain or weakness, low platelet counts, and vision changes. During pregnancy and breastfeeding, the amounts in food and standard prenatal vitamins are fine, but high-dose supplements should be avoided unless your doctor prescribes them.
If you're pregnant, breastfeeding, or have liver disease, kidney disease, gout, diabetes, or active peptic ulcers, talk with your doctor before starting.
Meds to double-check
Moderate interaction found
Before taking this product, double-check with your doctor or pharmacist if you take blood thinners or antiplatelet drugs (like warfarin or aspirin), blood pressure medications, diabetes medications, statins or other cholesterol drugs, gout medications (allopurinol or probenecid), bile acid sequestrants (like cholestyramine), or any drug that stresses your liver. These are the main areas where niacin can interfere with how your medications work or increase side effects.
The bottom line
Scorecard at a glanceFully disclosed formula with clinical evidence supporting its stated purpose. Moderate medication interactions have been identified, and safety information is well characterized.
Niacin 500 mg works best for people who need a B-vitamin boost or whose doctor has recommended it for cholesterol or metabolic reasons, but it's not a casual vitamin — it can interact with blood pressure, diabetes, cholesterol, and blood-thinning medications, and it can stress your liver if you have certain conditions. If you take any prescription medications, especially for blood pressure, diabetes, cholesterol, or clotting, clear this with your doctor or pharmacist first.
Expect possible flushing and stomach upset, and don't exceed the dose on the label without medical guidance.
Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI
Assessment coverage: 1 of 1 active ingredient matched to our full ingredient reviews (monographs). Based on the product label dated May 28, 2019.
This Scorecard evaluates available label information, ingredient evidence, and known medication-safety considerations. It does not independently verify product identity, purity, potency, contamination, or manufacturing quality. How these ratings are computed
General information
Key facts about Niacin 500 mg, straight from the product label.
| Brand | Major |
|---|---|
| Barcode (UPC) | 309044342702 |
| Net contents | 250 Caplet(s) |
| Market status | On market |
| Date entered into DSLD | May 28, 2019 |
| DSLD ID | 202039 |
| Product type | Vitamin |
| Supplement form | Other (e.g. Tea Bag) |
| Dietary claims / uses | Nutrient, All Other, Structure/Function |
| Intended target group(s) | Adult (18 - 50 Years), Gluten Free, Dairy Free, Sugar Free |
Everything in this section is reproduced from the manufacturer’s own product label — it’s the label speaking, not HelloPharmacist. We show it so you can see exactly what the maker states; we don’t verify or endorse those statements.
Supplement Facts
The label details for Niacin 500 mg by Major, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Niacin | 500 mg | 2500% |
Other ingredients: Dicalcium Phosphate, Microcrystalline Cellulose, Stearic Acid, Magnesium Stearate, Hypromellose, Titanium Dioxide, Magnesium Silicate, Triacetin, Mineral Oil, Sodium Lauryl Sulfate
Tap any ingredient to jump to its full detail below.
These statements are the manufacturer’s wording, reproduced from the product label — the label is saying it, not HelloPharmacist. We don’t verify or endorse them.
General
Re-Order No. 700269 M-140 Rev. 01/14 4210-250
General Statements
Potency guaranteed Time release New Formula Promotes energy production and healthy cholesterol levels already in the normal range.
This product is specially formulated to release the active ingredients over a prolonged period of time.
Made in the U.S.A.
FDA Statement of Identity
Dietary Supplement
Suggested/Recommended/Usage/Directions
Directions: For adults, take one (1) caplet daily, preferably with a meal. Do not take more than 500 mg of Niacin per day except under the supervision of your health care providers.
Precautions
Do not take more than 500 mg of Niacin per day except under the supervision of your health care providers. Possible Side Effects: Temporary flushing, itching, rash or gastric disturbances may occur. If these persist, discontinue use and consult a physician.
Warning: If you are pregnant, nursing, taking any medications or planning any medical procedure, consult your doctor before use.
Discontinue use and consult your doctor if any adverse reactions occur.
Keep out of reach of children.
Tamper resistant: Do not use if seal under cap is broken or missing.
Formula
Niacin helps maintain healthy functions of the nervous system, digestive system and skin. Niacin is a B-Vitamin that is part of a coenzyme needed for energy metabolism.
FDA Disclaimer Statement
These statements have not been evaluated by the Food and Drug Administration. This product is not intended for diagnose, treat, cure or prevent any disease.
Formulation
Free of: Sugar, sodium, starch, yeast, soy, corn, wheat, dairy, gluten, egg, fragrance, artificial colors or flavors and preservatives.
Storage
Store at room temperature in a dry place.
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
Niacin 500 mg by Major label
The label scan from the NIH Dietary Supplement Label Database. Tap to enlarge.
Label images are published by the NIH Dietary Supplement Label Database for the version of this product on file. Always read your actual product label.
View the full label (PDF)The Ingredients in Niacin 500 mg by Major
This is the 1 active ingredient this product is made of. Select it to open its full monograph.
Serving size1 Caplet(s) Dosage formOther (e.g. Tea Bag) Amounts shown are per serving.
Niacin
Interacts with727 drugs
Niacin (vitamin B3) is an essential nutrient your body needs for energy and metabolism, and deficiency is uncommon in most developed countries. Prescr...
Niacin monograph & interactionsOther (inactive) ingredients: Dicalcium Phosphate, Microcrystalline Cellulose, Stearic Acid, Magnesium Stearate, Hypromellose, Titanium Dioxide, Magnesium Silicate, Triacetin, Mineral Oil, Sodium Lauryl Sulfate. These complete the product’s ingredient list but are not active constituents.
Niacin 500 mg by Major Drug Interactions
HelloPharmacist Interaction Report
Niacin 500 mg by Major can interact with several medication types through effects on blood pressure, liver function, blood clotting, and blood sugar control.
The most serious concern is its potential interaction with blood thinners and antiplatelet drugs (like warfarin or aspirin), where niacin may add to their effects — in rare cases, sustained-release niacin has been linked to clotting problems and low platelet counts.
Read the full breakdown — every affected drug type, severity by severity
Niacin may lower blood pressure when combined with blood pressure medications, potentially causing dizziness or weakness. It can also increase liver stress when taken alongside medications that are hard on the liver, and it may raise blood sugar levels, making diabetes medications less effective.
If you take a statin (cholesterol drug), niacin theoretically raises the risk of muscle breakdown, though this hasn't been proven in large clinical studies. Niacin can also reduce the effectiveness of gout medications like allopurinol or probenecid by interfering with how your body clears uric acid.
Additionally, bile acid sequestrants (cholesterol-binding drugs like cholestyramine) can prevent niacin from being absorbed — if you take both, space them 4 to 6 hours apart. Altogether, these interactions span 728 individual medications.
Before starting this product, check your full medication list with your doctor or pharmacist to see if any of these drug types apply to you.
Check your own medications below · Editorial policy · How we use AI
Want to check YOUR meds against Niacin 500 mg?
Ask about interactions with your drugs in plain English — “Can I take it with lisinopril?” — and we find you the answer in seconds, ingredient by ingredient.
Go to the checkerIngredients driving the most interactions
Individual Drug Interactions
The ingredients in Niacin 500 mg interact with 727 drugs. Click any drug to see the details.
1 of the 1 ingredient in Niacin 500 mg interact with drugs. Each result below shows which ingredient is responsible. Niacin
6-mercaptopurinePurinethol
How 6-mercaptopurine interacts with Niacin 500 mg — through 1 ingredient. Tap an ingredient for the detail:
NiacinHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use of niacin and hepatotoxic drugs might increase the risk of hepatotoxicity.
Read the full Niacin + 6-mercaptopurine interactionAbacavir Sulfate, Dolutegravir, LamivudineTriumeq
How Abacavir Sulfate, Dolutegravir, Lamivudine interacts with Niacin 500 mg — through 1 ingredient. Tap an ingredient for the detail:
NiacinHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use of niacin and hepatotoxic drugs might increase the risk of hepatotoxicity.
Read the full Niacin + Abacavir Sulfate, Dolutegravir, Lamivudine interactionAbacavir, LamivudineEpzicom
How Abacavir, Lamivudine interacts with Niacin 500 mg — through 1 ingredient. Tap an ingredient for the detail:
NiacinHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use of niacin and hepatotoxic drugs might increase the risk of hepatotoxicity.
Read the full Niacin + Abacavir, Lamivudine interactionAbciximabReoPro
How Abciximab interacts with Niacin 500 mg — through 1 ingredient. Tap an ingredient for the detail:
NiacinAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, niacin may have additive effects when used with anticoagulant or antiplatelet drugs.
Read the full Niacin + Abciximab interactionAbiraterone
How Abiraterone interacts with Niacin 500 mg — through 1 ingredient. Tap an ingredient for the detail:
NiacinHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use of niacin and hepatotoxic drugs might increase the risk of hepatotoxicity.
Read the full Niacin + Abiraterone interactionAbiraterone AcetateYonsa, Zytiga
How Abiraterone Acetate interacts with Niacin 500 mg — through 1 ingredient. Tap an ingredient for the detail:
NiacinHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use of niacin and hepatotoxic drugs might increase the risk of hepatotoxicity.
Read the full Niacin + Abiraterone Acetate interactionAbrocitinibCibinqo
How Abrocitinib interacts with Niacin 500 mg — through 1 ingredient. Tap an ingredient for the detail:
NiacinAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, niacin may have additive effects when used with anticoagulant or antiplatelet drugs.
Read the full Niacin + Abrocitinib interactionAcarboseGlucobay, Prandase, Precose
How Acarbose interacts with Niacin 500 mg — through 1 ingredient. Tap an ingredient for the detail:
NiacinAntidiabetes Drugs, Hepatotoxic Drugs Moderate
Interaction Summary
Niacin can increase blood glucose levels and may diminish the effects of antidiabetes drugs.
Read the full Niacin + Acarbose interactionAcebutololRhotral, Sectral
How Acebutolol interacts with Niacin 500 mg — through 1 ingredient. Tap an ingredient for the detail:
NiacinAntihypertensive Drugs, Hepatotoxic Drugs Moderate
Interaction Summary
Theoretically, niacin may increase the risk of hypotension when used with antihypertensive drugs.
Read the full Niacin + Acebutolol interactionAcenocoumarolSintrom
How Acenocoumarol interacts with Niacin 500 mg — through 1 ingredient. Tap an ingredient for the detail:
NiacinAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, niacin may have additive effects when used with anticoagulant or antiplatelet drugs.
Read the full Niacin + Acenocoumarol interactionAcetaminophenChildren's Tylenol, Children's Tylenol Meltaways, Tylenol, Tylenol Ex Strength
How Acetaminophen interacts with Niacin 500 mg — through 1 ingredient. Tap an ingredient for the detail:
NiacinHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use of niacin and hepatotoxic drugs might increase the risk of hepatotoxicity.
Read the full Niacin + Acetaminophen interactionAcetaminophen, AspirinGemnisyn
How Acetaminophen, Aspirin interacts with Niacin 500 mg — through 1 ingredient. Tap an ingredient for the detail:
NiacinAnticoagulant/antiplatelet Drugs, Aspirin +1 Moderate
Interaction Summary
Theoretically, niacin may have additive effects when used with anticoagulant or antiplatelet drugs.
Read the full Niacin + Acetaminophen, Aspirin interactionAcetaminophen, Aspirin, CaffeineExcedrin, Excedrin Extra Strength, Excedrin Migraine
How Acetaminophen, Aspirin, Caffeine interacts with Niacin 500 mg — through 1 ingredient. Tap an ingredient for the detail:
NiacinAnticoagulant/antiplatelet Drugs, Hepatotoxic Drugs +1 Moderate
Interaction Summary
Theoretically, niacin may have additive effects when used with anticoagulant or antiplatelet drugs.
Read the full Niacin + Acetaminophen, Aspirin, Caffeine interactionAcetaminophen, Brompheniramine, PhenylpropanolamineDimetapp Cold and Flu
How Acetaminophen, Brompheniramine, Phenylpropanolamine interacts with Niacin 500 mg — through 1 ingredient. Tap an ingredient for the detail:
NiacinHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use of niacin and hepatotoxic drugs might increase the risk of hepatotoxicity.
Read the full Niacin + Acetaminophen, Brompheniramine, Phenylpropanolamine interactionAcetaminophen, ButalbitalAxocet, Bancap, Bucet, Butex Forte, Esgic CF, Orbivan CF +5 more
How Acetaminophen, Butalbital interacts with Niacin 500 mg — through 1 ingredient. Tap an ingredient for the detail:
NiacinHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use of niacin and hepatotoxic drugs might increase the risk of hepatotoxicity.
Read the full Niacin + Acetaminophen, Butalbital interactionAcetaminophen, Butalbital, CaffeineEsgic, Esgic Plus, Fiogesic, Fioricet, Repan, Tecnal +1 more
How Acetaminophen, Butalbital, Caffeine interacts with Niacin 500 mg — through 1 ingredient. Tap an ingredient for the detail:
NiacinHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use of niacin and hepatotoxic drugs might increase the risk of hepatotoxicity.
Read the full Niacin + Acetaminophen, Butalbital, Caffeine interactionAcetaminophen, Butalbital, Caffeine, CodeineEsgic with Codeine, Fioricet w/ Codeine
How Acetaminophen, Butalbital, Caffeine, Codeine interacts with Niacin 500 mg — through 1 ingredient. Tap an ingredient for the detail:
NiacinHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use of niacin and hepatotoxic drugs might increase the risk of hepatotoxicity.
Read the full Niacin + Acetaminophen, Butalbital, Caffeine, Codeine interactionAcetaminophen, Butalbital, CodeineBancap w/ Codeine
How Acetaminophen, Butalbital, Codeine interacts with Niacin 500 mg — through 1 ingredient. Tap an ingredient for the detail:
NiacinHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use of niacin and hepatotoxic drugs might increase the risk of hepatotoxicity.
Read the full Niacin + Acetaminophen, Butalbital, Codeine interactionAcetaminophen, Butalbital, Codeine PhosphatePhrenilin #3
How Acetaminophen, Butalbital, Codeine Phosphate interacts with Niacin 500 mg — through 1 ingredient. Tap an ingredient for the detail:
NiacinHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use of niacin and hepatotoxic drugs might increase the risk of hepatotoxicity.
Read the full Niacin + Acetaminophen, Butalbital, Codeine Phosphate interactionAcetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, PhenylephrineHycomine Compound
How Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interacts with Niacin 500 mg — through 1 ingredient. Tap an ingredient for the detail:
NiacinHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use of niacin and hepatotoxic drugs might increase the risk of hepatotoxicity.
Read the full Niacin + Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interactionAcetaminophen, Caffeine, CodeineGesic C15, Gesic C30, Gesic C8, Lenoltec 1, Lenoltec 2, Lenoltec 3 +1 more
How Acetaminophen, Caffeine, Codeine interacts with Niacin 500 mg — through 1 ingredient. Tap an ingredient for the detail:
NiacinHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use of niacin and hepatotoxic drugs might increase the risk of hepatotoxicity.
Read the full Niacin + Acetaminophen, Caffeine, Codeine interactionAcetaminophen, Caffeine, Codeine, SalicylamideCodalan No.1, Codalan No.2, Codalan No.3
How Acetaminophen, Caffeine, Codeine, Salicylamide interacts with Niacin 500 mg — through 1 ingredient. Tap an ingredient for the detail:
NiacinHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use of niacin and hepatotoxic drugs might increase the risk of hepatotoxicity.
Read the full Niacin + Acetaminophen, Caffeine, Codeine, Salicylamide interactionAcetaminophen, Caffeine, DihydrocodeineDHC Plus, Panlor DC, Panlor SS
How Acetaminophen, Caffeine, Dihydrocodeine interacts with Niacin 500 mg — through 1 ingredient. Tap an ingredient for the detail:
NiacinHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use of niacin and hepatotoxic drugs might increase the risk of hepatotoxicity.
Read the full Niacin + Acetaminophen, Caffeine, Dihydrocodeine interactionAcetaminophen, Caffeine, IsomethepteneMigralam
How Acetaminophen, Caffeine, Isometheptene interacts with Niacin 500 mg — through 1 ingredient. Tap an ingredient for the detail:
NiacinHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use of niacin and hepatotoxic drugs might increase the risk of hepatotoxicity.
Read the full Niacin + Acetaminophen, Caffeine, Isometheptene interactionAcetaminophen, Caffeine, PyrilamineMidol Max Strength Menstrual
How Acetaminophen, Caffeine, Pyrilamine interacts with Niacin 500 mg — through 1 ingredient. Tap an ingredient for the detail:
NiacinHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use of niacin and hepatotoxic drugs might increase the risk of hepatotoxicity.
Read the full Niacin + Acetaminophen, Caffeine, Pyrilamine interactionAcetaminophen, Chlorpheniramine Maleate, Dextromethorphan HbrVicks Formula 44M Cough, Cold & Flu Relief
How Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan Hbr interacts with Niacin 500 mg — through 1 ingredient. Tap an ingredient for the detail:
NiacinHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use of niacin and hepatotoxic drugs might increase the risk of hepatotoxicity.
Read the full Niacin + Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan Hbr interactionAcetaminophen, Chlorpheniramine, Codeine, PhenylephrineColrex
How Acetaminophen, Chlorpheniramine, Codeine, Phenylephrine interacts with Niacin 500 mg — through 1 ingredient. Tap an ingredient for the detail:
NiacinHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use of niacin and hepatotoxic drugs might increase the risk of hepatotoxicity.
Read the full Niacin + Acetaminophen, Chlorpheniramine, Codeine, Phenylephrine interactionAcetaminophen, Chlorpheniramine, DextromethorphanCoricidin II Extra Strength Cold and Flu
How Acetaminophen, Chlorpheniramine, Dextromethorphan interacts with Niacin 500 mg — through 1 ingredient. Tap an ingredient for the detail:
NiacinHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use of niacin and hepatotoxic drugs might increase the risk of hepatotoxicity.
Read the full Niacin + Acetaminophen, Chlorpheniramine, Dextromethorphan interactionAcetaminophen, Chlorpheniramine, Dextromethorphan HydrobromideCoricidin HBP Maximum Strength Flu
How Acetaminophen, Chlorpheniramine, Dextromethorphan Hydrobromide interacts with Niacin 500 mg — through 1 ingredient. Tap an ingredient for the detail:
NiacinHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use of niacin and hepatotoxic drugs might increase the risk of hepatotoxicity.
Read the full Niacin + Acetaminophen, Chlorpheniramine, Dextromethorphan Hydrobromide interactionAcetaminophen, Chlorpheniramine, Dextromethorphan, PhenylpropanolamineMulti Symptom Cold Relief
How Acetaminophen, Chlorpheniramine, Dextromethorphan, Phenylpropanolamine interacts with Niacin 500 mg — through 1 ingredient. Tap an ingredient for the detail:
NiacinHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use of niacin and hepatotoxic drugs might increase the risk of hepatotoxicity.
Read the full Niacin + Acetaminophen, Chlorpheniramine, Dextromethorphan, Phenylpropanolamine interactionEach ingredient & the kinds of drugs it affects
For each ingredient in Niacin 500 mg with known interactions, here are the types of medications it can affect. Open any type for the detail — or search your exact drug in the checker above.
Niacin
Alcohol (Ethanol)
Concomitant use of alcohol and niacin might increase the risk of flushing and hepatotoxicity.
Alcohol can exacerbate the flushing and pruritus associated with niacin. Large doses of niacin might also exacerbate liver dysfunction associated with chronic alcohol use. A case report describes delirium and lactic acidosis in a patient taking niacin 3 grams daily who ingested 1 liter of wine. Advise patients to avoid large amounts of alcohol while taking niacin.
Allopurinol (Zyloprim)
Theoretically, niacin might antagonize the therapeutic effects of uricosurics such as allopurinol.
Large doses of niacin can reduce urinary excretion of uric acid, potentially resulting in hyperuricemia. Doses of uricosurics such as allopurinol might need to be increased to maintain control of gout in patients who start taking niacin. People who have frequent attacks of gout despite uricosuric therapy should avoid niacin.
Anticoagulant/Antiplatelet Drugs
Theoretically, niacin may have additive effects when used with anticoagulant or antiplatelet drugs.
Several cases of clotting factor synthesis deficiency and coagulopathy have been reported in patients taking sustained-release niacin. Also, thrombocytopenia has been reported in patients treated with niacin or niacin plus lovastatin.
Antidiabetes Drugs
Niacin can increase blood glucose levels and may diminish the effects of antidiabetes drugs.
Niacin impairs glucose tolerance in a dose-dependent manner, probably by causing or aggravating insulin resistance and increasing hepatic production of glucose. In diabetes patients, niacin 4.5 grams daily for 5 weeks can increase plasma glucose by an average of 16% and glycated hemoglobin (HbA1c) by 21%. However, lower doses of 1.5 grams daily or less appear to have minimal effects on blood glucose. In some patients, glucose levels increase when niacin is started, but then return to baseline when a stable dose is reached. Up to 35% of patients with diabetes may need adjustments in hypoglycemic therapy when niacin is added.
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.
Bile Acid Sequestrants
Bile acid sequestrants can bind niacin and decrease absorption. Separate administration by 4-6 hours to avoid an interaction.
In vitro studies show that colestipol (Colestid) binds about 98% of available niacin and cholestyramine (Questran) binds 10% to 30%.
Gemfibrozil (Lopid)
Theoretically, concomitant use of niacin and gemfibrozil might increase the risk of myopathy in some patients.
A case of myopathy from concomitant use of niacin and gemfibrozil has been reported. Niacin alone has also been associated with cases of myopathy. Using gemfibrozil with niacin might further increase the risk of developing myopathy.
Hepatotoxic Drugs
Theoretically, concomitant use of niacin and hepatotoxic drugs might increase the risk of hepatotoxicity.
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.
Hmg-Coa Reductase Inhibitors ("Statins")
Theoretically, concomitant use of niacin and statins might increase the risk of myopathy and rhabdomyolysis in some patients.
Some case reports have raised concerns that niacin might increase the risk of myopathy and rhabdomyolysis when combined with statins. However, a significantly increased risk of myopathy has not been demonstrated in clinical trials, including those using an FDA-approved combination of lovastatin and niacin (Advicor).
Probenecid (Benemid)
Theoretically, niacin might antagonize the therapeutic effects of uricosurics such as probenecid.
Large doses of niacin reduce urinary excretion of uric acid, potentially causing hyperuricemia. Doses of uricosurics such as probenecid might need to be increased to maintain control of gout in patients who start taking niacin. People who have frequent attacks of gout despite uricosuric therapy should avoid niacin.
Sulfinpyrazone (Anturane)
Theoretically, niacin might antagonize the therapeutic effects of uricosurics such as sulfinpyrazone.
Large doses of niacin reduce urinary excretion of uric acid, potentially causing hyperuricemia. Doses of uricosurics such as sulfinpyrazone might need to be increased to maintain control of gout in patients who start taking niacin. People who have frequent attacks of gout despite uricosuric therapy should avoid niacin.
Thyroid Hormone
Theoretically, niacin might antagonize the therapeutic effects of thyroid hormones.
Clinical research and case reports suggests that taking niacin can reduce serum levels of thyroxine-binding globulin by up to 25% and moderately reduce levels of thyroxine (T4). Patients taking thyroid hormone for hypothyroidism might need dose adjustments when using niacin.
Transdermal Nicotine (Nicoderm)
Theoretically, concomitant use of niacin and transdermal nicotine might increase the risk of flushing and dizziness.
Niacin and nicotine can both cause flushing and dizziness.
Warfarin (Coumadin)
There is limited evidence that niacin may increase the anticoagulant effects of warfarin.
In a case report, a patient on warfarin developed an elevated international normalized ratio (INR) of 3.9 after taking niacin for two weeks. The patient's INR was previously stable, ranging between 2 and 3 in recent months, and no other medication changes were identified. The elevated INR returned to therapeutic range within 4 days following the discontinuation of niacin.
Aspirin
Large doses of aspirin might alter the clearance of niacin.
Aspirin is often used with niacin to reduce niacin-induced flushing. Doses of 80-975 mg aspirin have been used, but 325 mg appears to be optimal. Aspirin also seems to reduce the clearance of niacin by competing for glycine conjugation. Taking aspirin 1 gram seems to reduce niacin clearance by 45%. This is probably a dose-related effect and not clinically significant with the more common aspirin dose of 325 mg.
Brand information
Manufacturer and brand details for Niacin 500 mg, from the product label.
Major
See all Major products- Name
- Major Pharmaceuticals
- Street Address
- 31778 Enterprise Drive
- City
- Livonia
- State
- MI
- ZipCode
- 48150
- Phone Number
- 1-888-860-5376
Niacin 500 mg by Major: Common Questions
Does Niacin 500 mg by Major interact with any medications?
How can one product interact with so many drugs?
Where does this information come from?
Will this cause the niacin flush?
Can I take this if I'm pregnant?
Is niacin likely to help my cholesterol?
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The Full Monographs Behind Niacin 500 mg’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Sources & How We Checked
Niacin 500 mg's label data comes from the NIH Dietary Supplement Label Database; the ingredient interaction data is from the Natural Medicines database, reviewed by our pharmacists.
- NIH Dietary Supplement Label Database (DSLD) — The official product label on file for this supplement.
- Natural Medicines (Therapeutic Research Center) — Evidence-graded clinical reference behind the ingredient interaction data.
Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.
The 66 references behind this product’s interaction data
Every citation that drives the interaction findings for this product’s ingredients, from the evidence-graded Natural Medicines (TRC Healthcare) database. Open an ingredient to browse its citations — links open the study on PubMed or the publisher’s site.
Niacin 66 references
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- Litin SC, Anderson CF. Nicotinic acid-associated myopathy: a report of three cases. Am J Med. 1989;86(4):481-3. PubMed
- Fraunfelder FW, Fraunfelder FT, Illingworth DR. Adverse ocular effects associated with niacin therapy. Br J Ophthalmol 1995;79:54-56. PubMed
- Ali EH, McJunkin B, Jubelirer S, Hood W. Niacin induced coagulopathy as a manifestation of occult liver injury. W V Med J. 2013 Jan-Feb;109(1):12-4
- 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. PubMed
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- Loebl T, Raskin S. A novel case report: acute manic psychotic episode after treatment with niacin. J Neuropsychiatry Clin Neurosci. 2013 Fall;25(4):E14. PubMed
- Teo KK, Goldstein LB, Chaitman BR, Grant S, Weintraub WS, Anderson DC, Sila CA, Cruz-Flores S, Padley RJ, Kostuk WJ, Boden WE; AIM-HIGH Investigators. Extended-release niacin therapy and risk of ischemic stroke in patients with cardiovascular disease: the
- Goldie C, Taylor AJ, Nguyen P, McCoy C, Zhao XQ, Preiss D. Niacin therapy and the risk of new-onset diabetes: a meta-analysis of randomized controlled trials. Heart. 2016 Feb;102(3):198-203.
- Schandelmaier S, Briel M, Saccilotto R, Olu KK, Arpagaus A, Hemkens LG, Nordmann AJ. Niacin for primary and secondary prevention of cardiovascular events. Cochrane Database Syst Rev. 2017 Jun 14;6:CD009744. PubMed
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- Kimura H, Umemori Y, Yuki D. Anaphylactic shock-like symptoms due to niacin overdose: A case report. J Dermatol 2022;49(8):e287-e288. PubMed
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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