Niacin Ingredients & Drug Interactions
What is this page for?
First and foremost: checking Niacin 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 is a dietary supplement by Nature's Sunshine with 3 active ingredients. Its ingredients are commonly taken for high cholesterol, vitamin b3 deficiency (pellagra), heart health support.Based on those ingredients, 1,374 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Feverfew, Hops, Niacin. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.
Check Your Meds Against Niacin by Nature's Sunshine
Ask about any prescription or over-the-counter medication and we check it for interactions with Niacin by Nature's Sunshine — and tell you which ingredient is responsible.
AI summaries are generated from our interaction database for education only — always confirm with your pharmacist. How we use AI
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HelloPharmacist Scorecard of Niacin by Nature's Sunshine
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
Low disclosure
Nature's Sunshine Niacin contains 3 active ingredients: niacin (a B vitamin), feverfew (an herbal extract), and hops (another herbal extract). The product also includes several inactive ingredients — dicalcium phosphate, cellulose, stearic acid, silicon dioxide, and vegetable magnesium stearate — which are binders and fillers that hold the tablet together.
Niacin is a water-soluble B vitamin that plays a role in energy metabolism and cell function. Feverfew and hops are traditional herbal ingredients included for their traditional uses, though the strength of evidence for their effectiveness in this formulation isn't fully established in our data.
Does it work?
Strong evidence
Niacin is likely effective for pellagra (a rare deficiency disease) and possibly effective for HIV-related dyslipidemia (abnormal blood fats) and metabolic syndrome. For feverfew and hops, the evidence we hold doesn't establish effectiveness for tension headaches, skin conditions, arthritis, anxiety, sleep, or other claimed uses — the data rates these as having insufficient reliable evidence to rate.
Talk with your doctor about whether this product is right for your specific health goals.
How safe is it?
Well-documented data
At the amounts found in food and standard doses taken under medical supervision, niacin is generally well tolerated. However, high supplemental doses can cause flushing (affecting up to 70% of users), stomach upset (nausea, vomiting, heartburn, abdominal pain, diarrhea, constipation), and elevated liver enzymes.
Rare but serious side effects include liver damage, muscle problems, blood clotting issues, and vision changes — especially with sustained-release forms. Feverfew is generally well tolerated short-term but can cause mouth ulcers (especially if you chew fresh leaves), stomach upset, allergic reactions, and a withdrawal syndrome (anxiety, headaches, insomnia) if stopped abruptly after long-term use.
Hops is generally well tolerated short-term but may cause drowsiness, and long-term safety isn't well studied. The product is not recommended during pregnancy or breastfeeding — safety data is limited or advises against use.
Meds to double-check
Moderate interaction found
Check with your doctor or pharmacist before using this product if you take blood pressure medications (antihypertensives), blood thinners or antiplatelet drugs, diabetes medications, statin cholesterol drugs, liver-toxic medications, gout drugs (allopurinol or probenecid), bile acid sequestrants, sedative drugs, estrogen or hormone replacement therapy, or any drug metabolized by your liver's CYP2C19, CYP2D6, CYP1A2, CYP2C9, CYP3A4, or CYP2C8 enzymes. These are the main areas where interactions have been documented.
The bottom line
Scorecard at a glanceFormula with limited ingredient disclosure with clinical evidence supporting its stated purpose. Moderate medication interactions have been identified, and safety information is well characterized.
This product is designed around niacin for cholesterol and metabolic support, with added herbal ingredients of less-established benefit. If you're on blood pressure meds, diabetes drugs, blood thinners, statin cholesterol drugs, gout medications, or any other regular prescription, check your exact medications with the tool on this page or talk it through with your doctor or pharmacist before you start.
Women who are pregnant, breastfeeding, or planning to become pregnant should avoid it.
Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI
Assessment coverage: 3 of 3 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Oct 24, 2022.
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, straight from the product label.
| Brand | Nature's Sunshine |
|---|---|
| Barcode (UPC) | 099904017979 |
| Net contents | 90 Tablet(s) |
| Market status | On market |
| Date entered into DSLD | Oct 24, 2022 |
| DSLD ID | 278188 |
| Product type | Vitamin |
| Supplement form | Tablet Or Pill |
| Dietary claims / uses | All Other, Structure/Function |
| Intended target group(s) | Adult (18 - 50 Years), Kosher |
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 by Nature's Sunshine, sourced from the NIH Dietary Supplement Label Database.
Supplement Facts
| Ingredient | Amount | % DV |
|---|---|---|
| Niacin | 250 mg NE | 1563% |
| Proprietary Blend | 10 mg | -- |
| Feverfew | 0 NP | -- |
| Hops | 0 NP | -- |
Other ingredients: Dicalcium Phosphate, Cellulose, Stearic Acid, Silicon Dioxide, Vegetable Magnesium Stearate
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.
FDA Disclaimer Statement
These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.
General Statements
Bottle made from 100% post consumer recycled material. We are committed to you and our planet. Scan to learn more.
We source the world's purest ingredients, no matter where they are grown, to ensure the active nutrients are delivered just as nature intended.
New look! Same great product
Precautions
Pregnant or lactating women should consult their health care professional prior to taking this supplement.
Do not use if inner seal is missing or damaged.
Seals/Symbols
Ko Pareve (Kosher)
Formula
Ko Pareve (Kosher)
Formulation
Circulatory system support Support the nervous system
Guaranteed pure
FDA Statement of Identity
Dietary Supplement
Brand IP Statement(s)
Natures Sunshine Herbal experts since 1972
Suggested/Recommended/Usage/Directions
Recommended Use: Take 1 tablet daily with a meal.
Is this label outdated? Report a formula or label change and our pharmacy team will review it.
Niacin by Nature's Sunshine 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 by Nature's Sunshine
These are the 3 active ingredients this product is made of. Select any to open its full monograph.
Serving size1 Tablet(s) Dosage formTablet Or Pill Servings per container90 Amounts shown are per serving.
Most supplement products combine several ingredients, and a medication can interact with the product through any one of them. Each ingredient below shows whether it has known drug interactions.
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, Cellulose, Stearic Acid, Silicon Dioxide, Vegetable Magnesium Stearate. These complete the product’s ingredient list but are not active constituents.
Niacin by Nature's Sunshine Drug Interactions
HelloPharmacist Interaction Report
Nature's Sunshine Niacin interacts with medications through its niacin, feverfew, and hops content.
The most serious concern is niacin's moderate interaction with blood pressure drugs (antihypertensives) — niacin can lower blood pressure further and cause dangerously low readings.
Read the full breakdown — every affected drug type, severity by severity
Niacin also has moderate interactions with blood thinners and antiplatelet drugs (which may increase bleeding risk), diabetes medications (niacin can raise blood sugar and reduce their effectiveness), cholesterol-lowering statins (risk of muscle damage in some patients), liver-toxic drugs (increased toxicity risk), and gout medications like allopurinol and probenecid (niacin can reduce their effectiveness). Bile acid sequestrants, another cholesterol drug class, can bind and reduce niacin absorption — take them 4 to 6 hours apart.
Feverfew may slow the metabolism of many drugs processed by your liver's CYP enzymes (CYP2C19, CYP2D6, CYP1A2, CYP2C9, CYP3A4, and CYP2C8 substrates), theoretically raising their levels; it also carries a moderate interaction with blood thinners. Hops has moderate interactions with sedative drugs (additive drowsiness) and estrogens in hormone replacement therapy, and minor interactions with some CYP3A4 and CYP1A2 substrates.
Altogether, these interactions span 1,375 individual medications. Check your exact prescriptions with the search tool on this page before starting this product.
Check your own medications below · Editorial policy · How we use AI
Want to check YOUR meds against Niacin?
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 interact with 1,374 drugs. Click any drug to see the details.
3 of the 3 ingredients in Niacin interact with drugs. Each result below shows which ingredient is responsible. Feverfew Hops Niacin
6-mercaptopurinePurinethol
How 6-mercaptopurine interacts with Niacin — 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 interactionAdo-trastuzumab EmtansineKadcyla
How Ado-trastuzumab Emtansine interacts with Niacin — through 2 ingredients. Tap an ingredient for the detail:
FeverfewCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, feverfew might increase levels of drugs metabolized by CYP3A4.
Read the full Feverfew + Ado-trastuzumab Emtansine interactionHopsCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, hops extract might alter metabolism of CYP3A4 substrates; however, this effect may not be clinically significant.
Read the full Hops + Ado-trastuzumab Emtansine interactionAbacavir Sulfate, Dolutegravir, LamivudineTriumeq
How Abacavir Sulfate, Dolutegravir, Lamivudine interacts with Niacin — 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 — 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 — through 2 ingredients. 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 interactionFeverfewAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, feverfew might have additive effects and increase the risk of bleeding when used with anticoagulant or antiplatelet drugs.
Read the full Feverfew + Abciximab interactionAbemaciclibVerzenio
How Abemaciclib interacts with Niacin — through 2 ingredients. Tap an ingredient for the detail:
FeverfewCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, feverfew might increase levels of drugs metabolized by CYP3A4.
Read the full Feverfew + Abemaciclib interactionHopsCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, hops extract might alter metabolism of CYP3A4 substrates; however, this effect may not be clinically significant.
Read the full Hops + Abemaciclib interactionAbiraterone
How Abiraterone interacts with Niacin — through 3 ingredients. Tap an ingredient for the detail:
FeverfewCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, feverfew might increase levels of drugs metabolized by CYP3A4.
Read the full Feverfew + Abiraterone interactionNiacinHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use of niacin and hepatotoxic drugs might increase the risk of hepatotoxicity.
Read the full Niacin + Abiraterone interactionHopsCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, hops extract might alter metabolism of CYP3A4 substrates; however, this effect may not be clinically significant.
Read the full Hops + Abiraterone interactionAbiraterone AcetateYonsa, Zytiga
How Abiraterone Acetate interacts with Niacin — through 3 ingredients. 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 interactionFeverfewCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, feverfew might increase levels of drugs metabolized by CYP3A4.
Read the full Feverfew + Abiraterone Acetate interactionHopsCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, hops extract might alter metabolism of CYP3A4 substrates; however, this effect may not be clinically significant.
Read the full Hops + Abiraterone Acetate interactionAbrocitinibCibinqo
How Abrocitinib interacts with Niacin — through 2 ingredients. Tap an ingredient for the detail:
FeverfewCytochrome P450 2c19 (cyp2c19) Substrates, Cytochrome P450 2c9 (cyp2c9) Substrates +1 Moderate
Interaction Summary
Theoretically, feverfew might increase levels of drugs metabolized by CYP2C19.
Read the full Feverfew + Abrocitinib interactionNiacinAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, niacin may have additive effects when used with anticoagulant or antiplatelet drugs.
Read the full Niacin + Abrocitinib interactionAcalabrutinibCalquence
How Acalabrutinib interacts with Niacin — through 2 ingredients. Tap an ingredient for the detail:
FeverfewCytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, feverfew might increase levels of drugs metabolized by CYP3A4.
Read the full Feverfew + Acalabrutinib interactionHopsCytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Theoretically, hops extract might alter metabolism of CYP3A4 substrates; however, this effect may not be clinically significant.
Read the full Hops + Acalabrutinib interactionAcarboseGlucobay, Prandase, Precose
How Acarbose interacts with Niacin — 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 — through 1 ingredient. Tap an ingredient for the detail:
NiacinHepatotoxic Drugs, Antihypertensive Drugs Moderate
Interaction Summary
Theoretically, concomitant use of niacin and hepatotoxic drugs might increase the risk of hepatotoxicity.
Read the full Niacin + Acebutolol interactionAcenocoumarolSintrom
How Acenocoumarol interacts with Niacin — through 2 ingredients. Tap an ingredient for the detail:
FeverfewAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, feverfew might have additive effects and increase the risk of bleeding when used with anticoagulant or antiplatelet drugs.
Read the full Feverfew + Acenocoumarol interactionNiacinAnticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, niacin may have additive effects when used with anticoagulant or antiplatelet drugs.
Read the full Niacin + Acenocoumarol interactionAcepromazineAtravet
How Acepromazine interacts with Niacin — through 1 ingredient. Tap an ingredient for the detail:
HopsCns Depressants Moderate
Interaction Summary
Theoretically, concomitant use of hops with sedative drugs might cause additive sedation.
Read the full Hops + Acepromazine interactionAcetaminophenChildren's Tylenol, Children's Tylenol Meltaways, Tylenol, Tylenol Ex Strength
How Acetaminophen interacts with Niacin — through 3 ingredients. Tap an ingredient for the detail:
FeverfewCytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, feverfew might increase levels of drugs metabolized by CYP1A2.
Read the full Feverfew + Acetaminophen interactionNiacinHepatotoxic Drugs Moderate
Interaction Summary
Theoretically, concomitant use of niacin and hepatotoxic drugs might increase the risk of hepatotoxicity.
Read the full Niacin + Acetaminophen interactionHopsCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Hops extract does not seem to affect the metabolism of CYP1A2 substrates.
Read the full Hops + Acetaminophen interactionAcetaminophen, AspirinGemnisyn
How Acetaminophen, Aspirin interacts with Niacin — through 3 ingredients. Tap an ingredient for the detail:
NiacinHepatotoxic Drugs, Anticoagulant/antiplatelet Drugs +1 Moderate
Interaction Summary
Theoretically, concomitant use of niacin and hepatotoxic drugs might increase the risk of hepatotoxicity.
Read the full Niacin + Acetaminophen, Aspirin interactionFeverfewCytochrome P450 1a2 (cyp1a2) Substrates, Anticoagulant/antiplatelet Drugs Moderate
Interaction Summary
Theoretically, feverfew might increase levels of drugs metabolized by CYP1A2.
Read the full Feverfew + Acetaminophen, Aspirin interactionHopsCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Hops extract does not seem to affect the metabolism of CYP1A2 substrates.
Read the full Hops + Acetaminophen, Aspirin interactionAcetaminophen, Aspirin, CaffeineExcedrin, Excedrin Extra Strength, Excedrin Migraine
How Acetaminophen, Aspirin, Caffeine interacts with Niacin — through 3 ingredients. Tap an ingredient for the detail:
NiacinAspirin, Anticoagulant/antiplatelet Drugs +1 Moderate
Interaction Summary
Large doses of aspirin might alter the clearance of niacin.
Read the full Niacin + Acetaminophen, Aspirin, Caffeine interactionFeverfewCytochrome P450 1a2 (cyp1a2) Substrates, Anticoagulant/antiplatelet Drugs +1 Moderate
Interaction Summary
Theoretically, feverfew might increase levels of drugs metabolized by CYP1A2.
Read the full Feverfew + Acetaminophen, Aspirin, Caffeine interactionHopsCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, hops extract might alter metabolism of CYP3A4 substrates; however, this effect may not be clinically significant.
Read the full Hops + Acetaminophen, Aspirin, Caffeine interactionAcetaminophen, Brompheniramine, PhenylpropanolamineDimetapp Cold and Flu
How Acetaminophen, Brompheniramine, Phenylpropanolamine interacts with Niacin — through 3 ingredients. Tap an ingredient for the detail:
FeverfewCytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, feverfew might increase levels of drugs metabolized by CYP1A2.
Read the full Feverfew + Acetaminophen, Brompheniramine, Phenylpropanolamine interactionNiacinHepatotoxic 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 interactionHopsCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Hops extract does not seem to affect the metabolism of CYP1A2 substrates.
Read the full Hops + Acetaminophen, Brompheniramine, Phenylpropanolamine interactionAcetaminophen, ButalbitalAxocet, Bancap, Bucet, Butex Forte, Esgic CF, Orbivan CF +5 more
How Acetaminophen, Butalbital interacts with Niacin — through 3 ingredients. 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 interactionFeverfewCytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, feverfew might increase levels of drugs metabolized by CYP1A2.
Read the full Feverfew + Acetaminophen, Butalbital interactionHopsCytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Hops extract does not seem to affect the metabolism of CYP1A2 substrates.
Read the full Hops + Acetaminophen, Butalbital interactionAcetaminophen, Butalbital, CaffeineEsgic, Esgic Plus, Fiogesic, Fioricet, Repan, Tecnal +1 more
How Acetaminophen, Butalbital, Caffeine interacts with Niacin — through 3 ingredients. Tap an ingredient for the detail:
FeverfewCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, feverfew might increase levels of drugs metabolized by CYP1A2.
Read the full Feverfew + Acetaminophen, Butalbital, Caffeine interactionNiacinHepatotoxic 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 interactionHopsCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Hops extract does not seem to affect the metabolism of CYP1A2 substrates.
Read the full Hops + Acetaminophen, Butalbital, Caffeine interactionAcetaminophen, Butalbital, Caffeine, CodeineEsgic with Codeine, Fioricet w/ Codeine
How Acetaminophen, Butalbital, Caffeine, Codeine interacts with Niacin — through 3 ingredients. Tap an ingredient for the detail:
HopsCytochrome P450 3a4 (cyp3a4) Substrates, Cns Depressants +1 Moderate
Interaction Summary
Theoretically, hops extract might alter metabolism of CYP3A4 substrates; however, this effect may not be clinically significant.
Read the full Hops + Acetaminophen, Butalbital, Caffeine, Codeine interactionFeverfewCytochrome P450 2d6 (cyp2d6) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates +1 Moderate
Interaction Summary
Theoretically, feverfew might increase levels of drugs metabolized by CYP2D6.
Read the full Feverfew + Acetaminophen, Butalbital, Caffeine, Codeine interactionNiacinHepatotoxic 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 — through 3 ingredients. Tap an ingredient for the detail:
HopsCytochrome P450 1a2 (cyp1a2) Substrates, Cns Depressants Moderate
Interaction Summary
Hops extract does not seem to affect the metabolism of CYP1A2 substrates.
Read the full Hops + Acetaminophen, Butalbital, Codeine interactionFeverfewCytochrome P450 2d6 (cyp2d6) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, feverfew might increase levels of drugs metabolized by CYP2D6.
Read the full Feverfew + Acetaminophen, Butalbital, Codeine interactionNiacinHepatotoxic 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 — through 3 ingredients. Tap an ingredient for the detail:
HopsCns Depressants, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, concomitant use of hops with sedative drugs might cause additive sedation.
Read the full Hops + Acetaminophen, Butalbital, Codeine Phosphate interactionFeverfewCytochrome P450 2d6 (cyp2d6) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates Moderate
Interaction Summary
Theoretically, feverfew might increase levels of drugs metabolized by CYP2D6.
Read the full Feverfew + Acetaminophen, Butalbital, Codeine Phosphate interactionNiacinHepatotoxic 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 — through 3 ingredients. Tap an ingredient for the detail:
HopsCns Depressants, Cytochrome P450 3a4 (cyp3a4) Substrates +1 Moderate
Interaction Summary
Theoretically, concomitant use of hops with sedative drugs might cause additive sedation.
Read the full Hops + Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interactionFeverfewCytochrome P450 2d6 (cyp2d6) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates +1 Moderate
Interaction Summary
Theoretically, feverfew might increase levels of drugs metabolized by CYP2D6.
Read the full Feverfew + Acetaminophen, Caffeine, Chlorpheniramine, Hydrocodone, Phenylephrine interactionNiacinHepatotoxic 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 — through 3 ingredients. Tap an ingredient for the detail:
FeverfewCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 2d6 (cyp2d6) Substrates +1 Moderate
Interaction Summary
Theoretically, feverfew might increase levels of drugs metabolized by CYP3A4.
Read the full Feverfew + Acetaminophen, Caffeine, Codeine interactionNiacinHepatotoxic 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 interactionHopsCns Depressants, Cytochrome P450 1a2 (cyp1a2) Substrates +1 Moderate
Interaction Summary
Theoretically, concomitant use of hops with sedative drugs might cause additive sedation.
Read the full Hops + Acetaminophen, Caffeine, Codeine interactionAcetaminophen, Caffeine, Codeine, SalicylamideCodalan No.1, Codalan No.2, Codalan No.3
How Acetaminophen, Caffeine, Codeine, Salicylamide interacts with Niacin — through 3 ingredients. Tap an ingredient for the detail:
FeverfewCytochrome P450 2d6 (cyp2d6) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates +1 Moderate
Interaction Summary
Theoretically, feverfew might increase levels of drugs metabolized by CYP2D6.
Read the full Feverfew + Acetaminophen, Caffeine, Codeine, Salicylamide interactionNiacinHepatotoxic 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 interactionHopsCytochrome P450 3a4 (cyp3a4) Substrates, Cns Depressants +1 Moderate
Interaction Summary
Theoretically, hops extract might alter metabolism of CYP3A4 substrates; however, this effect may not be clinically significant.
Read the full Hops + Acetaminophen, Caffeine, Codeine, Salicylamide interactionAcetaminophen, Caffeine, DihydrocodeineDHC Plus, Panlor DC, Panlor SS
How Acetaminophen, Caffeine, Dihydrocodeine interacts with Niacin — through 3 ingredients. Tap an ingredient for the detail:
HopsCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates +1 Moderate
Interaction Summary
Hops extract does not seem to affect the metabolism of CYP1A2 substrates.
Read the full Hops + Acetaminophen, Caffeine, Dihydrocodeine interactionFeverfewCytochrome P450 2d6 (cyp2d6) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates +1 Moderate
Interaction Summary
Theoretically, feverfew might increase levels of drugs metabolized by CYP2D6.
Read the full Feverfew + Acetaminophen, Caffeine, Dihydrocodeine interactionNiacinHepatotoxic 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 — through 3 ingredients. Tap an ingredient for the detail:
FeverfewCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, feverfew might increase levels of drugs metabolized by CYP1A2.
Read the full Feverfew + Acetaminophen, Caffeine, Isometheptene interactionNiacinHepatotoxic 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 interactionHopsCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Minor
Interaction Summary
Hops extract does not seem to affect the metabolism of CYP1A2 substrates.
Read the full Hops + Acetaminophen, Caffeine, Isometheptene interactionAcetaminophen, Caffeine, PyrilamineMidol Max Strength Menstrual
How Acetaminophen, Caffeine, Pyrilamine interacts with Niacin — through 3 ingredients. Tap an ingredient for the detail:
FeverfewCytochrome P450 1a2 (cyp1a2) Substrates, Cytochrome P450 3a4 (cyp3a4) Substrates Moderate
Interaction Summary
Theoretically, feverfew might increase levels of drugs metabolized by CYP1A2.
Read the full Feverfew + Acetaminophen, Caffeine, Pyrilamine interactionNiacinHepatotoxic 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 interactionHopsCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, hops extract might alter metabolism of CYP3A4 substrates; however, this effect may not be clinically significant.
Read the full Hops + Acetaminophen, Caffeine, Pyrilamine interactionAcetaminophen, Chlorpheniramine Maleate, Dextromethorphan HbrVicks Formula 44M Cough, Cold & Flu Relief
How Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan Hbr interacts with Niacin — through 3 ingredients. 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 interactionFeverfewCytochrome P450 2d6 (cyp2d6) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates +1 Moderate
Interaction Summary
Theoretically, feverfew might increase levels of drugs metabolized by CYP2D6.
Read the full Feverfew + Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan Hbr interactionHopsCytochrome P450 3a4 (cyp3a4) Substrates, Cytochrome P450 1a2 (cyp1a2) Substrates Minor
Interaction Summary
Theoretically, hops extract might alter metabolism of CYP3A4 substrates; however, this effect may not be clinically significant.
Read the full Hops + Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan Hbr interactionEach ingredient & the kinds of drugs it affects
For each ingredient in Niacin with known interactions, here are the types of medications they can affect. Open any type for the detail — or search your exact drug in the checker above.
Feverfew
Anticoagulant/Antiplatelet Drugs
Theoretically, feverfew might have additive effects and increase the risk of bleeding when used with anticoagulant or antiplatelet drugs.
Laboratory research suggests that feverfew may inhibit platelet aggregation. Additionally, in one case report, a 36-year-old patient taking feverfew 2400 mg daily for 3 months experienced vaginal bleeding and a prolonged menstrual cycle, with a modest increase in partial thromboplastin time (PTT) and prothrombin time (PT).
Cytochrome P450 1A2 (Cyp1A2) Substrates
Theoretically, feverfew might increase levels of drugs metabolized by CYP1A2.
Laboratory research shows that feverfew might inhibit CYP1A2. So far, this interaction has not been reported in humans.
Cytochrome P450 2C19 (Cyp2C19) Substrates
Theoretically, feverfew might increase levels of drugs metabolized by CYP2C19.
Laboratory research shows that feverfew might inhibit CYP2C19. So far, this interaction has not been reported in humans.
Cytochrome P450 2C8 (Cyp2C8) Substrates
Theoretically, feverfew might increase levels of drugs metabolized by CYP2C8.
Laboratory research shows that feverfew might inhibit CYP2C8. So far, this interaction has not been reported in humans.
Cytochrome P450 2C9 (Cyp2C9) Substrates
Theoretically, feverfew might increase levels of drugs metabolized by CYP2C9.
Laboratory research shows that feverfew might inhibit CYP2C9. So far, this interaction has not been reported in humans.
Cytochrome P450 2D6 (Cyp2D6) Substrates
Theoretically, feverfew might increase levels of drugs metabolized by CYP2D6.
Laboratory research shows that feverfew might inhibit CYP2D6. So far, this interaction has not been reported in humans.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Theoretically, feverfew might increase levels of drugs metabolized by CYP3A4.
Laboratory research shows that feverfew might inhibit CYP3A4. So far, this interaction has not been reported in humans.
Hops
Cns Depressants
Theoretically, concomitant use of hops with sedative drugs might cause additive sedation.
Some animal research shows that hops has sedative effects.
Estrogens
Theoretically, concomitant use of large amounts of hops might interfere with hormone replacement therapy due to competition for estrogen receptors.
In vitro research suggests that certain hops constituents can competitively bind to estrogen receptors. However, most hops extracts contain very small amounts of these constituents.
Cytochrome P450 1A2 (Cyp1A2) Substrates
Hops extract does not seem to affect the metabolism of CYP1A2 substrates.
In vitro research suggests that flavonoid constituents of hops inhibit CYP1A2 enzyme activity. However, a pharmacokinetic study in healthy postmenopausal patients shows that taking a standardized extract of spent hops containing prenylated phenols, as 59.5 mg twice daily for 2 weeks, does not affect levels of caffeine, a CYP1A2 probe substrate.
Cytochrome P450 3A4 (Cyp3A4) Substrates
Theoretically, hops extract might alter metabolism of CYP3A4 substrates; however, this effect may not be clinically significant.
Animal research suggests that specific constituents of hops, called lupulones, can induce hepatic CYP3A4 enzyme activity. However, a pharmacokinetic study in healthy postmenopausal patients with normal metabolism shows that taking a standardized extract of spent hops containing prenylated phenols, as 59.5 mg twice daily for 2 weeks, decreases the concentration of alprazolam, a CYP3A4 probe substrate, by 7.6%. This reduction is unlikely to be clinically relevant.
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, from the product label.
Nature's Sunshine
See all Nature's Sunshine products- Name
- Nature's Sunshine Products, Inc.
- City
- Spanish Fork
- State
- UT
- ZipCode
- 84660
- Phone Number
- 1-800-223-8225
- Web Address
- www.naturessunshine.com
Niacin by Nature's Sunshine: Common Questions
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Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
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The Full Monographs Behind Niacin’s Ingredients
Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.
Niacin
Interacts with 727 drugsNiacin (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...
Read the full Niacin monograph → Herb & supplement monographFeverfew
Interacts with 929 drugsFeverfew is a daisy-family herb best known for migraine prevention, where some studies suggest it may modestly lower how often migraines occur, though the evidence is mixed. It is generally...
Read the full Feverfew monograph → Herb & supplement monographHops
Interacts with 863 drugsHops are most often used for sleep and mild anxiety, frequently combined with valerian, but the human evidence is limited and not very strong. They are generally well tolerated when used sho...
Read the full Hops monograph →Sources & How We Checked
Niacin'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 99 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
- Garg R, Malinow MR, Pettinger M, et al. Niacin treatment increases plasma homocysteine levels. Am Heart J 1999;138:1082-7.
- Anon. Inositol hexaniacinate. Altern Med Rev 1998;3:222-3.
- Knodel LC, Talbert RL. Adverse effects of hypolipidaemic drugs. Med Toxicol 1987;2:10-32. PubMed
- Guyton JR, Blazing MA, Hagar J, et al. Extended-release niacin vs gemfibrozil for the treatment of low levels of high-density lipoprotein cholesterol. Niaspan-Gemfibrozil Study Group. Arch Intern Med 2000;160:1177-84. PubMed
- Gibbons LW, Gonzalez V, Gordon N, Grundy S. The prevalence of side effects with regular and sustained-release nicotinic acid. Am J Med 1995;99:378-85. PubMed
- Whelan AM, Price SO, Fowler SF, Hainer BL. The effect of aspirin on niacin-induced cutaneous reactions. J Fam Pract 1992;34:165-8.
- Jungnickel PW, Maloley PA, Vander Tuin EL, et al. Effect of two aspirin pretreatment regimens on niacin-induced cutaneous reactions. J Gen Intern Med 1997;12:591-6. PubMed
- Capuzzi DM, Guyton JR, Morgan JM, et al. Efficacy and safety of an extended-release niacin (Niaspan): a long-term study. Am J Cardiol 1998;82:74-81;disc. 85U-6U. PubMed
- Gray DR, Morgan T, Chretien SD, Kashyap ML. Efficacy and safety of controlled-release niacin in dyslipoproteinemic veterans. Ann Intern Med 1994;121:252-8. PubMed
- McKenney JM, Proctor JD, Harris S, Chinchili VM. A comparison of the efficacy and toxic effects of sustained- vs immediate-release niacin in hypercholesterolemic patients. JAMA 1994;271:672-7. DOI
- Knopp RH, Alagona P, Davidson M, et al. Equivalent efficacy of a time-release form of niacin (Niaspan) given once-a-night versus plain niacin in the management of hyperlipidemia. Metabolism 1998;47:1097-104. PubMed
- Knopp RH. Clinical profiles of plain versus sustained-release niacin (Niaspan) and the physiologic rationale for nighttime dosing. Am J Cardiol 1998;82:24U-28U;discussion 39U-41U. PubMed
- Garg A, Grundy SM. Nicotinic acid as therapy for dyslipidemia in non-insulin-dependent diabetes mellitus. JAMA 1990;264:723-6. DOI
- Leighton RF, Gordon NF, Small GS, et al. Dental and gingival pain as side effects of niacin therapy. Chest 1998;114:1472-4. PubMed
- 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
- Vega GL, Grundy SM. Lipoprotein responses to treatment with lovastatin, gemfibrozil, and nicotinic acid in normolipidemic patients with hypoalphalipoproteinemia. Arch Intern Med 1994;154:73-82. DOI
- Guyton JR, Goldberg AC, Kreisberg RA, et al. Effectiveness of once-nightly dosing of extended-release niacin alone and in combination for hypercholesterolemia. Am J Cardiol 1998;82:737-43.
- Food and Nutrition Board, Institute of Medicine. Dietary Reference Intakes for Thiamin, Riboflavin, Niacin, Vitamin B6, Folate, Vitamin B12, Pantothenic Acid, Biotin, and Choline (2000). Washington, DC: National Academy Press, 2000. Available at: http://b
- Brown BG, Zhao XQ, Chait A, et al. Simvastatin and niacin, antioxidant vitamins, or the combination for the prevention of coronary disease. N Engl J Med 2001;345:1583-93. 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
- Kahn SE, Beard JC, Schwartz MW, et al. Increased B-cell secretory capacity as mechanism for islet adaptation to nicotinic acid-induced insulin resistance. Diabetes 1989;38:562-8.
- Schwartz ML. Severe reversible hyperglycemia as a consequence of niacin therapy. Arch Int Med 1993;153:2050-2. DOI
- Raising HDL and Niacin Use. Pharmacist's Letter/Prescriber's Letter 2004;20(5):200504.
- McKenney J. New perspectives on the use of niacin in the treatment of lipid disorders. Arch Intern Med 2004;164:697-705. PubMed
- Reaven P, Witztum JL. Lovastatin, nicotinic acid and rhabdomyolysis (letter). Ann Int Med 1988;109:597-8. PubMed
- Ito MK. Advances in the understanding and management of dyslipidemia: using niacin-based therapies. Am J Health-Syst Pharm 2003;60(suppl 2):s15-21. PubMed
- Schwab RA, Bachhuber BH. Delirium and lactic acidosis caused by ethanol and niacin coingestion. Am J Emerg Med 1991;9:363-5. PubMed
- Product information: Niaspan. Kos Pharmaceuticals. Cranbury, NJ. 2005. Available at www.niaspan.com/professional/content/pdfs/productinfo.pdf. (Accessed 3 March 2006).
- Ding RW, Kolbe K, Merz B, et al. Pharmacokinetics of nicotinic acid-salicylic acid interaction. Clin Pharmacol Ther 1989;46:642-7. PubMed
- NIH News. NIH stops clinical trial on combination cholesterol treatment. May 26, 2011. http://www.nih.gov/news/health/may2011/nhlbi-26.htm. (Accessed 3 June 2011).
- Dearing BD, Lavie CJ, Lohmann TP, Genton E. Niacin-induced clotting factor synthesis deficiency with coagulopathy. Arch Intern Med. 1992;152(4):861-3. DOI
- O'Brien T, Silverberg JD, Nguyen TT. Nicotinic acid-induced toxicity associated with cytopenia and decreased levels of thyroxine-binding globulin. Mayo Clin Proc. 1992;67(5):465-8. PubMed
- 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. PubMed
- Garnett WR. Interactions with hydroxymethylglutaryl-coenzyme A reductase inhibitors. Am J Health Syst Pharm. 1995;52(15):1639-45. PubMed
- Litin SC, Anderson CF. Nicotinic acid-associated myopathy: a report of three cases. Am J Med. 1989;86(4):481-3. PubMed
- Dunn RT, Ford MA, Rindone JP, Kwiecinski FA. Low-Dose Aspirin and Ibuprofen Reduce the Cutaneous Reactions Following Niacin Administration. Am J Ther. 1995;2(7):478-480. PubMed
- Cashin-Hemphill L, Spencer CA, Nicoloff JT, et al. Alterations in serum thyroid hormonal indices with colestipol-niacin therapy. Ann Intern Med. 1987;107(3):324-9. PubMed
- Drinka PJ. Alterations in thyroid and hepatic function tests associated with preparations of sustained-release niacin. Mayo Clin Proc. 1992;67(12):1206. PubMed
- Shakir KM, Kroll S, Aprill BS, Drake AJ 3rd, Eisold JF. Nicotinic acid decreases serum thyroid hormone levels while maintaining a euthyroid state. Mayo Clin Proc. 1995;70(6):556-8. 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
- Brown BG, Bardsley J, Poulin D, et al. Moderate dose, three-drug therapy with niacin, lovastatin, and colestipol to reduce low-density lipoprotein cholesterol <100 mg/dl in patients with hyperlipidemia and coronary artery disease. Am J Cardiol. 1997;80(2)
- Goldberg A, Alagona P Jr, Capuzzi DM, et al. Multiple-dose efficacy and safety of an extended-release form of niacin in the management of hyperlipidemia. Am J Cardiol. 2000;85(9):1100-5. PubMed
- Aronov DM, Keenan JM, Akhmedzhanov NM, et al. Clinical trial of wax-matrix sustained-release niacin in a Russian population with hypercholesterolemia. Arch Fam Med. 1996;5(10):567-75. PubMed
- Morgan JM, Capuzzi DM, Guyton JR, et al. Treatment Effect of Niaspan, a Controlled-release Niacin, in Patients With Hypercholesterolemia: A Placebo-controlled Trial. J Cardiovasc Pharmacol Ther. 1996;1(3):195-202. PubMed
- Andersson RG, Aberg G, Brattsand R, Ericsson E, Lundholm L. Studies on the mechanism of flush induced by nicotinic acid. Acta Pharmacol Toxicol (Copenh). 1977 Jul;41(1):1-10. PubMed
- Brown WV. Niacin for lipid disorders. Indications, effectiveness, and safety. Postgrad Med. 1995 Aug;98(2):185-9, 192-3. PubMed
- O'REILLY PO, CALLBECK MJ, HOFFER A. Sustained-release nicotinic acid (nicospan); effect on (1) cholesterol levels and (2) leukocytes. Can Med Assoc J. 1959;80(5):359-62.
- Gharavi AG, Diamond JA, Smith DA, Phillips RA. Niacin-induced myopathy. Am J Cardiol. 1994;74(8):841-2. PubMed
- 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
- Bassan M. A case for immediate-release niacin. Heart Lung. 2012 Jan-Feb;41(1):95-8. PubMed
- Davidson MH, Rooney M, Pollock E, Drucker J, Choy Y. Effect of colesevelam and niacin on low-density lipoprotein cholesterol and glycemic control in subjects with dyslipidemia and impaired fasting glucose. J Clin Lipidol. 2013 Sep-Oct;7(5):423-32. PubMed
- Guyton JR, Fazio S, Adewale AJ, Jensen E, Tomassini JE, Shah A, Tershakovec AM. Effect of extended-release niacin on new-onset diabetes among hyperlipidemic patients treated with ezetimibe/simvastatin in a randomized controlled trial. Diabetes Care. 2012 PubMed
- 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
- Jenkins DJA, Spence JD, Giovannucci EL, et al. Supplemental vitamins and minerals for CVD prevention and treatment. J Am Coll Cardiol 2018;71(22):2570-84. PubMed
- Song S, Lee CJ, Oh J, Park S, Kang SM, Lee SH. Effect of Niacin on Carotid Atherosclerosis in Patients at Low-Density Lipoprotein-Cholesterol Goal but High Lipoprotein (a) Level: a 2-Year Follow-Up Study. J Lipid Atheroscler. 2019;8(1):58-66. PubMed
- 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
- 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
Feverfew 18 references
- McGuffin M, Hobbs C, Upton R, Goldberg A, eds. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC 1997.
- Awang DVC. Prescribing therapeutic feverfew (Tancetum pathrnium (L.) Schultz Bip., syn. Chrysanthemumparthenium (L.) Bernh). Int Med 1998;1:11-3.
- Heptinstall S, Groenewegen WA, Spangenberg P, Loesche W. Extracts of feverfew may inhibit platelet behaviour via neutralization of sulphydryl groups. J Pharm Pharmacol 1987;39:459-65. PubMed
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