Interactions on record — worth a quick check against your medications. Check your meds →
Dietary supplement

Niacin Plus Ingredients & Drug Interactions

by Highland Laboratories

Tablet Or Pill Category: Other Combinations
Most serious interaction: Moderate
The interaction bottom line Most serious interaction: Moderate

Niacin Plus is a dietary supplement by Highland Laboratories with 4 active ingredients. Its ingredients are commonly taken for high cholesterol, vitamin b3 deficiency (pellagra), heart health support.Based on those ingredients, 1,351 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Fo Ti, Niacin, Policosanol. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

HelloPharmacist Scorecard of Niacin Plus by Highland Laboratories

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.

From our pharmacy team — supplement deep dive

What’s inside

Full disclosure
Ingredient Transparency · database check
Full

Every active ingredient lists its own amount on the label.

Why this rating?
  • The label discloses an exact amount for 4 of its 4 active ingredients.
  • No proprietary blends here — you can verify the dose of every single component.

Niacin Plus contains four active ingredients. Niacin (also called nicotinic acid) is a B vitamin that's established as effective for pellagra and has evidence for treating certain lipid problems in people with HIV/AIDS and metabolic syndrome.

Chromium is a mineral that's likely effective for chromium deficiency and possibly effective for type 2 diabetes. Policosanol is a plant compound likely effective for intermittent claudication (leg pain with walking), though evidence for heart disease is incomplete.

Fo-ti is an herbal ingredient with no established effectiveness in our data; it's mainly studied for cognitive decline and hair loss but the evidence is insufficient to rate it. The product also contains several inactive ingredients: vegetable wax, tragacanth gum, stearic acid, vegetable stearate, and silica.

These are standard binders and fillers that help hold the tablet together.

Does it work?

Strong evidence
Evidence for Intended Use · database check
By FDA rules, dietary supplements can’t claim to treat, cure, or prevent disease — so labels speak in careful marketing language. We discern each product’s intended use from its name, label claims, and label statements, then grade the clinical evidence for that use. How these ratings are computed

This product doesn't appear to be marketed for a specific use, so we graded its ingredients' overall clinical evidence instead.

Strong

Strong clinical evidence supports its ingredients for:

Why this rating?
  • We looked at the product name, claims, and label statements and couldn't find a stated purpose to grade.
  • Since the label doesn't commit to one use, we graded the ingredients' overall clinical evidence instead.
  • On file: Intermittent claudication — rated "Likely Effective" (Policosanol) (Natural Medicines).
  • On file: Pellagra — rated "Likely Effective" (Niacin) (Natural Medicines).
  • On file: Chromium deficiency — rated "Likely Effective" (Chromium) (Natural Medicines).
  • On file: HIV/AIDS-related dyslipidemia — rated "Possibly Effective" (Niacin) (Natural Medicines).
  • On file: Metabolic syndrome — rated "Possibly Effective" (Niacin) (Natural Medicines).

Niacin is likely effective for preventing and treating pellagra (a B-vitamin deficiency disease) and is possibly effective for treating abnormal cholesterol and blood fats in people with HIV/AIDS and metabolic syndrome. Chromium is likely effective if you're deficient in it, and possibly effective for type 2 diabetes, though evidence is mixed—it does not appear to be effective for prediabetes.

Policosanol is likely effective for intermittent claudication. Fo-ti has not been reliably established for any condition in the data we hold; the evidence is insufficient for cognitive decline, hair loss, Alzheimer's, bone health, and heart disease.

The evidence, ingredient by ingredient Niacin Chromium Policosanol Fo-ti

How safe is it?

Well-documented data
Safety Information · database check
Well characterized

Adverse-effect, pregnancy, and general safety data are on file for most of these ingredients.

Why this rating?
  • We hold adverse-effect (side-effect) data for 4 of the 4 matched ingredients.
  • Pregnancy & breastfeeding safety ratings cover 4 of 4.
  • General safety write-ups exist for 4 of 4.
  • Remember: this measures how much safety information exists. Thin data is not the same as being safe.

At normal dietary amounts, niacin is safe. At the higher supplement doses in this product, flushing (turning red and feeling warm, especially on the face and chest) is common—up to 70% of people experience it—and it usually appears at doses used for cholesterol treatment.

Niacin can also cause stomach upset, heartburn, and constipation or diarrhea, especially with time-release forms. Serious but rare side effects include liver damage, muscle problems, low platelet counts, and vision changes.

Chromium is generally well tolerated at typical supplement doses, though high or long-term use may carry risks. Possible side effects include stomach irritation, headaches, sleep problems, mood changes, and skin rashes.

Fo-ti is linked to liver injury in hundreds of documented cases across doses, formulations, and durations; it can also cause stomach pain, diarrhea, nausea, and vomiting, especially the unprocessed form. Niacin in normal amounts and chromium in small amounts are likely safe in pregnancy and lactation, but high-dose niacin and policosanol should be avoided in pregnancy and lactation without a doctor's guidance.

Fo-ti is possibly unsafe in pregnancy and lactation.

Side effects, ingredient by ingredient Niacin Chromium Policosanol Fo-ti

Meds to double-check

Moderate interaction found
Known Interaction Concern · database check
Moderate identified

The most serious documented interaction for these ingredients is Moderate. Check your medications for a personalized result.

Why this rating?
  • 4 of the 4 matched ingredients can interact with medications — Policosanol, Fo-ti, Niacin, Chromium.
  • The most serious interaction on file is rated Moderate.
  • Some involve high-stakes drug classes: anticoagulant / antiplatelet drugs; diabetes medications; heart-rhythm medications.
  • For scale: 1,352 individual medications appear in the full list. A big number alone doesn't make a product dangerous — what matters is whether YOUR medication is on it, so run yours through the interaction checker on this page.

Before taking Niacin Plus, double-check with your doctor or pharmacist if you take blood thinners or antiplatelet drugs (warfarin, aspirin, clopidogrel), blood pressure medications (beta-blockers, ACE inhibitors, calcium channel blockers), diabetes drugs (metformin, sulfonylureas, insulin), thyroid hormone (levothyroxine), cholesterol-lowering statins, gout medications (allopurinol, probenecid), or heart drugs (digoxin). These are the major moderate-severity interactions documented for this product.

Your doctor or pharmacist will know your full medication list and can tell you whether it's safe to take this supplement alongside what you're already on.

Check your own medication Run your meds through the checker above

The bottom line

Scorecard at a glanceFully disclosed formula with strong clinical evidence behind its ingredients' uses. Moderate medication interactions have been identified, and safety information is well characterized.

Niacin Plus is worth considering if you need a B-vitamin boost for pellagra or cholesterol support, want chromium for blood sugar management, or are interested in policosanol for leg circulation. However, this is not a product to start on your own if you take blood pressure medications, blood thinners, diabetes drugs, thyroid hormone, statins, or gout medications—the interactions are real and potentially serious.

Talk with your doctor or pharmacist before starting, especially if you have liver disease or are pregnant or breastfeeding.

Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI

Assessment coverage: 4 of 4 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Nov 20, 2017.

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

At a glance

General information

Key facts about Niacin Plus, straight from the product label.

Brand Highland Laboratories
Barcode (UPC) 768305119468
Net contents 60 Vegetarian Tablet(s)
Market status On market
Date entered into DSLD Nov 20, 2017
DSLD ID 79943
Product type Other Combinations
Supplement form Tablet Or Pill
Dietary claims / uses All Other
Intended target group(s) Adult (18 - 50 Years), Gluten Free, Dairy Free, Sugar Free
From the label
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 Plus by Highland Laboratories, sourced from the NIH Dietary Supplement Label Database.

Supplement Facts

Daily Value (DV) Target Group(s):
Adults and children 4 or more years of age
Minimum serving Sizes:
1 Vegetarian Tablet(s)
Maximum serving Sizes:
2 Vegetarian Tablet(s)
UPC/BARCODE
768305119468
IngredientAmount% DV
Niacin250 mg1250%
Chromium30 mcg25%
Policosanol100 mg--
Fo Ti100 mg--

Other ingredients: Vegetable Wax, Tragacanth Gum, Stearic Acid, Vegetable Stearate, Silica

Tap any ingredient to jump to its full detail below.

Label statements
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.
Formula

Slow release Niacin

FDA Statement of Identity

Dietary Supplement

Seals/Symbols

GMP Quality Assured Earth Friendly

General Statements

% Daily Value

Formulation

No corn, salt, yeast, gluten, milk & egg products, sugar, starch, or preservatives.

Suggested/Recommended/Usage/Directions

One to two tablets twice daily, as a dietary supplement.

Precautions

Warning: Not for use by children unless directed by health care practitioner.

General

PR 1194

See for yourself

Niacin Plus by Highland Laboratories label

The label scan from the NIH Dietary Supplement Label Database. Tap to enlarge.

What’s inside

The Ingredients in Niacin Plus by Highland Laboratories

These are the 4 active ingredients this product is made of. Select any to open its full monograph.

Serving size1 Vegetarian Tablet(s) Dosage formTablet Or Pill 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 with
727 drugs
250 mg per serving

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 & interactions

Chromium

Interacts with
178 drugs
30 mcg per serving Form: Chromium Polynicotinate

Chromium is an essential trace mineral involved in how the body handles sugar and fat. Some studies suggest it may modestly help blood sugar control i...

Chromium monograph & interactions

Policosanol

Interacts with
242 drugs
100 mg per serving Form: Sugar Cane

Policosanol is a mix of waxy alcohols (mostly octacosanol) made from sugar cane or other plant waxes, and it is often marketed as a natural way to low...

Policosanol monograph & interactions

Fo Ti

Interacts with
1,257 drugs
100 mg per serving

Fo-ti (He Shou Wu) is a root used in traditional Chinese medicine, often promoted for healthy aging and hair. High-quality human evidence for these be...

Fo Ti monograph & interactions

Other (inactive) ingredients: Vegetable Wax, Tragacanth Gum, Stearic Acid, Vegetable Stearate, Silica. These complete the product’s ingredient list but are not active constituents.

Interaction report

Niacin Plus by Highland Laboratories Drug Interactions

Want to check YOUR meds against Niacin Plus?

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 checker
1,351Drugs
1,333 Moderate 18 Minor

Ingredients driving the most interactions

Fo Ti 1,257
Niacin 727
Chromium 178

Each ingredient & the kinds of drugs it affects

For each ingredient in Niacin Plus 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.

Fo Ti17 drug types · 1,257 drugs

Anticoagulant/Antiplatelet Drugs

Fo-ti has been linked to cases of acute liver failure which can decrease clotting factor production and increase the effects of anticoagulants. In one case, a patient who had been stable on warfarin presented with acute hepatitis and an INR elevated to 14.98. The patient had been taking fo-ti for 90 days prior to admission. Discontinuation of warfarin and fo-ti lead to a decrease in the INR and full recovery. Theoretically, concomitant use of fo-ti with anticoagulant or antiplatelet drugs may increase the risk of bleeding in some patients. Until more is known, monitor patients taking fo-ti and drugs that affect bleeding.
Some of these drugs include aspirin, clopidogrel (Plavix), dalteparin (Fragmin), dipyridamole (Persantine), enoxaparin (Lovenox), heparin, ticlopidine (Ticlid), warfarin (Coumadin), and others.

Likelihood Possible Evidence D
Antidiabetes Drugs

Theoretically, fo-ti might increase the risk of hypoglycemia when taken with antidiabetes drugs.
Fo-ti reportedly has hypoglycemic effects.

Likelihood Possible Evidence D
Contraceptive Drugs

Theoretically, taking large amounts of fo-ti might interfere with contraceptive drugs due to competition for estrogen receptors.
In vitro research suggests that fo-ti extract has estrogenic activity.

Likelihood Probable Evidence D
Cytochrome P450 1A2 (Cyp1A2) Substrates

Theoretically, fo-ti might increase or decrease the levels and clinical effects of drugs metabolized by CYP1A2.
In vitro research suggests that fo-ti might inhibit CYP1A2. Additionally, in vitro research suggests that the degree of CYP1A2 inhibition depends on the type of fo-ti extract (i.e., the raw plant leads to greater inhibition than extensively processed extracts). However, in an animal study, an aqueous extract of fo-ti inhibited CYP1A2 while an alcoholic extract of fo-ti induced CYP1A2. Induction or inhibition of CYP1A2 by fo-ti has not been reported in humans.

Likelihood Possible Evidence D
Cytochrome P450 2B6 (Cyp2B6) Substrates

Theoretically, fo-ti might increase the levels and clinical effects of drugs metabolized by CYP2B6.
Animal research suggests that fo-ti might inhibit CYP2B6. One in vitro study suggests that the degree of CYP2B6 inhibition may depend on the type of fo-ti extract (i.e., the raw plant leads to greater inhibition than extensively processed extracts). However, this interaction has not been reported in humans.

Likelihood Possible Evidence D
Cytochrome P450 2C19 (Cyp2C19) Substrates

Theoretically, fo-ti may increase the levels and clinical effects of drugs metabolized by CYP2C19.
Animal and in vitro research suggests that fo-ti may inhibit CYP2C19. An in vitro study suggests that the degree of CYP2C19 inhibition may depend on the type of fo-ti extract (i.e., the raw plant leads to greater inhibition than extensively processed extracts). However, this interaction has not been reported in humans.

Likelihood Possible Evidence D
Cytochrome P450 2C8 (Cyp2C8) Substrates

Theoretically, fo-ti might increase the levels and clinical effects of drugs metabolized by CYP2C8.
In vitro research suggests that fo-ti might inhibit CYP2C8. However, this interaction has not been reported in humans.

Likelihood Possible Evidence D
Cytochrome P450 2C9 (Cyp2C9) Substrates

Theoretically, fo-ti may increase the levels and clinical effects of drugs metabolized by CYP2C9.
Animal and in vitro research suggests that fo-ti may inhibit CYP2C9. However, this interaction has not been reported in humans.

Likelihood Possible Evidence D
Cytochrome P450 2D6 (Cyp2D6) Substrates

Theoretically, fo-ti may increase the levels and clinical effects of drugs metabolized by CYP2D6.
Animal research suggests that fo-ti might inhibit CYP2D6. Additionally, an in vitro study suggests that the degree of CYP2D6 inhibition may depend on the type of fo-ti extract (i.e., the raw plant leads to greater inhibition than extensively processed extracts). However, this interaction has not been reported in humans.

Likelihood Possible Evidence D
Cytochrome P450 3A4 (Cyp3A4) Substrates

Theoretically, fo-ti might increase the levels and clinical effects of drugs metabolized by CYP3A4.
In vitro research suggests that fo-ti might inhibit CYP3A4. One in vitro study suggests that the degree of CYP3A4 inhibition may depend on the type of fo-ti extract (i.e., the raw plant leads to greater inhibition than extensively processed extracts). However, this evidence conflicts with animal research suggesting that fo-ti does not inhibit CYP3A4. This interaction has not been reported in humans.

Likelihood Possible Evidence D
Digoxin (Lanoxin)

Theoretically, fo-ti, particularly raw fo-ti root, might increase the risk of hypokalemia and cardiotoxicity when taken with digoxin.
Raw fo-ti root contains anthraquinone derivatives, which might have stimulant laxative effects. In vitro research shows that fermented and processed fo-ti root have reduced laxative effects compared with raw fo-ti root.

Likelihood Possible Evidence D
Diuretic Drugs

Theoretically, fo-ti, particularly raw fo-ti root, might increase the risk of hypokalemia when taken with diuretic drugs.
Raw fo-ti root contains anthraquinone derivatives, which might have stimulant laxative effects and compound diuretic-induced potassium loss. In vitro research shows that fermented and processed fo-ti root have reduced laxative effects compared with raw fo-ti root.

Likelihood Possible Evidence D
Estrogens

Theoretically, taking large amounts of fo-ti might interfere with hormone replacement therapy through competition for estrogen receptors.
In vitro research suggests that fo-ti extract has estrogenic activity.

Likelihood Probable Evidence D
Hepatotoxic Drugs

Theoretically, fo-ti might increase the risk of liver damage when taken with hepatotoxic drugs.
Fo-ti has been linked to liver damage in many reports.

Likelihood Possible Evidence D
Stimulant Laxatives

Theoretically, fo-ti, particularly raw fo-ti root, might increase the risk of fluid and electrolyte depletion when taken with stimulant laxatives.
Raw fo-ti root contains anthraquinone derivatives, which might have stimulant laxative effects. However, in vitro research shows that fermented and processed fo-ti root have reduced laxative effects compared with raw fo-ti root.

Likelihood Possible Evidence D
Sulindac (Clinoril)

Theoretically, fo-ti might increase or decrease the levels and clinical effects of sulindac.
Animal research suggests that the type of fo-ti extract might affect the levels of sulindac differently; the raw plant may increase levels, but processed parts may decrease levels. Induction or inhibition of CYP1A2 by fo-ti has not been reported in humans.

Likelihood Possible Evidence D
Warfarin (Coumadin)

Theoretically, fo-ti might increase the effects and adverse effects of warfarin.
Fo-ti may have stimulant laxative effects and cause diarrhea, especially when the raw or unprocessed fo-ti root is used. Diarrhea can increase the effects of warfarin, increase international normalized ratio (INR), and increase the risk of bleeding. Also, fo-ti has been linked to cases of acute liver failure which can decrease clotting factor production and increase the effects of warfarin. In one case, a patient who had been stable on warfarin presented with acute hepatitis and an INR elevated to 14.98. The patient had been taking fo-ti for 90 days prior to admission. Discontinuation of warfarin and fo-ti lead to a decrease in the INR and full recovery.

Likelihood Possible Evidence D

Niacin15 drug types · 727 drugs

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.

Likelihood Probable Evidence D
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.

Likelihood Probable Evidence C
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.

Likelihood Possible Evidence D
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.

Likelihood Probable Evidence B
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.

Likelihood Possible Evidence B
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%.

Likelihood Possible Evidence D
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.

Likelihood Possible Evidence D
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.

Likelihood Possible Evidence D
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).

Likelihood Possible Evidence D
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.

Likelihood Probable Evidence C
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.

Likelihood Probable Evidence C
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.

Likelihood Probable Evidence D
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.

Likelihood Possible Evidence D
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.

Likelihood Possible Evidence D
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.

Likelihood Likely Evidence B

Policosanol6 drug types · 242 drugs

Anticoagulant/Antiplatelet Drugs

Theoretically, taking policosanol with other antiplatelet or anticoagulant drugs might increase the risk of bruising and bleeding.
Some clinical research shows that taking policosanol 10-50 mg daily for 7-15 days can inhibit platelet aggregation in healthy patients. Although, one clinical trial shows that taking policosanol 10 mg twice daily for 2 weeks prior to warfarin dosing does not affect warfarin pharmacokinetics or warfarin response. Furthermore, a study in patients undergoing percutaneous coronary intervention with a drug-eluting stent found that taking policosanol 40 mg plus clopidogrel and aspirin daily for 30 days modestly reduced the risk for minor bleeding events when compared with taking clopidogrel and aspirin alone. Until more is known, use with caution.

Likelihood Possible Evidence B
Antidiabetes Drugs

Theoretically, policosanol might have additive effects with antidiabetes drugs and increase the risk of hypoglycemia.
Clinical research shows that policosanol can lower blood glucose levels.

Likelihood Possible Evidence B
Beta-Blockers

Concomitant use of policosanol with beta-blockers can cause additive blood pressure-lowering effects.
Clinical research shows that policosanol 5 mg daily can have additive blood pressure-lowering effects in patients with hypertension who are taking beta-blockers. Also, animal research shows that policosanol can increase the blood-pressure lowering effects of propranolol.

Likelihood Probable Evidence A
Nitroprusside (Nitropress)

Theoretically, concomitant use of policosanol with nitroprusside might cause additive blood pressure-lowering effects.
Animal research shows that taking policosanol along with nitroprusside can increase the blood pressure-lowering effects of nitroprusside.

Likelihood Possible Evidence D
Propranolol (Inderal)

Animal research shows that taking policosanol along with propranolol can increase the blood pressure-lowering effects of propranolol.

Likelihood Possible Evidence D
Warfarin (Coumadin)

Theoretically, taking policosanol with warfarin might increase the risk of bruising and bleeding.
Some clinical research shows that taking policosanol 10-50 mg daily for 7-15 days can inhibit platelet aggregation in healthy patients. However, one clinical trial shows that taking policosanol 10 mg twice daily for 2 weeks prior to warfarin dosing does not affect warfarin pharmacokinetics or warfarin response.

Likelihood Possible Evidence B

Chromium5 drug types · 178 drugs

Antidiabetes Drugs

Theoretically, chromium may have additive effects with antidiabetic agents and increase the risk of hypoglycemia.
Some research shows that taking chromium might lower blood glucose levels, especially in patients with poorly controlled type 2 diabetes.

Likelihood Possible Evidence A
Insulin

Theoretically, concomitant use of chromium and insulin might increase the risk of hypoglycemia.
In clinical research, chromium has been shown to increase insulin sensitivity,

Likelihood Possible Evidence B
Levothyroxine (Synthroid, Others)

Chromium might bind levothyroxine in the intestinal tract and decrease levothyroxine absorption.
Clinical research in healthy volunteers shows that taking chromium picolinate 1000 mcg with levothyroxine 1 mg decreases serum levels of levothyroxine by 17% when compared to taking levothyroxine alone. Advise patients to take levothyroxine at least 30 minutes before or 3-4 hours after taking chromium.

Likelihood Probable Evidence B
Aspirin

Theoretically, aspirin might increase chromium absorption.
Animal research suggests that aspirin may increase chromium absorption and chromium levels in the blood.

Likelihood Possible Evidence D
Nonsteroidal Anti-Inflammatory Drugs (Nsaids)

NSAIDs might increase chromium levels in the body.
Drugs that are prostaglandin inhibitors, such as NSAIDs, seem to increase chromium absorption and retention.

Likelihood Possible Evidence D
The maker

Brand information

Manufacturer and brand details for Niacin Plus, from the product label.

Highland Laboratories

See all Highland Laboratories products
Name
Highland Laboratories
Pharmacist Counseling Corner

Niacin Plus by Highland Laboratories: Common Questions

Does Niacin Plus by Highland Laboratories interact with any medications?
Yes. Based on its ingredients, Niacin Plus has a known interaction with 1,351 medications. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
Niacin Plus contains 4 active ingredients, and an interaction can come from any of them. We check every ingredient, combine the results into one list per medication, and show which ingredient and mechanism is responsible.
Where does this information come from?
The product label data comes from the NIH Dietary Supplement Label Database (DSLD); the interaction data is built on the Natural Medicines database and reviewed by HelloPharmacist pharmacists.
Does this product actually help with high cholesterol?
Niacin in here is possibly effective for abnormal lipid levels, especially in people with HIV/AIDS or metabolic syndrome. Policosanol has insufficient evidence for heart disease specifically, though it is likely effective for intermittent claudication—leg pain with walking. If you're taking this for cholesterol, talk with your doctor about whether these ingredients are right for your situation and whether they work alongside your other medications.
What's the flushing I've heard about with niacin?
Flushing is a very common side effect of niacin—up to 70% of people taking supplement doses experience it. It feels like redness, warmth, tingling, or burning, usually on the face and chest, and can come with itching. It's not dangerous, but it's uncomfortable and typically shows up soon after you take it. The flushing usually goes away within two weeks, and taking the product with meals or an antacid may help reduce it.
Can I take this if I'm pregnant?
Niacin in normal dietary amounts and chromium in small amounts are likely safe in pregnancy. However, high-dose niacin supplements and policosanol should not be used unless your doctor prescribes them. Fo-ti is possibly unsafe in pregnancy. Talk with your doctor or pharmacist before starting this product if you're pregnant or planning to be—they can assess your individual situation.
What's fo-ti and why is it in here?
Fo-ti is a traditional herbal ingredient that's been studied for cognitive decline, hair loss, and Alzheimer's disease, but the evidence isn't strong enough to rate its effectiveness. The main concern is that it's been linked to liver damage in hundreds of documented cases—both processed and unprocessed forms. It can also cause stomach upset and diarrhea. There's not enough established benefit to justify the risk, especially in combination with the other ingredients.
Is this safe to take long-term?
Niacin is generally well tolerated when monitored by a healthcare provider, but liver damage and other serious effects are rare at higher doses. Chromium is usually safe at typical supplement doses, though long-term high doses pose uncertain risks. Fo-ti has documented liver injury risks that increase with duration of use. Because this product combines all four, we can't say it's safe long-term without knowing your health history and medications—check with your doctor or pharmacist before committing to regular use.
Will this interact with my blood pressure medication?
Yes—niacin may lower blood pressure further when combined with blood pressure drugs, and policosanol can have additive blood-pressure-lowering effects with beta-blockers and other antihypertensives. This doesn't automatically mean you can't take it, but your doctor or pharmacist needs to know about it so they can monitor your blood pressure and adjust your medications if needed.

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

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Niacin Plus label
Sources

Sources & How We Checked

Niacin Plus'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.

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 162 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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  45. 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
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  47. 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
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  50. 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.
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  53. Fraunfelder FW, Fraunfelder FT, Illingworth DR. Adverse ocular effects associated with niacin therapy. Br J Ophthalmol 1995;79:54-56. PubMed
  54. 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
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  59. 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
  60. 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
  61. 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.
  62. 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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  64. 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
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See these in context on the Niacin monograph →

Chromium 53 references
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See these in context on the Chromium monograph →

Policosanol 15 references
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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

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