Meta Information
ID:niacin
Name:
Schema Version:AIM-2.0
Interactions
Target id:
/class/statins
Target name:
Statins (HMG-CoA Reductase Inhibitors)
Severity:
major
Interaction type:
adverse
Nature:
absolute
Description:
Both niacin and statins can cause muscle damage (myopathy). When taken together, this risk is significantly increased, potentially leading to a severe condition called rhabdomyolysis.
Actionable advice:
Avoid this combination unless specifically prescribed and closely monitored by a physician for muscle pain or weakness.
Target id:
/class/hepatotoxic-agents
Target name:
Hepatotoxic Agents
Severity:
major
Interaction type:
adverse
Nature:
absolute
Description:
Niacin, particularly in sustained-release formulations, can be stressful to the liver. Combining it with other substances known to harm the liver (like certain drugs or excessive alcohol) significantly increases the risk of liver injury.
Actionable advice:
Avoid combining with other potentially liver-toxic agents and strictly limit alcohol consumption.
Target id:
/condition/hepatic-impairment
Target name:
Hepatic Impairment
Severity:
major
Interaction type:
adverse
Nature:
absolute
Description:
Niacin is metabolized by the liver and can cause or worsen liver damage. It is generally contraindicated in patients with active or unexplained liver dysfunction.
Actionable advice:
Do not take high-dose niacin if you have active liver disease; regular liver function monitoring is required for all users.
Target id:
/condition/peptic-ulcer-disease
Target name:
Peptic Ulcer Disease (PUD)
Severity:
major
Interaction type:
adverse
Nature:
absolute
Description:
Niacin can increase stomach acid secretion and may reactivate a dormant peptic ulcer, leading to pain, discomfort, or bleeding.
Actionable advice:
Avoid high-dose niacin if you have an active peptic ulcer.
Target id:
/class/fibrates
Target name:
Fibrates
Severity:
major
Interaction type:
adverse
Nature:
absolute
Description:
Both niacin and fibrates can cause muscle damage (myopathy). The combined use significantly elevates this risk, similar to the interaction with statins.
Actionable advice:
Avoid this combination unless under strict medical supervision due to a high risk of severe muscle damage.
Target id:
/class/bile-acid-sequestrants
Target name:
Bile Acid Sequestrants & Binders
Severity:
moderate
Interaction type:
diminishing
Nature:
temporal
Temporal spacing:
Hours before target:
1
Hours after target:
4
Description:
Bile acid sequestrants can bind to niacin in the gut, preventing its full absorption and reducing its effectiveness.
Actionable advice:
Take niacin at least 1 hour before or 4 hours after taking a bile acid sequestrant.
Target id:
/class/antihypertensives
Target name:
Antihypertensive Medications
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Description:
Niacin causes blood vessels to widen (vasodilation), which can add to the effect of blood pressure medications, potentially leading to dizziness, lightheadedness, or fainting from low blood pressure.
Actionable advice:
Monitor blood pressure closely when starting or increasing the dose of niacin while on antihypertensive drugs.
Target id:
/class/antidiabetic-medications
Target name:
Diabetes Medications
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Description:
High-dose niacin can impair glucose tolerance and raise blood sugar levels, potentially counteracting the effects of medications used to treat diabetes.
Actionable advice:
Monitor blood glucose levels carefully, as adjustments to your diabetes medication may be needed under your doctor's guidance.
Target id:
/class/anticoagulants-antiplatelets
Target name:
Anticoagulants and Antiplatelets
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Description:
High-dose niacin can have a mild effect on blood clotting. This may slightly increase the risk of bleeding when combined with anticoagulant or antiplatelet medications like warfarin or aspirin.
Actionable advice:
Use with caution and under medical supervision; monitor for any signs of increased bleeding or bruising.
Target id:
/condition/diabetes-mellitus
Target name:
Diabetes Mellitus
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Description:
High-dose niacin can cause insulin resistance and raise blood sugar levels, making glycemic control more challenging for individuals with diabetes.
Actionable advice:
If you have diabetes, use niacin only under a doctor's supervision with frequent blood sugar monitoring.
Target id:
/condition/gout
Target name:
Gout
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Description:
Niacin can increase serum uric acid levels by competing for excretion in the kidneys, which can trigger a painful gout attack in susceptible individuals.
Actionable advice:
Use niacin with caution if you have a history of gout and ensure uric acid levels are monitored.
Target id:
/dietary/alcohol-acute
Target name:
Alcohol
Severity:
moderate
Interaction type:
adverse
Nature:
temporal
Temporal spacing:
Hours before target:
2
Hours after target:
2
Description:
Alcohol can significantly worsen the flushing (redness, warmth, itching) caused by niacin. It also adds to the potential for liver stress when used with high-dose niacin.
Actionable advice:
Avoid drinking alcohol for at least two hours before and after your niacin dose to reduce flushing and liver strain.
Target id:
/class/antioxidant-supplements
Target name:
Antioxidant Supplements (Vitamin C, E, Selenium)
Severity:
moderate
Interaction type:
diminishing
Nature:
absolute
Description:
Some clinical studies suggest that taking antioxidant supplements concurrently with niacin may blunt its beneficial effect of raising HDL ('good') cholesterol.
Actionable advice:
If your primary goal for taking niacin is to raise HDL, discuss the use of high-dose antioxidant supplements with your doctor.
Target id:
/dietary/meal
Target name:
Any Caloric Meal
Severity:
moderate
Interaction type:
synergistic
Nature:
temporal
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Taking niacin with food slows its absorption, which can significantly reduce the severity of stomach upset and the intensity of the 'niacin flush'.
Actionable advice:
Always take your niacin dose with a meal or a low-fat snack to improve tolerability.
Target id:
/intervention/aspirin
Target name:
Aspirin (Low-Dose)
Severity:
moderate
Interaction type:
synergistic
Nature:
temporal
Temporal spacing:
Hours before target:
0.5
Hours after target:
null
Description:
A low dose of aspirin (e.g., 81-325mg) blocks the production of prostaglandins that cause the characteristic flushing, itching, and warmth associated with niacin.
Actionable advice:
To prevent the niacin flush, consider taking a low-dose aspirin 30 minutes before your niacin dose, after consulting your doctor.
Target id:
/biomarker/alanine-aminotransferase
Target name:
Alanine Aminotransferase (ALT)
Severity:
moderate
Interaction type:
assay_interference
Nature:
absolute
Description:
High-dose niacin, especially sustained-release forms, can cause an elevation in liver enzymes, which is a key marker for liver stress or damage.
Actionable advice:
Regular monitoring of liver function tests is essential before starting and during therapy with high-dose niacin.
Target id:
/biomarker/uric-acid
Target name:
Uric Acid
Severity:
moderate
Interaction type:
assay_interference
Nature:
absolute
Description:
Niacin can increase serum uric acid levels by reducing its excretion from the kidneys, which can be measured in a blood test.
Actionable advice:
Monitor uric acid levels periodically, especially if you have a personal or family history of gout.
Target id:
/biomarker/fasting-glucose
Target name:
Fasting Glucose
Severity:
moderate
Interaction type:
assay_interference
Nature:
absolute
Description:
Niacin can impair glucose tolerance and lead to a measurable increase in fasting blood sugar levels.
Actionable advice:
Monitor fasting glucose and HbA1c regularly, particularly in individuals with diabetes or metabolic syndrome.
Target id:
/dietary/hot-foods-beverages
Target name:
Hot Beverages or Spicy Foods
Severity:
minor
Interaction type:
adverse
Nature:
temporal
Temporal spacing:
Hours before target:
1
Hours after target:
1
Description:
Hot liquids and spicy foods can also cause vasodilation and may trigger or worsen the flushing reaction caused by niacin.
Actionable advice:
Avoid consuming hot beverages or very spicy foods around the time you take your niacin dose.
Target id:
/circadian/sleep
Target name:
Going to Sleep
Severity:
minor
Interaction type:
synergistic
Nature:
temporal
Temporal spacing:
Hours before target:
0.5
Hours after target:
null
Description:
Taking the niacin dose shortly before bedtime may allow the peak flushing symptoms to occur while you are asleep, improving overall comfort and adherence.
Actionable advice:
Consider taking your niacin dose with an evening snack just before going to bed to minimize awareness of the flush.
Target id:
/biomarker/complete-blood-count
Target name:
Complete Blood Count
Severity:
minor
Interaction type:
assay_interference
Nature:
absolute
Description:
In rare cases, high-dose niacin can cause a mild, dose-related reduction in platelet count (thrombocytopenia), which would be detected on a CBC.
Actionable advice:
Be aware of this potential effect; periodic monitoring with a complete blood count may be recommended by your doctor.
Target id:
/condition/pregnancy
Target name:
Pregnancy
Severity:
major
Interaction type:
adverse
Nature:
absolute
Description:
Doses of niacin above the standard recommended dietary allowance have not been established as safe during pregnancy and should be avoided.
Actionable advice:
Do not take high-dose niacin during pregnancy unless specifically directed by a physician.
Target id:
/condition/lactation
Target name:
Breastfeeding (Lactation)
Severity:
major
Interaction type:
adverse
Nature:
absolute
Description:
It is not known if high doses of niacin are excreted in breast milk or what effect they might have on a nursing infant; therefore, it should be avoided.
Actionable advice:
Avoid taking high-dose niacin while breastfeeding.