Meta Information
ID:sustained-release-niacin
Name:Sustained Release Niacin
Schema Version:1.5
Alternate Names
- SR Niacin
- Slow-Release Niacin
Active Compound
nicotinic_acid
Intervention Type
therapeutic_agent
Delivery
Route:
oral
Scope:
- systemic
Regulatory Status
- us:dietary_supplement
- us:otc_drug
Indication
Focus:
healthspan
Description:
Used as a precursor to the coenzyme NAD+ to support cellular metabolism and to manage lipid profiles for cardiovascular health.
Typical Protocol
- Initiate with a low dose of 250-500 mg once daily, taken with a meal to minimize side effects.
- Slowly titrate dose upwards towards a target of 1000-2000 mg per day, based on tolerance and lab results.
- Regular liver function tests (LFTs) are strongly recommended due to the specific risk of hepatotoxicity with this formulation.
Expected Cost Mean
Low Cost:
10
High Cost:
30
Cost Type:
monthly
Description:
Widely available and affordable over-the-counter supplement; not covered by insurance.
Summary
Sustained-release (SR) niacin is a form of vitamin B3 designed to minimize the intense flushing associated with immediate-release versions. It functions as a precursor to NAD+, a vital coenzyme for cellular energy production and DNA repair that declines with age. While historically used to improve cholesterol profiles, its healthspan rationale centers on boosting NAD+ to support mitochondrial function. However, large-scale clinical trials have failed to show a cardiovascular benefit when added to statins, and the SR formulation carries a significant risk of liver toxicity.
Purpose
A NAD+ precursor intended to support cellular metabolism and cardiovascular health.
Card Summary
A slow-release form of Vitamin B3 that acts as an NAD+ precursor, potentially supporting cellular energy, but carries a notable risk of liver toxicity.
Drug Class
nad_precursor
Drugs In Class
Empty Array
Impact
Score:
3.5
Justification:
Limited evidence for healthspan benefits, overshadowed by significant safety concerns and disappointing clinical trials.
Evidence
Grade:
B
Score:
4
Justification:
Extensive human data on lipid effects, but poor outcomes in major cardiovascular trials.
Safety
Score:
6.5
Justification:
Significant, well-documented risk of dose-dependent liver toxicity unique to this formulation.
Flags
- Sustained-release formulations carry a significantly higher risk of hepatotoxicity (liver damage) than other forms of niacin.
- Large clinical trials (AIM-HIGH, HPS2-THRIVE) found no reduction in cardiovascular events when added to statin therapy.
- May worsen glycemic control in individuals with diabetes or metabolic syndrome.
- Regular monitoring of liver function tests (e.g., ALT, AST) is essential.
- Contraindicated in patients with active liver disease, peptic ulcer disease, or arterial bleeding.
Verdict
Risks, particularly liver toxicity, likely outweigh unproven healthspan benefits.
Created
2026-06-12T17:49:27.114751Z
Ai Model
Gemini 2.5 Pro (High)