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Taking Niacin: What Should You Expect?


Updated September 15, 2013

It well known that niacin effects extend to many aspects of your health in a positive manner, however you may have never considered niacin to lower cholesterol.

Nicotinic acid, a form of niacin, is an important B vitamin that is sold alone or in many multivitamin preparations. Not only can nicotinic acid be conveniently obtained over-the-counter, it also works very well in targeting all aspects of your cholesterol profile, by lowering LDL cholesterol and triglycerides and raising HDL cholesterol.

However, even though it's easy to buy, don't assume that it's automatically safe for everyone to take. If you decide to begin taking nicotinic acid to lower your cholesterol, be sure to discuss this with your healthcare provider in order to determine if taking nicotinic acid is right for you.

Additionally, if you have any of the following conditions or are taking any of the following medications below, be sure to talk to your healthcare provider before purchasing nicotinic acid.

Who Should Definitely Not Take Nicotinic Acid (Niacin)

If you have any of the following health conditions listed below, you should not take niacin:
  • an allergic reaction to niacin
  • active bleeding
  • hypotension (very low blood pressure)
  • a history of alcohol abuse
  • active peptic disease (like an ulcer)
  • active liver disease (like hepatitis)
  • abnormally high liver enzymes

Who Should Talk To Their Healthcare Provider Before Starting Nicotinic Acid (Niacin) Therapy?

If you have any of the following medical conditions listed below, you should also talk to your healthcare provider before you begin taking nicotinic acid. Just because you have one of these conditions, it doesn’t necessarily mean that you cannot take nicotinic acid. However, your healthcare provider may want to monitor you more closely while on nicotinic acid therapy:
  • If you have diabetes, nicotinic acid may interfere with your ability to control your glucose levels.
  • If you have active gallbladder disease, such as gallstones, nicotinic acid could make this condition worse.
  • If you have a bleeding disorder or are taking medication to prevent clotting, nicotinic acid could make your ability to clot decrease, and this could cause you to bleed more easily.
  • If you have unstable angina, nicotinic acid may make this condition worse.
  • If you have kidney disease, this may increase the amount of nicotinic acid in your body and increase the incidence of side effects.
  • If you have gout, nicotinic acid may worsen this condition.

Medications That Could Interact With Nicotinic Acid (Niacin)

Medications, such as bile acid sequestrants, statins, and oral diabetic medications, may interact with nicotinic acid, so be sure to consult your healthcare provider before taking it.


Lacy CF, Armstrong LL, Goldman MP, et al. Lexicomp's Drug Information Handbook, 15th ed 2007.

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