Interactions

Possible interactions include:

• Alcohol. Taking niacin with alcohol might raise the risk of liver damage. And it might make niacin side effects, such as flushing and itching, worse.
• Allopurinol (Lopurin, Zyloprim). If you take niacin and you have gout, you might need to take more of this gout medicine to manage your gout.
• Anticoagulant and antiplatelet medicines, herbs and supplements. These types of medicines, herbs and supplements limit blood clotting. Taking niacin with them might raise the risk of bleeding.
• Blood pressure medicines, herbs and supplements. Niacin might add to the effect of medicines, herbs and supplements that manage blood pressure. This could raise the risk of low blood pressure, also called hypotension.
• Chromium. Taking niacin with chromium might lower blood sugar. If you have diabetes and take niacin and chromium, watch your blood sugar levels.
• Diabetes medicines. If you have diabetes, niacin can affect blood sugar management. You might need to change the dose of the diabetes medicines.
• Medicines, herbs and supplements that cause liver damage, called hepatotoxic. Niacin can cause liver damage. So don't take it with medicines, herbs or supplements that also can cause liver damage.
• Statins. Research shows that taking niacin with these cholesterol medicines does little more than statins alone. Taking niacin with statins might raise the risk of side effects.
• Zinc. Taking zinc with niacin might worsen niacin side effects, such as flushing and itching.