Niacinamide, also called nicotinamide, is a form of vitamin B3. It’s found in many foods including meat, fish, milk, eggs, green vegetables, and cereals.

Niacinamide is required for the function of fats and sugars in the body and to maintain healthy cells. Niacin is converted to niacinamide when it is taken in amounts greater than what is needed by the body. Unlike niacin, niacinamide doesn’t help treat high cholesterol.

People use niacinamide to prevent vitamin B3 deficiency and related conditions such as pellagra. It is also used for acne, diabetes, cancer, osteoarthritis, aging skin, skin discoloration, and many other conditions, but there is no good scientific evidence to support most of these uses.

Do not confuse niacinamide with niacin, NADH, nicotinamide riboside, inositol nicotinate, or L-tryptophan. These are not the same.

Natural Medicines Comprehensive Database rates effectiveness based on scientific evidence according to the following scale: Effective, Likely Effective, Possibly Effective, Possibly Ineffective, Likely Ineffective, Ineffective, and Insufficient Evidence to Rate.

The effectiveness ratings for NIACINAMIDE are as follows:

Likely effective for…

• A disease cause by niacin deficiency (pellagra). Niacinamide prescription products are US FDA approved for preventing and treating pellagra. It’s sometimes preferred over niacin because it doesn’t cause flushing, a side effect of niacin treatment.

Possibly effective for…

• Acne. Applying a cream containing niacinamide seems to improve the appearance of skin in people with acne.
• Diabetes. Taking niacinamide by mouth might help slow the progression of type 1 diabetes. But it doesn’t seem to prevent diabetes.
• High levels of phosphate in the blood (hyperphosphatemia). In people who need hemodialysis due to kidney failure and have high levels of phosphate, taking niacinamide by mouth seems to help decrease phosphate levels.
• Nonmelanoma skin cancer. Taking niacinamide by mouth seems to help prevent new skin cancer or precancerous spots from forming in people with a history of nonmelanoma skin cancer.
• Osteoarthritis. Taking niacinamide by mouth seems to improve joint flexibility and reduce pain and swelling in people with osteoarthritis.

Possibly ineffective for…

• Brain tumor. Taking niacinamide by mouth while undergoing chemotherapy doesn’t seem to benefit people with brain tumors.

There is interest in using niacinamide for a number of other purposes, but there isn’t enough reliable information to say whether it might be helpful.

When taken by mouth: Niacinamide is likely safe when used appropriately. Prescription products containing niacinamide are safe when taken as directed. Niacinamide-containing foods or supplements are safe when taken in doses lower than 35 mg daily. Niacinamide is possibly safe when taken in doses up to 900-1500 mg daily. It might cause side effects such as stomach upset, gas, dizziness, headache, and rash.

When applied to the skin: Niacinamide is possibly safe. Niacinamide cream might cause mild burning, itching, or redness.

Special precautions & warnings:

Pregnancy and breast-feeding: Niacinamide is likely safe when taken in recommended amounts. The maximum recommended amount while pregnant or breast-feeding is 30 mg daily for those under 18 years of age, and 35 mg daily for those over 18 years of age.

Children: Niacinamide is likely safe when taken by mouth in the recommended amounts by age. Children should avoid taking niacinamide doses above the daily upper limits, which are 10 mg for children 1-3 years of age, 15 mg for children 4-8 years of age, 20 mg for children 9-13 years of age, and 30 mg for children 14-18 years of age.

Diabetes: Niacinamide might increase blood sugar. People with diabetes who take niacinamide should check their blood sugar regularly.

Gallbladder disease: Niacinamide might make gallbladder disease worse.

Kidney dialysis: Taking niacinamide seems to increase the risk of low platelet levels in people with kidney failure who are on dialysis.

Stomach or intestinal ulcers: Niacinamide might make ulcers worse. Don’t use it if you have ulcers.

Moderate

Be cautious with this combination.

Carbamazepine (Tegretol)

Carbamazepine is broken down by the body. Niacinamide might decrease how fast the body breaks down carbamazepine. But it isn’t clear if this is a major concern.

Medications that slow blood clotting (Anticoagulant / Antiplatelet drugs)

Niacinamide might slow blood clotting. Taking niacinamide along with medications that also slow blood clotting might increase the risk of bruising and bleeding.

Primidone (Mysoline)

Primidone is broken down by the body. Niacinamide might decrease how fast the body breaks down primidone. But there isn’t enough information to know if this is a major concern.

Herbs and supplements that might slow blood clotting

Niacinamide might slow blood clotting and increase the risk of bleeding. Taking it with other supplements with similar effects might increase the risk of bleeding in some people. Examples of supplements with this effect include garlic, ginger, ginkgo, nattokinase, and Panax ginseng.

There are no known interactions with foods.

In supplements, niacinamide might be listed on the label in niacin equivalents (NE). 1 mg of niacinamide is the same as 1 mg NE. Niacinamide is found in many vitamin B complex supplements with other B vitamins. It’s also used in many topical creams and gels.

Niacinamide is also found in many foods, including meat, fish, milk, eggs, vegetables, and cereals. The amount that should be consumed on a daily basis is called the recommended dietary allowance (RDA). In males, the RDA is 16 mg NE. In females, the RDA is 14 mg NE. While pregnant, the RDA is 18 mg NE. While breast-feeding, the RDA is 17 mg NE. In children, the RDA depends on age. Speak with a healthcare provider to find out what dose might be best for a specific condition.

3-Pyridine Carboxamide, 3-Pyridinecarboxamide, Amide de l’Acide Nicotinique, B Complex Vitamin, Complexe de Vitamines B, Niacinamida, Niacinamide Ascorbate, Nicamid, Nicosedine, Nicotinamide, Nicotinic Acid Amide, Nicotylamidum, Pyridine-3-carboxamide, Vitamin B3, Vitamina B3, Vitamine B3.

To learn more about how this article was written, please see the Natural Medicines Comprehensive Database methodology.

1. Ferreira ER, Miola AC, Lima TRR, Schmitt JV, Abbade LPF, Miot HA. Efficacy of intermittent topical 5-fluorouracil 5% and oral nicotinamide in the skin field cancerization: a randomized clinical trial. An Bras Dermatol 2021;96:784-787. View abstract.
2. DeBoer MD, Platts-Mills JA, Elwood SE, et al. Effect of scheduled antimicrobial and nicotinamide treatment on linear growth in children in rural Tanzania: A factorial randomized, double-blind, placebo-controlled trial. PLoS Med 2021;18:e1003617. View abstract.
3. Connell NJ, Grevendonk L, Fealy CE, et al. NAD+-Precursor Supplementation With L-Tryptophan, Nicotinic Acid, and Nicotinamide Does Not Affect Mitochondrial Function or Skeletal Muscle Function in Physically Compromised Older Adults. J Nutr 2021;151:2917-2931. View abstract.
4. Kaewsanit T, Chakkavittumrong P, Waranuch N. Clinical Comparison of Topical 2.5% Benzoyl Peroxide plus 5% Niacinamide to 2.5% Benzoyl Peroxide Alone in the Treatment of Mild to Moderate Facial Acne Vulgaris. J Clin Aesthet Dermatol 2021;14:35-41. View abstract.
5. Lenglet A, Rahali MA, Sauvage FL, et al. Effect of Sevelamer and Nicotinamide on Albumin Carbamylation in Patients with End-Stage Kidney Disease. Drugs R D 2021;21:231-238. View abstract.
6. Ketteler M, Wiecek A, Rosenkranz AR, et al. Efficacy and Safety of a Novel Nicotinamide Modified-Release Formulation in the Treatment of Refractory Hyperphosphatemia in Patients Receiving Hemodialysis-A Randomized Clinical Trial. Kidney Int Rep 2020;6:594-604. View abstract.
7. De Moraes CG, John SWM, Williams PA, Blumberg DM, Cioffi GA, Liebmann JM. Nicotinamide and Pyruvate for Neuroenhancement in Open-Angle Glaucoma: A Phase 2 Randomized Clinical Trial. JAMA Ophthalmol 2022;140:11-18. View abstract.
8. Niaspan [package insert]. Barcelona, Spain: AbbVie LTD; 2015.
9. Turck D, Castenmiller J, de Henauw S, et al. Safety of nicotinamide riboside chloride as a novel food pursuant to Regulation (EU) 2015/2283 and bioavailability of nicotinamide from this source, in the context of Directive 2002/46/EC. EFSA J. 2019;17:e05775. View abstract.
10. Kozan A, Guner RY, Akyol M. A retrospective assessment and comparison of the effectiveness of benzoyl peroxide; the combination of topical niacinamide, gallic acid, and lauric acid; and the combination of benzoyl peroxide and erythromycin in acne vulgaris. Dermatol Ther. 2020;33:e13534. View abstract.
11. Zhang Y, Ma T, Zhang P. Efficacy and safety of nicotinamide on phosphorus metabolism in hemodialysis patients: A systematic review and meta-analysis. Medicine (Baltimore). 2018;97:e12731. View abstract.
12. Cannizzaro MV, Dattola A, Garofalo V, Del Duca E, Bianchi L. Reducing the oral isotretinoin skin side effects: efficacy of 8% omega-ceramides, hydrophilic sugars, 5% niacinamide cream compound in acne patients. G Ital Dermatol Venereol. 2018;153:161-164. View abstract.
13. Centre for Clinical Practice at NICE (UK). Hyperphosphataemia in Chronic Kidney Disease: Management of Hyperphosphataemia in Patients with Stage 4 or 5 Chronic Kidney Disease. National Institute for Health and Care Excellence: Clinical Guidelines. Manchester: National Institute for Health and Care Excellence (UK); 2013 Mar.
14. Hoskin PJ, Rojas AM, Bentzen SM, Saunders MI. Radiotherapy with concurrent carbogen and nicotinamide in bladder carcinoma. J Clin Oncol. 2010 Nov 20;28:4912-8. View abstract.
15. Surjana D, Halliday GM, Martin AJ, Moloney FJ, Damian DL. Oral nicotinamide reduces actinic keratoses in phase II double-blinded randomized controlled trials. J Invest Dermatol. 2012 May;132:1497-500. View abstract.
16. Omidian M, Khazanee A, Yaghoobi R, Ghorbani AR, Pazyar N, Beladimousavi SS, Ghadimi M, Mohebbipour A, Feily A. Therapeutic effect of oral nicotinamide on refractory uremic pruritus: a randomized, double-blind study. Saudi J Kidney Dis Transpl. 2013 Sep;24:995-9. View abstract.
17. Nijkamp MM, Span PN, Terhaard CH, Doornaert PA, Langendijk JA, van den Ende PL, de Jong M, van der Kogel AJ, Bussink J, Kaanders JH. Epidermal growth factor receptor expression in laryngeal cancer predicts the effect of hypoxia modification as an additive to accelerated radiotherapy in a randomised controlled trial. Eur J Cancer. 2013 Oct;49:3202-9. View abstract.
18. Martin AJ, Chen A, Choy B, et al. Oral nicotinamide to reduce actinic cancer: A phase 3 double-blind randomized controlled trial. J Clin Oncol 33, 2015 (suppl; abstr 9000).
19. Lee DH, Oh IY, Koo KT, Suk JM, Jung SW, Park JO, Kim BJ, Choi YM. Reduction in facial hyperpigmentation after treatment with a combination of topical niacinamide and tranexamic acid: a randomized, double-blind, vehicle-controlled trial. Skin Res Technol. 2014 May;20:208-12. View abstract.
20. Khodaeiani E, Fouladi RF, Amirnia M, Saeidi M, Karimi ER. Topical 4% nicotinamide vs. 1% clindamycin in moderate inflammatory acne vulgaris. Int J Dermatol. 2013 Aug;52:999-1004. View abstract.
21. Janssens GO, Rademakers SE, Terhaard CH, Doornaert PA, Bijl HP, van den Ende P, Chin A, Takes RP, de Bree R, Hoogsteen IJ, Bussink J, Span PN, Kaanders JH. Improved recurrence-free survival with ARCON for anemic patients with laryngeal cancer. Clin Cancer Res. 2014 Mar 1;20:1345-54. View abstract.
22. Janssens GO, Rademakers SE, Terhaard CH, Doornaert PA, Bijl HP, van den Ende P, Chin A, Marres HA, de Bree R, van der Kogel AJ, Hoogsteen IJ, Bussink J, Span PN, Kaanders JH. Accelerated radiotherapy with carbogen and nicotinamide for laryngeal cancer: results of a phase III randomized trial. J Clin Oncol. 2012 May 20;30:1777-83. View abstract.
23. Fabbrocini G, Cantelli M, Monfrecola G. Topical nicotinamide for seborrheic dermatitis: an open randomized study. J Dermatolog Treat. 2014 Jun;25:241-5. View abstract.
24. Eustace A, Irlam JJ, Taylor J, Denley H, Agrawal S, Choudhury A, Ryder D, Ord JJ, Harris AL, Rojas AM, Hoskin PJ, West CM. Necrosis predicts benefit from hypoxia-modifying therapy in patients with high risk bladder cancer enrolled in a phase III randomised trial. Radiother Oncol. 2013 Jul;108:40-7. View abstract .
25. Amengual JE, Clark-Garvey S, Kalac M, Scotto L, Marchi E, Neylon E, Johannet P, Wei Y, Zain J, O’Connor OA. Sirtuin and pan-class I/II deacetylase (DAC) inhibition is synergistic in preclinical models and clinical studies of lymphoma. Blood. 2013 Sep 19;122:2104-13. View abstract.
26. Shalita AR, Falcon R, Olansky A, Iannotta P, Akhavan A, Day D, Janiga A, Singri P, Kallal JE. Inflammatory acne management with a novel prescription dietary supplement. J Drugs Dermatol. 2012;11:1428-33. View abstract.
27. Falsini, B., Piccardi, M., Iarossi, G., Fadda, A., Merendino, E., and Valentini, P. Influence of short-term antioxidant supplementation on macular function in age-related maculopathy: a pilot study including electrophysiologic assessment. Ophthalmology 2003;110:51-60. View abstract.
28. Rottembourg JB, Launay-Vacher V, Massard J. Thrombocytopenia induced by nicotinamide in hemodialysis patients. Kidney Int. 2005;68:2911-2. View abstract.
29. Takahashi Y, Tanaka A, Nakamura T, et al. Nicotinamide suppresses hyperphosphatemia in hemodialysis patients. Kidney Int. 2004;65:1099-104. View abstract.
30. Soma Y, Kashima M, Imaizumi A, et al. Moisturizing effects of topical nicotinamide on atopic dry skin. Int J Dermatol. 2005;44:197-202. View abstract.
31. Powell ME, Hill SA, Saunders MI, Hoskin PJ, Chaplin DJ. Human tumor blood flow is enhanced by nicotinamide and carbogen breathing. Cancer Res. 1997;57:5261-4. View abstract.
32. Hoskin PJ, Rojas AM, Phillips H, Saunders MI. Acute and late morbidity in the treatment of advanced bladder carcinoma with accelerated radiotherapy, carbogen, and nicotinamide. Cancer. 2005;103:2287-97. View abstract.
33. Niren NM, Torok HM. The Nicomide Improvement in Clinical Outcomes Study (NICOS): results of an 8-week trial. Cutis. 2006;77(1 Suppl):17-28. View abstract.
34. Kamal M, Abbasy AJ, Muslemani AA, Bener A. Effect of nicotinamide on newly diagnosed type 1 diabetic children. Acta Pharmacol Sin. 2006;27:724-7. View abstract.
35. Olmos PR, Hodgson MI, Maiz A, et al. Nicotinamide protected first-phase insulin response (FPIR) and prevented clinical disease in first-degree relatives of type-1 diabetics. Diabetes Res Clin Pract. 2006;71:320-33. View abstract.
36. Gale EA, Bingley PJ, Emmett CL, Collier T; European Nicotinamide Diabetes Intervention Trial (ENDIT) Group. European Nicotinamide Diabetes Intervention Trial (ENDIT): a randomised controlled trial of intervention before the onset of type 1 diabetes. Lancet. 2004;363:925-31. View abstract.
37. Cabrera-Rode E, Molina G, Arranz C, Vera M, et al. Effect of standard nicotinamide in the prevention of type 1 diabetes in first degree relatives of persons with type 1 diabetes. Autoimmunity. 2006;39:333-40. View abstract.
38. Hakozaki T, Minwalla L, Zhuang J, et al. The effect of niacinamide on reducing cutaneous pigmentation and suppression of melanosome transfer. Br J Dermatol. 2002 Jul;147:20-31. View abstract .
39. Bissett DL, Oblong JE, Berge CA. Niacinamide: A B vitamin that improves aging facial skin appearance. Dermatol Surg. 2005;31(7 Pt 2):860-5; discussion 865. View abstract.
40. Jorgensen J. Pellagra probably due to pyrazinamide: development during combined chemotherapy of tuberculosis. Int J Dermatol 1983;22:44-5. View abstract.
41. Swash M, Roberts AH. Reversible pellagra-like encephalopathy with ethionamide and cycloserine. Tubercle 1972;53:132. View abstract.
42. Brooks-Hill RW, Bishop ME, Vellend H. Pellagra-like encephalopathy complicating a multiple drug regimen for the treatment of pulmonary infection due to Mycobacterium avium-intracellulare (letter). Am Rev Resp Dis 1985;131:476. View abstract.
43. Visalli N, Cavallo MG, Signore A, et al. A multi-centre randomized trial of two different doses of nicotinamide in patients with recent-onset type 1 diabetes (the IMDIAB VI). Diabetes Metab Res Rev 1999;15:181-5. View abstract.
44. Bourgeois BF, Dodson WE, Ferrendelli JA. Interactions between primidone, carbamazepine, and nicotinamide. Neurology 1982;32:1122-6.