What Is Niacinamide?

Niacinamide (nicotinamide) is a form of vitamin B3. Your body needs it to create energy, and your cells need it to function correctly. Niacinamide is also a water-soluble vitamin. Water-soluble vitamins are not stored in the body and must be consumed through food or supplements.

The umbrella “vitamin B3” includes both niacinamide (nicotinamide) and nicotinic acid ("niacin") to make things even more interesting. It’s important, however, not to confuse niacinamide (nicotinamide) with nicotinic acid (“niacin”), “nicotinamide mononucleotide,” “nicotinamide riboside,” nicotinamide adenine dinucleotide (NAD+)," or "nicotine."

Although they’re both different forms of vitamin B3, niacinamide (nicotinamide) and nicotinic acid ("niacin") have two different chemical structures and therefore work differently in your body.

Niacinamide and nicotinic acid (aka “niacin”) are forms of vitamin B3 found in supplements. However, your body can convert tryptophan from the food that you eat into niacinamide. Your body may be able to make niacinamide from niacin when there's enough of it. Note: some companies may list niacinamide and nicotinic acid under "niacin."

This article discusses potential uses for niacinamide, possible side effects, precautions, niacinamide dosage, known interactions, and other essential facts regarding niacinamide supplements.

Dietary supplements are not regulated in the United States, meaning the Food and Drug Administration (FDA) does not approve them for safety and effectiveness before products are marketed. When possible, choose a supplement that has been tested by a trusted third party, such as USP, ConsumerLabs, or NSF. However, even if supplements are third-party tested, that doesn’t mean that they are necessarily safe for all or effective in general. It is important to talk to your healthcare provider about any supplements you plan to take and to check in about any potential interactions with other supplements or medications.

Supplement Facts

  • Active Ingredient(s): Niacinamide
  • Alternate Name(s): Nicotinamide
  • Legal Status: Legal, over-the-counter (OTC)
  • Suggested Dose: Generally considered safe at less than 35 milligrams (mg) per day.
  • Safety Considerations: Rash, stomach upset. Rare: elevated liver enzymes (at more than 3 grams (g) per day), thrombocytopenia (in people with renal disease on dialysis).

Uses of Niacinamide

Supplement use should be individualized and vetted by a healthcare professional, such as a registered dietitian, pharmacist, or other healthcare providers. No supplement is intended to treat, cure, or prevent disease.

Oral (by mouth) niacinamide (nicotinamide) supplements have been studied for several conditions, including:

  • Delaying the development of type 1 diabetes
  • Hyperphosphatemia (high blood levels of phosphate)
  • Niacinamide deficiency
  • Pellagra
  • Treatment of neurological degeneration

Topical (on the skin) niacinamide (nicotinamide) has been studied for use in:

It’s important to note that niacinamide (nicotinamide) is different from niacin (aka, nicotinic acid). For example, niacin (nicotinic acid) is used to treat high cholesterol. Niacinamide, however, does not lower cholesterol.

Let's take a closer look at niacinamide.

Acne treatment

Niacinamide's anti-inflammatory effects are thought to reduce the redness and inflammation caused by acne. According to a review, topical (on the skin) niacinamide reduced acne. While the review also found that oral (by mouth) niacinamide combined with other supplements treated acne, conclusions cannot be made on using oral niacinamide alone for acne.

Niacinamide Deficiency

Niacinamide deficiency can be due to an inability to absorb tryptophan (Hartnup disease), isoniazid treatment, carcinoid syndrome, excess alcohol consumption or lack of dietary intake (ex., in anorexia). Symptoms include stomatitis (mouth inflammation), glossitis (red, swollen tongue), stomach upset, and pellagra which can be reversed with niacinamide supplementation. Niacinamide is generally recommended over nicotinic acid (niacin) to treat pellagra because it has fewer possible side effects. Talk with your healthcare provider if you believe you may have a niacinamide deficiency. They will be able to help diagnose and treat this condition.

Pellagra

Pellagra is a severe condition that occurs when a person is deficient in vitamin B3. Common symptoms of pellagra include:

It's possible to become deficient in niacinamide from not eating enough foods containing the vitamin (ex., starvation, anorexia), excess alcohol intake, disorders in which niacinamide is not adequately absorbed in the body, and certain genetic disorders.

Fortunately, pellagra can often be reversed with the help of niacinamide supplements. Niacinamide is recommended over nicotinic acid to treat pellagra because it has fewer possible side effects.

Skin cancer prevention

In a randomized controlled trial, after 12 months of treatment, niacinamide reduced the risk of developing new non-melanoma skin cancers by 23% (p=0.02), new squamous-cell carcinomas by 30% (p=0.05), and actinic keratosis (a.k.a., “pre-skin cancer”) by 13% (p=0.001). More high quality studies are needed before we can make recommendations for use of niacinamide for these conditions.

Other conditions

Niacinamide has also been studied for its use in:

  • Aging skin: According to a review, niacinamide increased keratin, an important protein needed for healthy skin, in cell cultures. It may also be helpful for other aspects of skincare, including reducing the appearance of wrinkles and other signs of aging skin using topical (skin) products.
  • Hyperphosphatemia: Hyperphosphatemia occurs when there is a high phosphate level in the blood. It's one of the most common complications of chronic kidney disease. A meta-analysis found oral (by mouth) niacinamide supplements to be safe and effective in reducing blood levels of phosphate in people receiving dialysis for chronic kidney disease.
  • Melasma: A skin condition that causes hyperpigmentation, or dark spots, melasma often occurs on areas of the skin that are regularly exposed to the sun. According to a study, topical (skin) niacinamide cream reduced the appearance of dark spots in people with melasma.
  • Type 1 diabetes (T1DM): Niacinamide has been studied for delaying T1DM development in high-risk individuals. Studies used 1 gram (g) to 3 grams (g) per day for four months to four years.
  • Neurological degeneration.

Further high-quality studies are needed before recommendations can be made.

What Are the Side Effects of Niacinamide?

Like with most supplements and medications, side effects are possible when taking niacinamide.

Your healthcare provider may recommend that you start taking a niacinamide supplement for any of the reasons discussed in the previous section. No matter the reason for taking niacinamide, it's important to know and understand any common or severe side effects you may or may not experience.

Common Side Effects

Niacinamide is considered generally safe for oral (by mouth) and topical (skin) use. Unlike niacin (aka, nicotinic acid), niacinamide does not cause skin flushing.

In general, niacinamide has fewer potential side effects than other forms of niacin. However, taking higher doses than normal of niacinamide can make side effects more likely.

Possible side effects from taking oral (by mouth) niacinamide supplements include:

  • Diarrhea
  • Increased liver enzymes (rare, at doses >3g/d)
  • Symptoms of thrombocytopenia (ex., increased bruising and bleeding - rare)
  • Upset stomach

Side effects of topical (skin) niacinamide creams include:

Severe Side Effects

When niacinamide supplements are taken at a dose that's too high, severe side effects may occur.

Severe side effects of niacinamide include:

  • Nausea
  • Vomiting
  • Liver damage

Be sure to talk to your healthcare provider if you experience side effects from taking niacinamide supplements. It may be necessary to stop taking niacinamide in some instances.

Precautions

Specific populations of people should take precautions when starting niacinamide supplements.

Pregnancy and breastfeeding: Niacinamide is generally considered acceptable when used by people who are pregnant or breastfeeding. However, it's always best to talk with your healthcare provider before starting a new supplement if pregnant or breastfeeding.

Children: Niacinamide is likely safe when used by children, as long as the dosage does not exceed recommended amounts.

Liver and gallbladder issues: People with liver or gallbladder disease should take special precautions when considering taking niacinamide. Niacinamide may worsen symptoms in these populations.

Kidney issues: People receiving dialysis for kidney disease may need to avoid taking niacinamide. This is because niacinamide may decrease blood counts when taken by dialysis patients.

Ulcers: People with stomach ulcers may need to avoid using niacinamide as it may worsen ulcers.

Dosage: How Much Niacinamide Should I Take?

Always speak with a healthcare provider before taking a supplement to ensure that the supplement and dosage is appropriate for your individual needs.

Niacinamide is generally considered safe to take in doses of lower than 35 milligrams (mg) per day. 200 milligrams (mg) per day, or 50 milligrams (mg) per kilogram (kg) (eq. ~3.5 grams (g) per day) for up to 12 months have been used in different studies. While niacinamide may be safe in higher amounts, side effects may arise (ex., increased bleeding, stomach upset).

Talk with your healthcare provider when deciding how much niacinamide to take per day. You may need more or less niacinamide, depending on your individual needs or health conditions.

As a general rule, never use more niacinamide than what is listed on the supplement label unless directed to do so by a healthcare professional.

What Happens If I Take Too Much Niacinamide?

Of all the forms of niacin available in supplement form, niacinamide seems to be the least harmful. However, it's still possible to take too much niacinamide.

Rash, stomach upset, elevated liver enzymes (rare side effects, has happened at a dose of more than 3 grams (g) per day), and symptoms of thrombocytopenia (rare, in people with renal disease on dialysis) have been reported. In people undergoing hemodialysis, the most common side effects of niacinamide (500 to 1,500 milligrams (mg) per day for several months) were diarrhea and low platelet counts (thrombocytopenia).

Again, it's important to not exceed the recommended dose of niacinamide either as suggested by your healthcare provider, or by what's listed on the supplement label.

Interactions

The following moderate interactions are possible between niacinamide and other medications:

  • Tegretol (carbamazepine): Niacinamide may slow the breakdown of this drug. This could change the effectiveness of this drug.
  • Anticoagulant/antiplatelet drugs, supplements, or plant-based medicines: These blood-thinning medications are known to slow blood clotting. Because niacinamide may also slow blood clotting, it is possible for bleeding to increase if mixed with these medications.
  • Mysoline (primidone): Because niacinamide may decrease how quickly your body breaks down primidone, niacinamide may increase the blood levels of primidone. Higher blood levels of primidone may mean amplified effects of the drug in the body and increased risk of primidone side effects.

There are no known interactions between niacinamide and foods.

It's possible for niacinamide supplements to slow blood clotting and increase your bleeding risk. For these reasons, it may be best to avoid taking niacinamide with other supplements that may also increase bleeding, such as garlic, ginger, ginkgo, nattokinase, and Panax ginseng.

It is imperative that you carefully read the ingredient list on the nutrition label of any supplement you take to know which ingredients and how much of each ingredient is in the supplement. Please review all supplement labels with your healthcare provider to discuss any potential interactions with foods, other supplements, and medications.

How to Store Niacinamide

Niacinamide supplements should be stored in a cool, dry place.

You should avoid storing your supplements in places that could become too hot or too cold. It's also best to keep supplements away from direct sunlight.

Some niacinamide creams or serums may require refrigeration.

Consult the label of your products for the best storage techniques.

Discard niacinamide supplements as indicated by the "use by" date listed on the label.

Similar Supplements

Some supplements work similarly to niacinamide:

Niacinamide has several potential uses. Similar supplements may replicate the effects of niacinamide.

Consult with your healthcare provider to find the safest supplement regimen.

Frequently Asked Questions

  • How is niacinamide different from niacin?

    Niacinamide (nicotinamide) is a form of vitamin B3. Niacinamide is a water-soluble vitamin. Your body needs it to create energy, and your cells need it to function correctly. Water-soluble vitamins are not stored in the body and must be regularly consumed through food or supplements. To make things even more interesting, the umbrella “vitamin B3” includes nicotinic acid and nicotinamide.

    Niacinamide and nicotinic acid (aka “niacin”) are common forms of vitamin B3 found in supplements. Your body can convert tryptophan from food into niacinamide as needed, and it may be able to make niacinamide from niacin to an extent when there's enough of it.

  • What is a water-soluble vitamin?

    Niacinamide is a form of vitamin B3, a water-soluble vitamin. This means that vitamin B3 and other water-soluble vitamins can be dissolved in water.

    In contrast, fat-soluble vitamins, like vitamins A, D, E, and K, are dissolved in fat.

  • Do niacinamide supplements contain other ingredients?

    It's important to know what else is in your supplements before taking them. Niacinamide supplements, including oral (by mouth) capsules and topical (skin) serums, often contain other ingredients.

    Common ingredients added to niacinamide supplements include cellulose, gelatin, and stearic acid. Serums may contain vitamin B5, vitamin C, licorice extract, and glucosamine.

Sources of Niacinamide & What to Look For

Typically, you may be getting enough niacinamide through your diet. If possible, take a "food first" approach to getting enough niacinamide. Eating a variety of whole foods can help you get most of the vitamins and minerals that you need.

Niacinamide supplements may be necessary to treat certain skin conditions, if your body cannot absorb enough niacinamide or if you have any other conditions for which your healthcare provider feels niacinamide can help.

Food Sources of Niacinamide

Tryptophan in foods can be converted to niacinamide. Food sources of tryptophan include:

  • Turkey
  • Poultry
  • Fish (tuna)
  • Dairy
  • Eggs
  • Oats

Niacinamide Supplements

Niacinamide supplements can be used in topical (skin) form as creams or serums and orally (by mouth) as capsules or powder. The supplement form you use will depend on your health needs.

When purchasing a new supplement, look for the word "niacinamide" on the label. Other products may claim the benefits of niacinamide but contain different ingredients or forms of vitamin B3, like niacin (nicotinic acid). These do not work the same as niacinamide.

Niacinamide supplements are generally safe and may help with various medical conditions. Before taking any supplements containing niacinamide, it's best to talk to your healthcare provider. This will ensure you know the correct dosage for your health needs and goals.

Summary

Niacinamide is a form of vitamin B3 that your body needs to create energy and your cells need to function correctly. It is also a water-soluble vitamin, often consumed through food or supplement form. Niacinamide supplements can be used topically (on the skin) in cream or serum formulas or orally through capsules or powder.

Niacinamide has been studied for use in several health conditions, such as pellagra, acne, and skin cancer prevention. Niacinamide supplements may help treat certain skin conditions or if your body cannot absorb enough niacinamide.

Although niacinamide supplements are generally safe, you should always consult with a healthcare provider before taking any supplements.

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Additional Reading

By Regina C. Windsor, MPH, RDN
Listen to yourself. Connect the dots. Find your people. Go have fun.

Originally written by
Tolu Ajiboye
Tolu Ajiboye
Tolu Ajiboye is a health writer who works with medical, wellness, biotech, and other healthcare technology companies.
Learn about our editorial process