Specifically, the Food and Drug Administration (FDA) has approved niacin extended-release* oral tablet to:
- lower high levels of bad cholesterol, triglycerides, and other blood fats
- increase good cholesterol levels
- lower the risk of heart attack in people with high cholesterol who have had a heart attack in the past
- slow the progression of atherosclerosis (hardening of the arteries) in people with coronary artery disease and high cholesterol, along with other medications
This article describes possible side effects of niacin (ER) oral tablet. You can explore this overview article to learn more about niacin, including the drug’s uses, side effects, ways to save on cost, and more.
Niacin (ER) oral tablet is a generic medication. It isn’t available in a brand-name version. Niacin also comes in an immediate-release* form that you swallow, but that form isn’t described in this article. To learn more about that form, talk with your doctor.
* “Immediate release” means the drug is released into your body right away.
More common side effects of niacin
Niacin (ER) oral tablet may cause mild or serious side effects. Below are some of the more common side effects of this medication.
Commonly reported side effects of niacin (ER) oral tablet include:
* To learn more about this side effect, see the “Side effects of niacin in detail” section below.
Mild side effects of niacin
Niacin may cause certain mild side effects. Usually, mild side effects are temporary and can be easily managed. Tell your doctor or pharmacist if you have side effects that don’t go away or become bothersome.
Mild side effects of niacin (ER) oral tablet that occurred in studies include:
- diarrhea
- flushing*
- increased cough
- itching
- nausea or vomiting
- mild allergic reaction*†
Niacin (ER) oral tablet may cause more mild side effects than those listed above. For details, see the drug’s prescribing information.
* To learn more about these side effects, see the “Side effects of niacin in detail” section below.
† An allergic reaction is possible with niacin (ER) oral tablet. But it’s unclear whether it occurred in the drug’s studies.
Serious side effects of niacin
Niacin may cause certain serious side effects. If you have any serious side effects from niacin (ER) oral tablet, call your doctor right away. But if you think you’re having a medical emergency or your side effects feel life threatening, take immediate action. Call 911 or a local emergency number, or go to the nearest emergency room.
After the Food and Drug Administration (FDA) approves a drug, it tracks and reviews side effects of the medication. Visit MedWatch’s website if you’d like to notify the FDA about a side effect you’ve had with niacin.
Serious side effects of niacin (ER) oral tablet that occurred in studies include:
- high blood sugar
- liver problems, which can be severe and lead to liver failure*
- rhabdomyolysis (muscle breakdown)*
- severe allergic reaction*†
* To learn more about these side effects, see the “Side effects of niacin in detail” section below.
† An allergic reaction is possible with niacin (ER) oral tablet. But it’s unclear whether it occurred in the drug’s studies.
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Get free cardCommon questions about side effects of niacin
Here are answers to some common questions about side effects of niacin (ER) oral tablet. If you have other questions, talk with your doctor or pharmacist.
Is niacin safe for older adults?
Yes, niacin is usually safe for older adults (ages 65 years and older). In studies, the safety of niacin was similar in older adults and in younger adults. But it’s possible that older adults might be more sensitive to the side effects of niacin.
If you have concerns about taking niacin at your age, talk with your doctor.
Does niacin cause long-term side effects?
Long-term side effects aren’t expected with niacin (ER) oral tablet. In studies, specific side effects weren’t seen in people who had taken the drug for a long time. Long lasting side effects after treatment ended also weren’t reported.
Talk with your doctor if you have more questions about possible long-term side effects with niacin.
Side effects of niacin in detail
Below you’ll find details on some of the side effects of niacin (ER) oral tablet.
Flushing
Flushing was the most common side effect in studies of people taking niacin (ER) oral tablet. This side effect is usually mild, but may be serious in some people.
With flushing, small blood vessels near the surface of your skin widen. This increases blood flow to your skin. It most often happens in the skin of your face, neck, chest, and back. Symptoms of flushing may include:
- itching
- skin discolouration
- tingling
- warmth
Flushing is most likely to occur when you first start niacin (ER) tablet and after an increase in your dosage. If flushing happens, it usually starts within 2–4 hours of taking a dose.
Sometimes, flushing causes serious symptoms including:
- burning sensation in the skin
- chills
- dizziness
- edema (fluid buildup in your body)
- fainting
- fast heart rate
- heart palpitations (feeling of skipped or extra heartbeats)
- shortness of breath
- sweating
Ways to manage
Flushing may improve after a few weeks of taking niacin (ER) tablet. If you experience symptoms of flushing, tell your doctor. They may recommend taking aspirin 30 minutes before your niacin (ER) tablet dose.
You can help lower your risk of flushing by taking niacin (ER) tablet with a low fat snack. Also, when you take your dose, avoid the following:
- alcohol (if you drink)
- hot drinks
- spicy foods
If you have serious symptoms of flushing, call your doctor right away. These symptoms can be similar to a heart attack. Your doctor may recommend getting immediate medical care.
Liver problems
Liver problems were reported in studies of people taking niacin (ER) oral tablet. This side effect is usually mild, but may be serious in some people.
With liver problems, you have increased levels of enzymes or proteins in liver function tests. You may or may not have symptoms. When symptoms occur, they may include:
- fatigue (low energy)
- malaise (general feeling of being unwell)
- nausea
Sometimes, liver problems are severe and can lead to liver failure. Symptoms of severe liver problems may include:
- dark urine
- fatigue
- itchy skin
- loss of appetite
- pain in the upper right side of your abdomen
- pale stool
- jaundice (yellowish color of your skin and the white of your eyes)
Certain factors increase the risk of liver problems with niacin (ER) tablets. This includes drinking alcohol and having liver problems or liver disease in the past.
Ways to manage
Due to the risk of liver problems, doctors usually don’t prescribe niacin (ER) tablets for people with active liver disease or high liver enzymes.
Your doctor will typically order a liver function test before prescribing a treatment plan that includes niacin (ER) oral tablets. They’ll check these test results from time to time during your treatment.
If you experience symptoms of liver problems, call your doctor right away. They may recommend getting immediate medical treatment.
Rhabdomyolysis
Rhabdomyolysis (muscle breakdown) was also reported in studies of people taking niacin (ER) oral tablet. This side effect is serious.
Rhabdomyolysis is a type of muscle injury that causes muscle breakdown. It can lead to disability, kidney failure, and death. Symptoms may include:
- muscle pain
- muscle tenderness
- muscle weakness
Rhabdomyolysis is most likely to occur when you first start taking niacin (ER) oral tablet and after your dosage is increased.
Certain factors can increase the risk of rhabdomyolysis with niacin (ER) oral tablet. These include:
- being age 65 years or older
- diabetes
- kidney failure
- low thyroid that isn’t managed with medications
Ways to manage
If you experience symptoms of rhabdomyolysis, get medical care right away.
Allergic reaction
For some people, niacin (ER) oral tablet can cause an allergic reaction.
But it’s not clear whether this side effect occurred in the drug’s studies.
Symptoms can be mild or serious and may include:
- itchiness
- skin rash
- swelling under the skin, usually affecting eyelids, lips, hands, or feet
- swelling of the mouth, tongue, or throat, which can make it hard to breathe
- flushing (temporary warmth, redness, or deepening of skin color)
Ways to manage
For mild allergic reaction symptoms, such as a mild rash, call your doctor right away. They may recommend treatments to help manage your symptoms. They’ll also let you know whether you should keep taking the medication.
For severe allergic reaction symptoms, such as swelling or trouble breathing, call 911 or your local emergency number right away. These symptoms require immediate medical care because they can become life threatening. If you’ve had a serious allergic reaction to niacin (ER) oral tablet, your doctor may recommend taking a different medication instead.
Warnings for niacin
Below are some factors you may want to discuss with your doctor before taking niacin (ER) oral tablet.
Warnings
It may not be safe for you to take niacin (ER) oral tablet if you have specific health conditions. These are sometimes called drug-condition interactions. Other things may also affect whether niacin (ER) oral tablet is a safe treatment option for you.
Before taking niacin (ER) oral tablet, tell your doctor about your health and medications you take. Things to consider include:
- bleeding problems
- diabetes
- gout
- kidney problems
- liver problems
- stomach ulcer
- thyroid problems
- past allergic reaction to niacin
Niacin and pregnancy
It’s not known whether niacin (ER) oral tablet should be taken during pregnancy. But doctors may recommend not taking it in some cases. If you’re planning a pregnancy or can become pregnant, talk with your doctor before taking this medication.
Niacin and breastfeeding
Niacin (ER) oral tablet should not be taken while breastfeeding. If you’re breastfeeding or planning to do so, talk with your doctor before taking this medication. Your doctor may recommend other ways to feed your child during treatment with niacin.
Niacin and alcohol
Niacin (ER) oral tablet is known to interact with alcohol.
Drinking alcohol while taking niacin (ER) oral tablet increases the risk of liver problems and flushing.
If you drink alcohol, talk with your doctor about whether it’s safe to consume it during your treatment with niacin (ER) oral tablet.
What to ask your doctor
This article describes common and serious side effects of niacin (ER) oral tablet. If your doctor prescribes this medication, they can discuss possible side effects with you. Let your doctor know if you have concerns or questions about treatment with this medication.
Here are some possible questions you may want to ask your doctor:
- Am I at higher risk of having side effects from niacin (ER) oral tablet than other people?
- How can I lower my risk of side effects from niacin (ER) oral tablet?
- Does my dosage affect my risk of side effects from niacin (ER) oral tablet?
Disclaimer: Optum Perks has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.