Nutritional Supplement
Vitamin B3
Negative Interactions
2- Potential Negative Interaction
Vitamin B3 (Niacin)
Glimepiride
Vitamin B3 can raise blood sugar levels, which makes diabetes difficult to control. Use of niacin along with glimepiride may increase requirements for the drug. On the other hand, individuals who stop taking niacin while on glimepiride should monitor their blood for lower-than-usual glucose levels.
GlimepirideVitamin B3 (Niacin)- Sifton DW, ed. Physicians Desk Reference. Montvale, NJ: Medical Economics Company, Inc., 2000, 1346-9.
- Potential Negative Interaction
Vitamin B3 (Niacin)
Repaglinide
Supplementation with large amounts of niacin (also called nicotinic acid) can increase blood glucose levels in diabetics, which might interfere with the blood-sugar-lowering effects of repaglinide. The form of vitamin B3 known as niacinamide does not have this effect. People who start or stop supplementing niacin while on repaglinide should carefully monitor their blood sugar levels and consult their prescribing doctor about making adjustments in the daily amount of drug taken.
RepaglinideVitamin B3 (Niacin)- Sifton DW, ed. Physicians Desk Reference. Montvale, NJ: Medical Economics Company, Inc., 2000, 2071-3.
Supportive Interactions
25- Replenish Depleted Nutrients
Vitamin B3 (Niacin)
Carbidopa
This interaction is based on this drug belonging to a drug class. While this drug may differ from the text and references below, drugs within this class work in a similar way and this interaction is applicable to drugs within the same class.
A study in animals has found that carbidopa inhibits an enzyme involved in the synthesis of niacin in the body. In addition, there is evidence that niacin synthesis is decreased in people taking carbidopa and other drugs in its class, raising the concern that people taking these drugs could be at risk of niacin deficiency, even if not frankly deficient. Further studies will be required determine if niacin supplementation is appropriate in people taking carbidopa.
CarbidopaVitamin B3 (Niacin)- Bender DA, Smith WR. Inhibition of kynurenine hydrolase by benserazide, carbidopa and other aromatic hydrazine derivatives: evidence for sub-clinical iatrogenic niacin deficiency. Biochem Soc Trans 1978;6:120-2.
- Bender DA, Earl CJ, Lees AJ. Niacin depletion in Parkinsonian patients treated with L-dopa, benserizide and carbidopa. Clin Sci 1979;56:89-93.
- Replenish Depleted Nutrients
Vitamin B3 (Niacin)
Carbidopa-Levodopa
A study in animals has found that carbidopa inhibits an enzyme involved in the synthesis of niacin in the body. In addition, there is evidence that niacin synthesis is decreased in people taking carbidopa and other drugs in its class. Further studies are needed to determine whether niacin supplementation is appropriate in people taking carbidopa.
Carbidopa-LevodopaVitamin B3 (Niacin)- Bender DA, Smith WR. Inhibition of kynurenine hydrolase by benserazide, carbidopa and other aromatic hydrazine derivatives: evidence for sub-clinical iatrogenic niacin deficiency. Biochem Soc Trans 1978;6:120-2.
- Bender DA, Earl CJ, Lees AJ. Niacin depletion in Parkinsonian patients treated with L-dopa, benserizide and carbidopa. Clin Sci 1979;56:89-93.
- Replenish Depleted Nutrients
Vitamin B3 (Niacin)
Desogestrel-Ethinyl Estradiol
A review of literature suggests that women who use oral contraceptives may experience decreased vitamin B1, B2, B3, B12, C, and zinc levels. Oral contraceptive use has been associated with increased absorption of calcium and copper and with increased blood levels of copper and vitamin A. Oral contraceptives may interfere with manganese absorption. The clinical importance of these actions remains unclear.
Desogestrel-Ethinyl EstradiolVitamin B3 (Niacin)- Werbach MR. Foundations of Nutritional Medicine. Tarzana, CA: Third Line Press, 1997, 210-1 [review].
- Wynn V. Vitamins and oral contraceptive use. Lancet 1975;1:561-4.
- Holt GA. Food & Drug Interaction. Chicago: Precept Press, 1998, 197-8.
- Holt GA. Food & Drug Interaction. Chicago: Precept Press, 1998, 197.
- Replenish Depleted Nutrients
Vitamin B3 (Niacin)
Ethinyl Estradiol and Levonorgestrel
A review of literature suggests that women who use oral contraceptives may experience decreased vitamin B1, B2, B3, B12, C, and zinc levels. Oral contraceptive use has been associated with increased absorption of calcium and copper and with increased blood levels of copper and vitamin A. Oral contraceptives may interfere with manganese absorption. The clinical importance of these actions remains unclear.
Ethinyl Estradiol and LevonorgestrelVitamin B3 (Niacin)- Werbach MR. Foundations of Nutritional Medicine. Tarzana, CA: Third Line Press, 1997, 210-1 [review].
- Wynn V. Vitamins and oral contraceptive use. Lancet 1975;1:561-4.
- Holt GA. Food & Drug Interaction. Chicago: Precept Press, 1998, 197-8.
- Holt GA. Food & Drug Interaction. Chicago: Precept Press, 1998, 197.
- Replenish Depleted Nutrients
Vitamin B3 (Niacin)
Ethinyl Estradiol and Norethindrone
A review of literature suggests that women who use OCs may experience decreased vitamin B1, B2, B3, B12, C, and zinc levels. OC use has been associated with increased absorption of calcium and copper and with increased blood levels of copper and vitamin A. OCs may interfere with manganese absorption. The clinical importance of these actions remains unclear.
Ethinyl Estradiol and NorethindroneVitamin B3 (Niacin)- Werbach MR. Foundations of Nutritional Medicine. Tarzana, CA: Third Line Press, 1997, 210-1 [review].
- Wynn V. Vitamins and oral contraceptive use. Lancet 1975;1:561-4.
- Holt GA. Food & Drug Interaction. Chicago: Precept Press, 1998, 197-8.
- Holt GA. Food & Drug Interaction. Chicago: Precept Press, 1998, 197.
- Replenish Depleted Nutrients
Vitamin B3 (Niacin)
Ethinyl Estradiol and Norgestimate
A review of literature suggests that women who use OCs may experience decreased vitamin B1, B2, B3, B12, C, and zinc levels. OC use has been associated with increased absorption of calcium and copper and with increased blood levels of copper and vitamin A. OCs may interfere with manganese absorption. The clinical importance of these actions remains unclear.
Ethinyl Estradiol and NorgestimateVitamin B3 (Niacin)- Werbach MR. Foundations of Nutritional Medicine. Tarzana, CA: Third Line Press, 1997, 210-1 [review].
- Wynn V. Vitamins and oral contraceptive use. Lancet 1975;1:561-4.
- Holt GA. Food & Drug Interaction. Chicago: Precept Press, 1998, 197-8.
- Holt GA. Food & Drug Interaction. Chicago: Precept Press, 1998, 197.
- Replenish Depleted Nutrients
Vitamin B3 (Niacin)
Ethinyl Estradiol and Norgestrel
A review of literature suggests that women who use oral contraceptives may experience decreased vitamin B1, B2, B3, B12, C, and zinc levels. Oral contraceptive use has been associated with increased absorption of calcium and copper and with increased blood levels of copper and vitamin A. Oral contraceptives may interfere with manganese absorption. The clinical importance of these actions remains unclear.
Ethinyl Estradiol and NorgestrelVitamin B3 (Niacin)- Werbach MR. Foundations of Nutritional Medicine. Tarzana, CA: Third Line Press, 1997, 210-1 [review].
- Wynn V. Vitamins and oral contraceptive use. Lancet 1975;1:561-4.
- Holt GA. Food & Drug Interaction. Chicago: Precept Press, 1998, 197-8.
- Holt GA. Food & Drug Interaction. Chicago: Precept Press, 1998, 197.
- Replenish Depleted Nutrients
Vitamin B3 (Niacin)
Isoniazid
Isoniazid is capable of causing vitamin B3 (niacin) deficiency, most likely due to its ability to interfere with cell-repair enzymes made from niacin. Significant niacin deficiency, also known as pellagra, features dermatitis, diarrhea, and dementia (impaired intellectual function). Supplementation with vitamin B6 is thought to reduce this risk, although small amounts (e.g. 10 mg daily) has been noted to be inadequate in some cases.
IsoniazidVitamin B3 (Niacin)- Darvay A, Basarab T, McGregor JM, Russell-Jones R. Isoniazid induced pellagra despite pyridoxine supplementation. Clin Exp Dermatol 1999;24:167-70.
- Replenish Depleted Nutrients
Vitamin B3 (Niacin)
Levonorgestrel
A review of literature suggests that women who use oral contraceptives may experience decreased vitamin B1, B2, B3, B12, C, and zinc levels. Oral contraceptive use has been associated with increased absorption of calcium and copper and with increased blood levels of copper and vitamin A. Oral contraceptives may interfere with manganese absorption. The clinical importance of these actions remains unclear.
LevonorgestrelVitamin B3 (Niacin)- Werbach MR. Foundations of Nutritional Medicine. Tarzana, CA: Third Line Press, 1997, 210-1 [review].
- Wynn V. Vitamins and oral contraceptive use. Lancet 1975;1:561-4.
- Holt GA. Food & Drug Interaction. Chicago: Precept Press, 1998, 197-8.
- Holt GA. Food & Drug Interaction. Chicago: Precept Press, 1998, 197.
- Replenish Depleted Nutrients
Vitamin B3 (Niacin)
Levonorgestrel-Ethinyl Estrad
A review of literature suggests that women who use oral contraceptives may experience decreased vitamin B1, B2, B3, B12, C, and zinc levels. Oral contraceptive use has been associated with increased absorption of calcium and copper and with increased blood levels of copper and vitamin A. Oral contraceptives may interfere with manganese absorption. The clinical importance of these actions remains unclear.
Levonorgestrel-Ethinyl EstradVitamin B3 (Niacin)- Werbach MR. Foundations of Nutritional Medicine. Tarzana, CA: Third Line Press, 1997, 210-1 [review].
- Holt GA. Food & Drug Interaction. Chicago: Precept Press, 1998, 197-8.
- Wynn V. Vitamins and oral contraceptive use. Lancet 1975;1:561-4.
- Holt GA. Food & Drug Interaction. Chicago: Precept Press, 1998, 197.
- Replenish Depleted Nutrients
Vitamin B3 (Niacin)
Mestranol and Norethindrone
A review of literature suggests that women who use oral contraceptives may experience decreased vitamin B1, B2, B3, B12, C, and zinc levels. Oral contraceptive use has been associated with increased absorption of calcium and copper and with increased blood levels of copper and vitamin A. Oral contraceptives may interfere with manganese absorption. The clinical importance of these actions remains unclear.
Mestranol and NorethindroneVitamin B3 (Niacin)- Werbach MR. Foundations of Nutritional Medicine. Tarzana, CA: Third Line Press, 1997, 210-1 [review].
- Holt GA. Food & Drug Interaction. Chicago: Precept Press, 1998, 197-8.
- Wynn V. Vitamins and oral contraceptive use. Lancet 1975;1:561-4.
- Holt GA. Food & Drug Interaction. Chicago: Precept Press, 1998, 197.
- Replenish Depleted Nutrients
Vitamin B3 (Niacin)
Norgestimate-Ethinyl Estradiol
A review of literature suggests that women who use oral contraceptives may experience decreased vitamin B1, B2, B3, B12, C, and zinc levels. Oral contraceptive use has been associated with increased absorption of calcium and copper and with increased blood levels of copper and vitamin A. Oral contraceptives may interfere with manganese absorption. The clinical importance of these actions remains unclear.
Norgestimate-Ethinyl EstradiolVitamin B3 (Niacin)- Werbach MR. Foundations of Nutritional Medicine. Tarzana, CA: Third Line Press, 1997, 210-1 [review].
- Wynn V. Vitamins and oral contraceptive use. Lancet 1975;1:561-4.
- Holt GA. Food & Drug Interaction. Chicago: Precept Press, 1998, 197-8.
- Holt GA. Food & Drug Interaction. Chicago: Precept Press, 1998, 197.
- Replenish Depleted Nutrients
Vitamin B3 (Niacin)
Tetracycline
Taking large amounts of niacinamide, a form of vitamin B3, can suppress inflammation in the body. According to numerous preliminary reports, niacinamide, given in combination with tetracycline or minocycline, may be effective against bullous pemphigoid, a benign, autoimmune blistering disease of the skin. Preliminary evidence also suggests a similar beneficial interaction may exist between tetracycline and niacinamide in the treatment of dermatitis herpetiformis.
TetracyclineVitamin B3 (Niacin)- Yomoda M, Komai A, Hasimoto T. Sublamina densa-type linear IgA bullous dermatosis successfully treated with oral tetracycline and niacinamide. Br J Dermatol 1999;141:608-9.
- Dragan L, Eng AM, Lam S, Persson T. Tetracycline and niacinamide: treatment alternatives in ocular cicatricial pemphigoid. Cutis 1999;63:181-3.
- Berk MA, Lorincz AL. The treatment of bullous pemphigoid with tetracycline and niacinamide. A preliminary report. Arch Dermatol 1986;122:670-4.
- Kawahara Y, Hashimoto T, Ohata K, Nishikawa T. Eleven cases of bullous pemphigoid treated with combination of minocycline and nicotinamide. Eur J Dermatol 1996;6:427-9.
- Reiche L, Wojnarowska F, Mallon E. Combination therapy with nicotinamide and tetracyclines for cicatricial pemphigoid; further support for its efficacy. Clin Exp Dermatol 1998;23:254-7.
- Peoples D, Fivenson DP. Linear IgA bullous dermatosis: successful treatment with tetracycline and nicotinamide. J Am Acad Dermatol 1992;26:498-9.
- Chaffins ML, Collison D, Fivenson DP. Treatment of pemphigus and linear IgA dermatosis with nicotinamide and tetracycline: a review of 13 cases. J Am Acad Dermatol 1993;28:998-1000.
- Shah SA, Ormerod AD. Dermatitis herpetiformis effectively treated with heparin, tetracycline and nicotinamide. Clin Exp Dermatol 2000;25:204-5.
- Zemtsov A, Neldner KH. Successful treatment of dermatitis herpetiformis with tetracycline and nicotinamide in a patient unable to tolerate dapsone. J Am Acad Dermatol 1993;28:505-6.
- Support Medicine
L-Tryptophan and Vitamin B3
Amitriptyline
Combination of 6 grams per day L-tryptophan and 1,500 mg per day niacinamide (a form of vitamin B3) with imipramine has shown to be more effective than imipramine alone for people with bipolar disorder. These levels did not improve the effects of imipramine in people with depression. Lower amounts (4 grams per day of L-tryptophan and 1,000 mg per day of niacinamide) did show some tendency to enhance the effect of imipramine.
The importance of the amount of L-tryptophan was confirmed in other studies, suggesting that if too much L-tryptophan (6 grams per day) is used, it is not beneficial, while levels around 4 grams per day may make tricyclic antidepressants work better.
AmitriptylineL-Tryptophan and Vitamin B3- Chouinard G, Young SN, Annable L, Sourkes TL. Tryptophan-nicotinamide, imipramine and their combination in depression. Acta Psychiatr Scand 1979;59:395-414.
- Walinder J, Skott A, Carlsson A, et al. Potentiation of the antidepressant action of clomipramine by tryptophan. Arch Gen Psychiatry 1976;33:1384-9.
- Shaw DM, MacSweeney DA, Hewland R, Johnson AL. Tricyclic antidepressants and tryptophan in unipolar depression. Psychol Med 1975;5:276-8.
- Support Medicine
L-Tryptophan and Vitamin B3
Amoxapine
Combination of 6 grams per day L-tryptophan and 1,500 mg per day niacinamide (a form of vitamin B3) with imipramine has shown to be more effective than imipramine alone for people with bipolar disorder. These levels did not improve the effects of imipramine in people with depression. Lower amounts (4 grams per day of L-tryptophan and 1,000 mg per day of niacinamide) did show some tendency to enhance the effect of imipramine.
The importance of the amount of L-tryptophan was confirmed in other studies, suggesting that if too much L-tryptophan (6 grams per day) is used, it is not beneficial, while levels around 4 grams per day may make tricyclic antidepressants work better.
AmoxapineL-Tryptophan and Vitamin B3- Chouinard G, Young SN, Annable L, Sourkes TL. Tryptophan-nicotinamide, imipramine and their combination in depression. Acta Psychiatr Scand 1979;59:395-414.
- Walinder J, Skott A, Carlsson A, et al. Potentiation of the antidepressant action of clomipramine by tryptophan. Arch Gen Psychiatry 1976;33:1384-9.
- Shaw DM, MacSweeney DA, Hewland R, Johnson AL. Tricyclic antidepressants and tryptophan in unipolar depression. Psychol Med 1975;5:276-8.
- Support Medicine
L-Tryptophan and Vitamin B3
Benztropine
Akathisia is an adverse reaction to anti-psychotic drugs, where a person has an uncontrollable desire to be in constant motion. One preliminary report suggested that 4,000 mg of L-tryptophan and 25 mg niacin per day taken with benztropine enhances the treatment of akathisia. Controlled studies are necessary to determine whether L-tryptophan and niacin supplements might benefit most people taking benztropine who experience adverse reactions to anti-psychotic drugs.
BenztropineL-Tryptophan and Vitamin B3- Kramer MS, DiJohnson C, Davis P, et al. L-tryptophan in neuroleptic-induced akathisia. Biol Psychiatry 1990;27:671-2.
- Support Medicine
L-Tryptophan and Vitamin B3
Clomipramine
Combination of 6 grams per day L-tryptophan and 1,500 mg per day niacinamide (a form of vitamin B3) with imipramine has shown to be more effective than imipramine alone for people with bipolar disorder. These levels did not improve the effects of imipramine in people with depression. Lower amounts (4 grams per day of L-tryptophan and 1,000 mg per day of niacinamide) did show some tendency to enhance the effect of imipramine.
The importance of the amount of L-tryptophan was confirmed in other studies, suggesting that if too much L-tryptophan (6 grams per day) is used, it is not beneficial, while levels around 4 grams per day may make tricyclic antidepressants work better.
ClomipramineL-Tryptophan and Vitamin B3- Chouinard G, Young SN, Annable L, Sourkes TL. Tryptophan-nicotinamide, imipramine and their combination in depression. Acta Psychiatr Scand 1979;59:395-414.
- Walinder J, Skott A, Carlsson A, et al. Potentiation of the antidepressant action of clomipramine by tryptophan. Arch Gen Psychiatry 1976;33:1384-9.
- Shaw DM, MacSweeney DA, Hewland R, Johnson AL. Tricyclic antidepressants and tryptophan in unipolar depression. Psychol Med 1975;5:276-8.
- Support Medicine
L-Tryptophan and Vitamin B3
Doxepin
Combination of 6 grams per day L-tryptophan and 1,500 mg per day niacinamide (a form of vitamin B3) with imipramine has shown to be more effective than imipramine alone for people with bipolar disorder. These levels did not improve the effects of imipramine in people with depression. Lower amounts (4 grams per day of L-tryptophan and 1,000 mg per day of niacinamide) did show some tendency to enhance the effect of imipramine.
The importance of the amount of L-tryptophan was confirmed in other studies, suggesting that if too much L-tryptophan (6 grams per day) is used, it is not beneficial, while levels around 4 grams per day may make tricyclic antidepressants work better.
DoxepinL-Tryptophan and Vitamin B3- Chouinard G, Young SN, Annable L, Sourkes TL. Tryptophan-nicotinamide, imipramine and their combination in depression. Acta Psychiatr Scand 1979;59:395-414.
- Walinder J, Skott A, Carlsson A, et al. Potentiation of the antidepressant action of clomipramine by tryptophan. Arch Gen Psychiatry 1976;33:1384-9.
- Shaw DM, MacSweeney DA, Hewland R, Johnson AL. Tricyclic antidepressants and tryptophan in unipolar depression. Psychol Med 1975;5:276-8.
- Support Medicine
Vitamin B3 (Niacin)
Gemfibrozil
Niacin (not niacinamide) and gemfibrozil have successfully raised HDL (good) cholesterol levels, both alone and in combination.
GemfibrozilVitamin B3 (Niacin)- Zema MJ. Gemfibrozil, nicotinic acid and combination therapy in patients with isolated hypoalphalipoproteinemia: a randomized, open-label, crossover study. J Am Coll Cardiol 2000;35:640-6.
- Support Medicine
L-Tryptophan and Vitamin B3
Imipramine
Combination of 6 grams per day L-tryptophan and 1,500 mg per day niacinamide (a form of vitamin B3) with imipramine has shown to be more effective than imipramine alone for people with bipolar disorder. These levels did not improve the effects of imipramine in people with depression. Lower amounts (4 grams per day of L-tryptophan and 1,000 mg per day of niacinamide) did show some tendency to enhance the effect of imipramine.
The importance of the amount of L-tryptophan was confirmed in other studies, suggesting that if too much L-tryptophan (6 grams per day) is used, it is not beneficial, while levels around 4 grams per day may make tricyclic antidepressants work better.
ImipramineL-Tryptophan and Vitamin B3- Chouinard G, Young SN, Annable L, Sourkes TL. Tryptophan-nicotinamide, imipramine and their combination in depression. Acta Psychiatr Scand 1979;59:395-414.
- Walinder J, Skott A, Carlsson A, et al. Potentiation of the antidepressant action of clomipramine by tryptophan. Arch Gen Psychiatry 1976;33:1384-9.
- Shaw DM, MacSweeney DA, Hewland R, Johnson AL. Tricyclic antidepressants and tryptophan in unipolar depression. Psychol Med 1975;5:276-8.
- Support Medicine
Vitamin B3 (Niacin)
Minocycline
Niacinamide taken in combination with minocycline has produced beneficial effects in an individual with cicatricial pemphigoid, an autoimmune blistering disease, as well as in a 46-year-old woman with pemphigus vegetans, another blistering disease. Several other studies have confirmed the efficacy of this combination for bullous (blistering) pemphigoid.
MinocyclineVitamin B3 (Niacin)- Reiche L, Wojnarowska F, Mallon E. Combination therapy with nicotinamide and tetracyclines for cicatricial pemphigoid; further support for its efficacy. Clin Exp Dermatol 1998;23:254-7.
- Sawai T, Kitazawa K, Danno K, et al. Pemphigus vegetans with oesophageal involvement: successful treatment with minocycline and nicotinamide. Br J Dermatol 1995;132:668-70.
- Yomoda M, Komai A, Hasimoto T. Sublamina densa-type linear IgA bullous dermatosis successfully treated with oral tetracycline and niacinamide. Br J Dermatol 1999;141:608-9.
- Berk MA, Lorincz AL. The treatment of bullous pemphigoid with tetracycline and niacinamide. A preliminary report. Arch Dermatol 1986;122:670-4.
- Kawahara Y, Hashimoto T, Ohata K, Nishikawa T. Eleven cases of bullous pemphigoid treated with combination of minocycline and nicotinamide. Eur J Dermatol 1996;6:427-9.
- Peoples D, Fivenson DP. Linear IgA bullous dermatosis: successful treatment with tetracycline and nicotinamide. J Am Acad Dermatol 1992;26:498-9.
- Chaffins ML, Collison D, Fivenson DP. Treatment of pemphigus and linear IgA dermatosis with nicotinamide and tetracycline: a review of 13 cases. J Am Acad Dermatol 1993;28:998-1000.
- Support Medicine
L-Tryptophan and Vitamin B3
Nortriptyline
Combination of 6 grams per day L-tryptophan and 1,500 mg per day niacinamide (a form of vitamin B3) with imipramine has shown to be more effective than imipramine alone for people with bipolar disorder. These levels did not improve the effects of imipramine in people with depression. Lower amounts (4 grams per day of L-tryptophan and 1,000 mg per day of niacinamide) did show some tendency to enhance the effect of imipramine.
The importance of the amount of L-tryptophan was confirmed in other studies, suggesting that if too much L-tryptophan (6 grams per day) is used, it is not beneficial, while levels around 4 grams per day may make tricyclic antidepressants work better.
NortriptylineL-Tryptophan and Vitamin B3- Chouinard G, Young SN, Annable L, Sourkes TL. Tryptophan-nicotinamide, imipramine and their combination in depression. Acta Psychiatr Scand 1979;59:395-414.
- Walinder J, Skott A, Carlsson A, et al. Potentiation of the antidepressant action of clomipramine by tryptophan. Arch Gen Psychiatry 1976;33:1384-9.
- Shaw DM, MacSweeney DA, Hewland R, Johnson AL. Tricyclic antidepressants and tryptophan in unipolar depression. Psychol Med 1975;5:276-8.
- Support Medicine
L-Tryptophan and Vitamin B3
Protriptyline
Combination of 6 grams per day L-tryptophan and 1,500 mg per day niacinamide (a form of vitamin B3) with imipramine has shown to be more effective than imipramine alone for people with bipolar disorder. These levels did not improve the effects of imipramine in people with depression. Lower amounts (4 grams per day of L-tryptophan and 1,000 mg per day of niacinamide) did show some tendency to enhance the effect of imipramine.
The importance of the amount of L-tryptophan was confirmed in other studies, suggesting that if too much L-tryptophan (6 grams per day) is used, it is not beneficial, while levels around 4 grams per day may make tricyclic antidepressants work better.
ProtriptylineL-Tryptophan and Vitamin B3- Chouinard G, Young SN, Annable L, Sourkes TL. Tryptophan-nicotinamide, imipramine and their combination in depression. Acta Psychiatr Scand 1979;59:395-414.
- Walinder J, Skott A, Carlsson A, et al. Potentiation of the antidepressant action of clomipramine by tryptophan. Arch Gen Psychiatry 1976;33:1384-9.
- Shaw DM, MacSweeney DA, Hewland R, Johnson AL. Tricyclic antidepressants and tryptophan in unipolar depression. Psychol Med 1975;5:276-8.
- Support Medicine
Vitamin B3 (Niacin)
Thioridazine
In a controlled study, individuals taking thioridazine for psychosis cooperated better and withdrew less from other people when niacin (nicotinic acid), 300–1,500 mg each day, was added. Whether people who are taking thioridazine for other mental health problems might benefit from niacin supplementation is unknown.
ThioridazineVitamin B3 (Niacin)- Lehmann HE, Ban TA, Saxena BM. Nicotinic acid, thioridazine, fluoxymesterone and their combinations in hospitalized geriatric patients. Can Psychiatr Assoc J 1972;17:315-20.
- Support Medicine
L-Tryptophan and Vitamin B3
Trimipramine
Combination of 6 grams per day L-tryptophan and 1,500 mg per day niacinamide (a form of vitamin B3) with imipramine has shown to be more effective than imipramine alone for people with bipolar disorder. These levels did not improve the effects of imipramine in people with depression. Lower amounts (4 grams per day of L-tryptophan and 1,000 mg per day of niacinamide) did show some tendency to enhance the effect of imipramine.
The importance of the amount of L-tryptophan was confirmed in other studies, suggesting that if too much L-tryptophan (6 grams per day) is used, it is not beneficial, while levels around 4 grams per day may make tricyclic antidepressants work better.
TrimipramineL-Tryptophan and Vitamin B3- Chouinard G, Young SN, Annable L, Sourkes TL. Tryptophan-nicotinamide, imipramine and their combination in depression. Acta Psychiatr Scand 1979;59:395-414.
- Walinder J, Skott A, Carlsson A, et al. Potentiation of the antidepressant action of clomipramine by tryptophan. Arch Gen Psychiatry 1976;33:1384-9.
- Shaw DM, MacSweeney DA, Hewland R, Johnson AL. Tricyclic antidepressants and tryptophan in unipolar depression. Psychol Med 1975;5:276-8.
Explanation Required
7- Needs Explanation
Vitamin B3 (Niacin)
Atorvastatin
Niacin is the form of vitamin B3 used to lower cholesterol. Ingestion of large amounts of niacin along with lovastatin (a drug closely related to atorvastatin) or with atorvastatin itself may cause muscle disorders (myopathy) that can become serious (rhabdomyolysis). Such problems appear to be uncommon when HMG-CoA reductase inhibitors are combined with niacin. Moreover, concurrent use of niacin with HMG-CoA reductase inhibitors has been reported to enhance the cholesterol-lowering effect of the drugs. Individuals taking atorvastatin should consult their physician before taking niacin.
AtorvastatinVitamin B3 (Niacin)- Garnett WR. Interactions with hydroxymethylglutaryl-coenzyme A reductase inhibitors. Am J Health Syst Pharm 1995;52:1639-45.
- Yee HS, Fong NT. Atorvastatin in the treatment of primary hypercholesterolemia and mixed dyslipidemias. Ann Pharmacother 1998;32:1030-43.
- Jacobson TA, Amorosa LF. Combination therapy with fluvastatin and niacin in hypercholesterolemia: a preliminary report on safety. Am J Cardiol 1994;73:25D-9D.
- Jokubaitis LA. Fluvastatin in combination with other lipid-lowering agents. Br J Clin Pract Suppl 1996;77A:28-32.
- Davignon J, Roederer G, Montigny M, et al. Comparative efficacy and safety of pravastatin, Nicotinic acid and the two combined in patients with hypercholesterolemia. Am J Cardiol 1994;73:339-45.
- Jacobson TA, Jokubaitis LA, Amorosa LF. Fluvastatin and niacin in hypercholesterolemia: a preliminary report on gender differences in efficacy. Am J Med 1994;96(suppl 6A):64S-8S.
- Needs Explanation
Vitamin B3 (Niacin)
Cerivastatin
Some sources have reported that taking niacin (vitamin B3) together with HMG-CoA reductase inhibitors may result in serious muscle damage. However, niacin has also been used in combination with statin drugs without ill effects, and has been found to enhance the cholesterol-lowering effect of these drugs. Persons taking cerivastatin or any other HMG-CoA reductase inhibitor should consult with their doctor before taking niacin.
CerivastatinVitamin B3 (Niacin)- Sifton DW, et. Physicians' Desk Reference. Montvale, NJ: Medical Economics Company, Inc., 2000, 675-7.
- Davignon J, Roederer G, Montigny M, et al. Comparative efficacy and safety of pravastatin, Nicotinic acid and the two combined in patients with hypercholesterolemia. Am J Cardiol 1994;73:339-45.
- Jacobson TA, Jokubaitis LA, Amorosa LF. Fluvastatin and niacin in hypercholesterolemia: a preliminary report on gender differences in efficacy. Am J Med 1994;96(suppl 6A):64S-8S.
- Needs Explanation
Vitamin B3 (Niacin)
Fluvastatin
Niacin is the form of vitamin B3 used to lower cholesterol. Fluvastatin and niacin used together have been shown to be more effective than either substance alone. Ingestion of large amounts of niacin along with HMG-CoA reductase inhibitors such as fluvastatin may cause muscle disorders (myopathy) that can become serious (rhabdomyolysis). Such problems appear to be uncommon. Nonetheless, individuals taking fluvastatin should consult with their doctor before taking niacin.
FluvastatinVitamin B3 (Niacin)- Jacobson TA, Chin MM, Fromell GJ, et al. Fluvastatin with and without niacin for hypercholesterolemia. Am J Cardiol 1994;74:149-54.
- Garnett WR. Interactions with hydroxymethylglutaryl-coenzyme A reductase inhibitors. Am J Health Syst Pharm 1995;52:1639-45.
- Yee HS, Fong NT. Atorvastatin in the treatment of primary hypercholesterolemia and mixed dyslipidemias. Ann Pharmacother 1998;32:1030-43.
- Jacobson TA, Amorosa LF. Combination therapy with fluvastatin and niacin in hypercholesterolemia: a preliminary report on safety. Am J Cardiol 1994;73:25D-9D.
- Jokubaitis LA. Fluvastatin in combination with other lipid-lowering agents. Br J Clin Pract Suppl 1996;77A:28-32.
- Needs Explanation
Vitamin B3 (Niacin)
Lovastatin
Niacin is a vitamin used to lower cholesterol. Large amounts of niacin taken with lovastatin have been reported to cause potentially serious muscle disorders (myopathy or rhabdomyolysis). However, niacin also enhances the cholesterol-lowering effect of lovastatin. Taking as little as 500 mg three times per day of niacin with lovastatin has been shown to have these complementary, supportive actions with almost none of the side effects seen when higher amounts of niacin are taken. Nevertheless, individuals taking lovastatin should consult with their doctor before taking niacin.
LovastatinVitamin B3 (Niacin)- Garnett WR. Interactions with hydroxymethylglutaryl-coenzyme A reductase inhibitors. Am J Health Syst Pharm 1995;52:1639-45.
- Malloy MJ, Kane JP, Kunitake ST, Tun P. Complementarity of colestipol, niacin, and lovastatin in treatment of severe familial hypercholesterolemia. Ann Intern Med 1987;107:616-23.
- Gardner SF, Schneider EF, Granberry MG, Carter IR. Combination therapy with low-dose lovastatin and niacin is as effective as higher-dose lovastatin. Pharmacotherapy 1996;16:419-23.
- Needs Explanation
Vitamin B3 (Niacin)
Pravastatin
Niacin is a vitamin used to lower cholesterol. Sixteen people with diabetes and high cholesterol were given pravastatin plus niacin to lower cholesterol. Niacin was added over a two week period, to a maximum amount of 500 mg three times per day. The combination of pravastatin plus niacin was continued for four weeks. Compared with pravastatin, niacin plus pravastatin resulted in significantly reduced cholesterol levels. Others have also shown that the combination of pravastatin and niacin is more effective in lowering cholesterol levels than is pravastatin alone. However, large amounts of niacin taken with pravastatin might cause serious muscle disorders (myopathy or rhabdomyolysis). Individuals taking pravastatin should consult a doctor before taking niacin.
PravastatinVitamin B3 (Niacin)- Gardner SF, Marx MA, White LM, et al. Combination of low-dose niacin and pravastatin improves the lipid profile in diabetic patients without compromising glycemic control. Ann Pharmacother 1997;31:677-82.
- O'Keefe JH Jr, Harris WS, Nelson J, Windsor SL. Effects of pravastatin with niacin or magnesium on lipid levels and postprandial lipemia. Am J Cardiol 1995;76:480-4.
- Garnett WR. Interactions with hydroxymethylglutaryl-coenzyme A reductase inhibitors. Am J Health Syst Pharm 1995;52:1639-45.
- Needs Explanation
Vitamin B3 (Niacin)
Rosuvastatin
A recent blinded study showed that individuals taking both rosuvastatin and niacin had a greater increase in HDL (“good”) cholesterol and apolipoprotein A-I than did those taking rosuvastatin alone. People taking rosuvastatin might benefit from taking niacin, though they should consult with their healthcare provider before starting the supplement. When taken with niacin, some statin drugs may become more toxic so there is a possibility of an adverse interaction.
RosuvastatinVitamin B3 (Niacin)- Capuzzi DM, Morgan JM, Weiss RJ, et al. Beneficial effects of rosuvastatin alone and in combination with extended-release niacin in patients with a combined hyperlipidemia and low high-density lipoprotein cholesterol levels. Am J Cardiol 2003;91:1304-10.
- Needs Explanation
Vitamin B3 (Niacin)
Simvastatin
Niacin is the form of vitamin B3 used to lower cholesterol. Taking large amounts of niacin along with HMG-CoA reductase inhibitors may cause muscle disorders (myopathy) that can become serious (rhabdomyolysis). Such problems appear to be uncommon. Moreover, concurrent use of niacin has been reported to enhance the cholesterol-lowering effect of HMG-CoA reductase inhibitors. Individuals taking simvastatin should consult a doctor before taking niacin.
SimvastatinVitamin B3 (Niacin)- Garnett WR. Interactions with hydroxymethylglutaryl-coenzyme A reductase inhibitors. Am J Health Syst Pharm 1995;52:1639-45.
- Yee HS, Fong NT. Atorvastatin in the treatment of primary hypercholesterolemia and mixed dyslipidemias. Ann Pharmacother 1998;32:1030-43.
- Jacobson TA, Amorosa LF. Combination therapy with fluvastatin and niacin in hypercholesterolemia: a preliminary report on safety. Am J Cardiol 1994;73:25D-9D.
- Jokubaitis LA. Fluvastatin in combination with other lipid-lowering agents. Br J Clin Pract Suppl 1996;77A:28-32.
- Davignon J, Roederer G, Montigny M, et al. Comparative efficacy and safety of pravastatin, Nicotinic acid and the two combined in patients with hypercholesterolemia. Am J Cardiol 1994;73:339-45.
- Jacobson TA, Jokubaitis LA, Amorosa LF. Fluvastatin and niacin in hypercholesterolemia: a preliminary report on gender differences in efficacy. Am J Med 1994;96(suppl 6A):64S-8S.