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Niacinamide

By Rania Gollakner, BS, DVM, MPH

Medications

What is niacinamide?

Niacinamide or vitamin B3 (brand names: Nicotinamide®) is a nutritional supplement and immunomodulator used in conjunction with other medications to treat inflammatory skin conditions in dogs, such as lupoid or pemphigoid conditions. Niacinamide is NOT the same as niacin.

Dietary supplements are substances that can be used to supplement the diet, such as vitamins, minerals, amino acids, herbs, botanicals, enzymes, and probiotics. While many supplements are sold over the counter, they still contain ingredients that have biological effects that should be managed by your veterinarian. Follow your veterinarian’s directions and cautions very carefully as their directions may be significantly different from those on the label.

There are differences in how countries regulate supplements. In the United States, these substances are not as vigorously regulated by the FDA as other medications, which means they can be sold without the manufacturer proving their effectiveness, safety, and without a guarantee of consistent or accurately reported ingredients. In Canada, products that have been evaluated for quality, safety, and effectiveness by Health Canada and authorized for sale will have a license number on the label.

How effective is niacinamide?

Limited studies in animals have been performed, but there is anecdotal evidence that niacinamide as an adjunctive therapy works to treat inflammatory skin conditions by blocking the action of inflammatory cells. Niacinamide may be the most effective for milder disease forms.

How is niacinamide given?

Niacinamide is given by mouth in the form of a tablet or capsule. It may also be compounded into a liquid form. It may be given with or without food; however, if vomiting occurs when given on an empty stomach, give future doses with food. Measure liquid forms carefully.

This medication can take up to 6-8 weeks before full effects are noted, but gradual improvements are usually noticeable as the supplement becomes fully effective.

What if I miss giving my pet the supplement?

If you miss a dose, give it when you remember, but if it is close to the time for the next dose, skip the dose you missed and give it at the next scheduled time, and return to the regular dosing schedule. Never give your pet two doses at once or give extra doses.

Are there any potential side effects?

Side effects are uncommon, but most commonly include lack of appetite, vomiting, diarrhea, and sleepiness. Serious side effects include an increase in liver enzymes or seizures. Because this supplement is used in conjunction with tetracycline, side effects may not be due solely to niacinamide.

This short-acting medication should stop working within 24 hours, although effects can be longer in pets with liver or kidney disease.

Are there any risk factors for this supplement?

Studies in animals are limited for this supplement and therefore information regarding risk factors is also limited. In humans, patients with liver disease or stomach/intestinal ulcers should not use this supplement; therefore, use niacinamide cautiously in pets with these conditions. Niacinamide should be used cautiously in pets with seizures or diabetes. Use of this supplement alone is likely safe in pregnant or nursing animals; however, when used in conjunction with tetracycline, its use may not be safe.

Niacinamide may also interact with skin allergy testing; as a precaution, do not administer this supplement for 1-2 weeks prior to testing.

Are there any drug interactions I should be aware of?

The following medications should be used with caution when given with niacinamide: insulin and oral antidiabetic agents.

Niacinamide may also interact with skin allergy testing; as a precaution, do not administer this supplement for 1-2 weeks prior to testing.

Vitamins, herbal therapies, and supplements have the potential to interact with each other, as well as with prescription and over the counter medications. It is important to tell your veterinarian about any medications (including all vitamins, supplements, or herbal therapies) that your pet is taking.

Is there any monitoring that needs to be done with this supplement?

Your veterinarian may monitor your pet to be sure that the medication is working. A baseline liver enzyme panel, followed by occasional rechecks during therapy is recommended. Monitor your pet at home for seizures.

How do I store niacinamide?

Store this supplement at room temperature unless otherwise noted on the label. Protect from light.

What should I do in case of emergency?

If you suspect an overdose or an adverse reaction to the medication, call your veterinary office immediately. If they are not available, follow their directions in contacting an emergency facility.

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