Niacin Dosage

Usual Adult Dose for Hyperlipoproteinemia Type IV (Elevated VLDL)

Initial dose: 100 mg orally 3 times a day, with or after meals.
Maintenance dose: 1 to 2 g orally 3 times a day, with or after meals.
The maximum recommended dose is 6 g/day.

Extended Release (Niaspan):
Initial dose: 500 mg orally once a day at bedtime after a low fat snack. Maximum recommended dose is 2 g/day.

Extended Release (Slo-Niacin):
Initial dose: 250 to 750 mg orally once a day morning or evening.

Usual Adult Dose for Hyperlipoproteinemia Type V (Elevated Chylomicrons + VLDL)

Initial dose: 100 mg orally 3 times a day, with or after meals.
Maintenance dose: 1 to 2 g orally 3 times a day, with or after meals.
The maximum recommended dose is 6 g/day.

Extended Release (Niaspan):
Initial dose: 500 mg orally once a day at bedtime after a low fat snack. Maximum recommended dose is 2 g/day.

Extended Release (Slo-Niacin):
Initial dose: 250 to 750 mg orally once a day morning or evening.

Usual Adult Dose for Pellagra

50 to 100 mg orally 3 to 4 times a day.
The maximum recommended dose is 500 mg orally each day.

Usual Adult Dose for Niacin Deficiency

10 to 20 mg orally once a day. Niacin may also be administered parenterally as a component of injectable multivitamin additives contained in parenteral nutrition products.

The maximum recommended dose is 100 mg orally each day.

Usual Pediatric Dose for Pellagra

50 to 100 mg orally 3 times daily.
Note: Some experts prefer niacinamide for treatment due to a more favorable side effect profile.

Usual Pediatric Dose for Niacin Deficiency

Dosages are Recommended Daily Allowances (RDA):
1 to 5 months: 2 mg orally each day.
6 to 11 months: 3 mg orally each day.
1 to 3 years: 6 mg orally each day.
4 to 8 years: 8 mg orally each day.
9 to 13 years: 12 mg orally each day.

Males:
14 to 18 years: 16 mg orally each day.

Females:
14 to 18 years: 14 mg orally each day.

Niacin may also be administered parenterally as a component of injectable multivitamin additives contained in parenteral nutrition products.

Renal Dose Adjustments

Data not available

Liver Dose Adjustments

Because niacin is primarily metabolized by the liver and because of the risk of hepatotoxicity, niacin is not recommended in patients with liver dysfunction. Extended-release preparations of niacin are considered contraindicated in patients with liver disease.

Dose Adjustments

Titrate the dose in increments of 100 mg/dose (125 mg for time-release) every week. Daily dose increments > 500 mg are not recommended.

Precautions

If the patient develops liver dysfunction, discontinuing niacin is usually necessary.

Dialysis

Data not available

Other Comments

Different formulations of niacin (e.g., regular release versus extended release) are not interchangeable.

See also...