Skip to Content

Niacin Dosage

Applies to the following strength(s): 500 mg ; 50 mg ; 100 mg ; 750 mg ; 1000 mg ; 125 mg ; 250 mg ; 50 mg/5 mL ; 400 mg

The information at Drugs.com is not a substitute for medical advice. Always consult your doctor or pharmacist.

Usual Adult Dose for Hyperlipoproteinemia Type IV (Elevated VLDL)

Immediate-release:
-Initial dose: 250 mg orally once a day following the evening meal; increase frequency and/or dose every 4 to 7 days to the desired effect or first-level therapeutic dose (1.5 to 2 g/day in 2 to 3 divided doses); if the response is inadequate after 2 months, the dose can be increased at 2 to 4 week intervals to 1
-Maintenance dose: 1 to 2 g orally 2 to 3 times a day
-Maximum dose: 6 g/day (in 2 to 3 divided doses)

Sustained-release:
-Weeks 1 to 4: 500 mg orally at bedtime
-Weeks 5 to 8: 1000 mg orally at bedtime
-After week 8: Titrate to patient response and tolerance; if response to 1000 mg a day is inadequate, increase to 1500 mg a day; may subsequently increase to 2000 mg a day: daily dose should not be increased more than 500 mg in a 4-week period
-Maintenance dose: 1000 to 2000 mg orally at bedtime
-Maximum dose: 2000 mg/day

Comments:
-Individualize doses according to patient response.
-Women may respond at lower doses than men.
-Tolerance to flushing develops rapidly over the course of several weeks; flushing, pruritus, and GI distress can be reduced by slowly increasing the dose and avoiding administration on an empty stomach.
-Concomitant alcoholic drinks, hot drinks, or spicy foods may increase the side effects of flushing and pruritus and should be avoided near the time this drug is taken.
-If therapy with the extended-release formulation is discontinued for an extended period, reinstitution of therapy should include a titration phase.
-The extended-release formulation should be taken whole and should not be broken, crushed, or chewed before swallowing.
-Flushing can be minimized by pretreatment with aspirin or nonsteroidal anti-inflammatory drugs.
-Flushing, pruritus, and GI distress can be reduced by slowly increasing the dose and avoiding administration on an empty stomach.

Uses:
-To reduce elevated TC, LDL-C, Apo B and TG, and to increase HDL-C in patients with primary hyperlipidemia and mixed dyslipidemia; to reduce the risk of recurrent nonfatal myocardial infarction in patients with a history of myocardial infarction and hyperlipidemia
-In combination with a bile acid binding resin: Slows progression or promotes regression of atherosclerotic disease in patients with a history of coronary artery disease (CAD) and hyperlipidemia
-As an adjunct to diet to reduce elevated TC and LDL-C in adult patients with primary hyperlipidemia
-To reduce TG in adult patients with severe hypertriglyceridemia

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

Immediate-release:
-Initial dose: 250 mg orally once a day following the evening meal; increase frequency and/or dose every 4 to 7 days to the desired effect or first-level therapeutic dose (1.5 to 2 g/day in 2 to 3 divided doses); if the response is inadequate after 2 months, the dose can be increased at 2 to 4 week intervals to 1
-Maintenance dose: 1 to 2 g orally 2 to 3 times a day
-Maximum dose: 6 g/day (in 2 to 3 divided doses)

Sustained-release:
-Weeks 1 to 4: 500 mg orally at bedtime
-Weeks 5 to 8: 1000 mg orally at bedtime
-After week 8: Titrate to patient response and tolerance; if response to 1000 mg a day is inadequate, increase to 1500 mg a day; may subsequently increase to 2000 mg a day: daily dose should not be increased more than 500 mg in a 4-week period
-Maintenance dose: 1000 to 2000 mg orally at bedtime
-Maximum dose: 2000 mg/day

Comments:
-Individualize doses according to patient response.
-Women may respond at lower doses than men.
-Tolerance to flushing develops rapidly over the course of several weeks; flushing, pruritus, and GI distress can be reduced by slowly increasing the dose and avoiding administration on an empty stomach.
-Concomitant alcoholic drinks, hot drinks, or spicy foods may increase the side effects of flushing and pruritus and should be avoided near the time this drug is taken.
-If therapy with the extended-release formulation is discontinued for an extended period, reinstitution of therapy should include a titration phase.
-The extended-release formulation should be taken whole and should not be broken, crushed, or chewed before swallowing.
-Flushing can be minimized by pretreatment with aspirin or nonsteroidal anti-inflammatory drugs.
-Flushing, pruritus, and GI distress can be reduced by slowly increasing the dose and avoiding administration on an empty stomach.

Uses:
-To reduce elevated TC, LDL-C, Apo B and TG, and to increase HDL-C in patients with primary hyperlipidemia and mixed dyslipidemia; to reduce the risk of recurrent nonfatal myocardial infarction in patients with a history of myocardial infarction and hyperlipidemia
-In combination with a bile acid binding resin: Slows progression or promotes regression of atherosclerotic disease in patients with a history of coronary artery disease (CAD) and hyperlipidemia
-As an adjunct to diet to reduce elevated TC and LDL-C in adult patients with primary hyperlipidemia
-To reduce TG in adult patients with severe hypertriglyceridemia

Usual Adult Dose for Vitamin/Mineral Supplementation

Recommended Dietary Allowance (RDA):
-Males: 16 mg/day
-Females: 14 mg/day
-Pregnancy: 18 mg/day
-Lactation: 17 mg/day

Comments:
-Niacin may be given orally and also parenterally as a component of injectable multivitamin additives contained in parenteral nutrition products.
-The best way to get the daily requirement of essential vitamins is to eat a balanced diet that contains a variety of foods.

Uses:
-Recommended Dietary Allowance (RDA): Average daily level of intake that is enough to meet the nutrient requirements of nearly all (97 to 98%) healthy people.

Usual Adult Dose for Vitamin/Mineral Supplementation during Pregnancy/Lactation

Recommended Dietary Allowance (RDA):
-Males: 16 mg/day
-Females: 14 mg/day
-Pregnancy: 18 mg/day
-Lactation: 17 mg/day

Comments:
-Niacin may be given orally and also parenterally as a component of injectable multivitamin additives contained in parenteral nutrition products.
-The best way to get the daily requirement of essential vitamins is to eat a balanced diet that contains a variety of foods.

Uses:
-Recommended Dietary Allowance (RDA): Average daily level of intake that is enough to meet the nutrient requirements of nearly all (97 to 98%) healthy people.

Usual Pediatric Dose for Vitamin/Mineral Supplementation

Adequate Intake (AI):
-Infants 0 to 6 months: 2 mg/day
-Infants 7 to 12 months: 4 mg/day

Recommended Dietary Allowance (RDA):
-Children 1 to 3 years: 6 mg/day
-Children 4 to 8 years: 8 mg/day
-Children 9 to 13 years: 12 mg/day
-Males: 14 to 18 years: 16 mg/day
-Females: 14 to 18 years: 14 mg/day
-Pregnancy: 18 mg/day
-Lactation: 17 mg/day

Comments:
-Niacin may be given orally and also parenterally as a component of injectable multivitamin additives contained in parenteral nutrition products.
-The best way to get the daily requirement of essential vitamins is to eat a balanced diet that contains a variety of foods.

Uses:
-Adequate Intake (AI): When there is not enough evidence to develop an RDA, the AI is set at a level that is thought to ensure enough nutrition.
-Recommended Dietary Allowance (RDA): Average daily level of intake that is enough to meet the nutrient requirements of nearly all (97 to 98%) healthy people.

Usual Pediatric Dose for Vitamin/Mineral Supplementation during Pregnancy/Lactation

Adequate Intake (AI):
-Infants 0 to 6 months: 2 mg/day
-Infants 7 to 12 months: 4 mg/day

Recommended Dietary Allowance (RDA):
-Children 1 to 3 years: 6 mg/day
-Children 4 to 8 years: 8 mg/day
-Children 9 to 13 years: 12 mg/day
-Males: 14 to 18 years: 16 mg/day
-Females: 14 to 18 years: 14 mg/day
-Pregnancy: 18 mg/day
-Lactation: 17 mg/day

Comments:
-Niacin may be given orally and also parenterally as a component of injectable multivitamin additives contained in parenteral nutrition products.
-The best way to get the daily requirement of essential vitamins is to eat a balanced diet that contains a variety of foods.

Uses:
-Adequate Intake (AI): When there is not enough evidence to develop an RDA, the AI is set at a level that is thought to ensure enough nutrition.
-Recommended Dietary Allowance (RDA): Average daily level of intake that is enough to meet the nutrient requirements of nearly all (97 to 98%) healthy people.

Renal Dose Adjustments

Data not available

Liver Dose Adjustments

-Mild to moderate liver dysfunction with alcohol use: No specific dose adjustment guidelines have been suggested; however, caution is recommended.
-Severe or unexplained hepatic dysfunction: Contraindicated

Precautions

Safety and efficacy of the extended-release formulation have not been established in patients younger than 16 years.

Consult WARNINGS section for additional precautions.

Dialysis

Data not available

Other Comments

Administration advice:
-Switching from immediate release to extended release products: Patients previously receiving other niacin products should be started with the recommended niacin extended-release tablets titration schedule, and the dose should subsequently be individualized based on patient response.
-This drug should be administered at bedtime following a snack.
-Concomitant alcohol or hot drinks may increase flushing and pruritus and should be avoided at the time of dosing.

General:
-Equivalent doses of niacin extended-release tablets should not be substituted for sustained-release (modified-release, timed-release) niacin preparations or immediate-release (crystalline) niacin.
-Extended-release formulations should not be broken, crushed, or chewed before swallowing.

Hide