Nicomide, B3, Niacinamide

[Guest guest]

On the whole confusing issue of nicomide, nicotinamide/niacinamide and

niacin/nocitinic acid (B3), I found the following explanations and info:

Niacin, or nicotinic acid, is one of two compounds that are categorized as

Vitamin B3. The other is niacinamide, or nicotinamide. The two differ only

slightly in chemical structure, but this change accounts for some profound

differences physiologically. Niacin, for instance, is quickly absorbed in

the intestine and enters the blood stream within minutes. Niacinamide is

absorbed much more slowly and is later converted to niacin by the body.

Niacin is also far more potent as a vasodilator. Consequently, it should

come as no surprise that niacin is far more likely to produce a flush than

niacinamide.

Safety of high-dose nicotinamide: a review

Abstract: Nicotinamide, the amide derivative of nicotinic acid, has over the

past forty years been given at high doses for a variety of therapeutic

applications. It is currently in trial as a potential means of preventing

the onset of Type I (insulin-dependent) diabetes mellitus in high-risk,

first-degree relatives. Nicotinamide is for regulatory purposes classed as a

food additive rather than a drug and has not therefore required the formal

safety evaluation normally expected of a new therapy. Because the safety of

treatment with megadoses of vitamins cannot be assumed, a full literature

review has been undertaken. The therapeutic index of nicotinamide is wide

but at very high doses reversible hepatotoxicity has been reported in

animals and humans. Minor abnormalities of liver enzymes can infrequently

occur at the doses used for diabetes prevention. There is no evidence of

teratogenicity from animal studies and nicotinamide is not in itself

oncogenic; at very high doses it does however potentiate islet tumour

formation in rats treated with streptozotocin or alloxan. There is no

evidence of oncogenicity in man. Growth inhibition can occur in rats but

growth in children is unaffected. Studies of its effects on glucose kinetics

and insulin sensitivity are inconsistent but minor degrees of insulin

resistance have been reported. The drug is well tolerated, especially in

recent studies which have used relatively pure preparations of the vitamin.

Experience to date therefore suggests that the ratio of risk to benefit of

long-term nicotinamide treatment would be highly favourable, should the drug

prove efficacious in diabetes prevention. High-dose nicotinamide should

still, however, be considered as a drug with toxic potential at adult doses

in excess of 3 gm/day and unsupervised use should be discouraged.

[Diabetologia (2000) 43: 1337-1345]

Information on Nicomide

Nicomide Tablets:

Chemical Name: NICOTINAMIDE (NIK-oh-tin-a-mide), ZINC OXIDE (zink OX-ide),

and FOLIC ACID (FOE-lik AS-id)

Common uses

This medicine is a vitamin and mineral combination used to certain types of

acne (e.g., acne vulgaris or acne rosacea) or other irritated skin

conditions. People who have low levels of nicotinamide, zinc, or folic acid

may develop, or be at increased risk of developing these types of skin

conditions.

Before using:

Some medicines or medical conditions may interact with this medicine. INFORM

YOUR DOCTOR OR PHARMACIST of all prescription and over-the-counter medicine

that you are taking. DO NOT TAKE THIS MEDICINE if you are also taking

fluorouracil. ADDITIONAL MONITORING OF YOUR DOSE OR CONDITION may be needed

if you are taking medicine for seizures, tetracyclines, or drug to lower

cholesterol (statins). Inform your doctor of any other medical conditions,

allergies, pregnancy, or breast-feeding. ADDITIONAL MONITORING OF YOUR DOSE

OR CONDITION may be needed if you have liver disease or diabetes. Contact

your doctor or pharmacist if you have any questions or concerns about using

this medicine.

Directions:

Follow the directions for using this medicine provided by your doctor or on

the package. THIS MEDICINE MAY BE TAKEN WITH FOOD if it upsets your stomach.

STORE THIS MEDICINE at room temperature between 59 and 86 degrees F (15 and

30 degrees C) in a tightly-closed container, away from heat and light. IF

YOU MISS TAKING A DOSE OF THIS MEDICINE, take it as soon as possible. If it

is almost time for your next dose, skip the missed dose and go back to your

regular dosing schedule. Do NOT take 2 doses at once.

Cautions:

DO NOT EXCEED THE RECOMMENDED DOSE of this medicine. BEFORE YOU BEGIN TAKING

ANY NEW MEDICINE, either prescription or over-the-counter, check with your

doctor or pharmacist. CHECK ANY OTHER VITAMIN PRODUCTS you may be taking for

folic acid content. Tell your doctor or pharmacist if any other medicines

that you take contain folic acid. FOR WOMEN: DO NOT USE THIS MEDICINE if you

are pregnant. IF YOU SUSPECT THAT YOU COULD BE PREGNANT contact your doctor

immediately. THIS MEDICINE IS EXCRETED IN BREAST MILK. IF YOU ARE OR WILL BE

BREAST-FEEDING while you are using this medicine, check with your doctor or

pharmacist to discuss the risks to your baby.

Possible side effects:

SIDE EFFECTS that may occur while taking this medicine include nausea or

vomiting. If they continue or are bothersome, check with your doctor.

CONTACT YOUR DOCTOR AS SOON AS POSSIBLE if you experience rash or itching.

If you notice other effects not listed above, contact your doctor, nurse, or

pharmacist.

Drug interactions:

Drug interactions can result in unwanted side effects or prevent a medicine

from doing its job. Use our drug interaction checker to find out if your

medicines interact with each other. Check drug interactions

If you take too much:

If overdose is suspected, contact your local poison control center or

emergency room immediately.

Additional information:

DO NOT SHARE THIS MEDICINE with others for whom it was not prescribed. DO

NOT USE THIS MEDICINE for other health conditions. KEEP THIS MEDICINE out of

the reach of children. IF USING THIS MEDICINE FOR AN EXTENDED PERIOD OF

TIME, obtain refills before your supply runs out.