[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Pharmacology](https://durgical.com/en/pharmacology/) › [Vitamins](https://durgical.com/en/pharmacology/classes/vitamins/) › Nicotinamide

# Nicotinamide

## Vitamins?

Vitamins

A form of vitamin B3 used to treat pellagra. Unlike nicotinic acid, it does not cause flushing and does not lower cholesterol.

Updated Nov 1, 2026

Also called: niacinamide, vitamin B3

## Quick facts

**Group**
[Vitamins](https://durgical.com/en/pharmacology/classes/vitamins/)

**Target**
Precursor of NAD and NADP, the coenzymes of oxidation–reduction reactions

**Used for**
Pellagra

**Key effects**
Usually well tolerated · Stomach upset

**Monitor**
Skin lesions

**ATC**
A11HA01

No doses: the clinician sets them by the current guideline.

On this page

- The basics Mechanism of action
- Indications
- Adverse effects
- Pharmacokinetics
- Memory aid

- Safety Contraindications
- Key interactions
- What is monitored
- Pregnancy and breastfeeding
- Nursing care

- Study Test yourself

- Connections Connections

## Mechanism of action

Nicotinamide is the amide form of niacin (vitamin B3). Cells use it to build NAD and NADP, which carry electrons in energy production and in many other reactions. Deficiency of niacin or of its precursor tryptophan causes pellagra: sore skin on sun-exposed areas, diarrhoea and confusion. Nicotinamide does not act on the niacin receptor of fat cells, so it has neither the flushing nor the lipid effects of nicotinic acid.

- Nicotinamide is built into NAD and NADP
- NAD/NADP carry electrons in energy metabolism
- Skin, gut and brain recover in pellagra

## Indications

- Pellagra (niacin deficiency) [Pellagra (niacin deficiency) →](https://durgical.com/en/conditions/pellagra/)

## Adverse effects

### Common

- Usually well tolerated; no flushing
- Stomach upset

### Serious (rare, important)

- Very high intakes of niacin forms can raise blood glucose, damage the liver and cause peptic ulcers

## Contraindications

- Hypersensitivity to the product
- Caution at high intakes with liver disease, diabetes or peptic ulcer

## Key interactions

**Isoniazid**
Can cause pellagra by interfering with niacin; nicotinamide replaces it

**Alcohol**
Heavy drinking is a major cause of pellagra

## What is monitored

- Skin lesions, diarrhoea and mental state in pellagra

## Pregnancy and breastfeeding

Niacin is needed in pregnancy; replacement amounts are used when there is deficiency.

## Nursing care

- Look for pellagra in people with alcohol dependence, malabsorption, carcinoid syndrome or isoniazid treatment.
- Protect skin lesions from the sun and watch them for infection.
- Explain that nicotinamide and nicotinic acid are not interchangeable for cholesterol.

## Pharmacokinetics

**Absorption**
Absorbed by mouth; water-soluble and not stored in large amounts

## Memory aid

«AMIDE = no flush»: nicotinAMIDE treats pellagra without the hot face of nicotinic acid.

## Test yourself

Think of the answer, then tap the question to see it.

## What are the main features of pellagra?

Dermatitis on sun-exposed skin, diarrhoea and confusion (dementia); untreated, death.

## How does nicotinamide differ from nicotinic acid?

Nicotinamide treats deficiency but causes no flushing and has no lipid-lowering effect.

## Which antitubercular drug can cause pellagra?

Isoniazid.

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## Connections

## Related drugs 3

- [Nicotinic acid (niacin)](https://durgical.com/en/pharmacology/nicotinic-acid/)
- [Isoniazid](https://durgical.com/en/pharmacology/isoniazid/)
- [Thiamine](https://durgical.com/en/pharmacology/thiamine/)

## Related conditions 1

- [Pellagra (niacin deficiency)](https://durgical.com/en/conditions/pellagra/)

[← Back to the class: Vitamins](https://durgical.com/en/pharmacology/classes/vitamins/)

Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.

Sources: [Pellagra: MedlinePlus Medical Encyclopedia](https://medlineplus.gov/ency/article/000342.htm) (MedlinePlus (U.S. National Library of Medicine), 2026); [Niacin: MedlinePlus Medical Encyclopedia](https://medlineplus.gov/ency/article/002409.htm) (MedlinePlus (U.S. National Library of Medicine), 2026); [ATCDDD - ATC/DDD Index](https://atcddd.fhi.no/atc_ddd_index/?code=A11HA01) (WHO Collaborating Centre for Drug Statistics Methodology, 2026).

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Representative model, for educational purposes only.

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Source: https://durgical.com/en/pharmacology/nicotinamide/
License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/pharmacology/nicotinamide/