- dermatological complaints
- facial flushing and itching
- dry skin
- skin rashes including acanthosis nigricans
- gastrointestinal complaints
- dyspepsia (indigestion)
- liver toxicity
- fulminant hepatic failure
- hyperglycemia
- cardiac arrhythmias
- birth defects
Doses above 2 g per day have been associated with liver damage, particularly with slow-release formulations. High-dose niacin may also elevate blood sugar, thereby worsening diabetes mellitus.
Niacin for cholesterol
Niacin at doses used in lowering cholesterol has been associated with birth defects in laboratory animals and should not be taken by pregnant women.Niacin at extremely high doses can have life-threatening acute toxic reactions. One patient suffered vomiting after taking eleven 500-milligram niacin tablets over 36 hours, and another was unresponsive for several minutes after taking five 500-milligram tablets over two days.
Extremely high doses of niacin can also cause niacin maculopathy, a thickening of the macula and retina which leads to blurred vision and blindness.



