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Side Effects
Vitamin B3: Niacin, but not niacinamide, causes flushing at the beginning. Your skin turns pink, as though you had a sunburn. You might feel your skin tighten and you may have some prickling feeling or itching. This flush might start almost immediately, or hours after you take die pill, and at the beginning it might last for a few hours. Some people like it; others, especially children, cannot tolerate it. If you drink a glass of cold milk after taking the tablets it reduces the flush. Or take niacin with the solid part of your meal. Regulate your schedule so that there is little flushing in public. Your physician can prescribe 4 mg. Periactin, but take this only when you wish to eliminate flush or other side effects. Even if you got accustomed to niacin and do not flush any more, it starts again if you neglect taking niacin for a few days and then take it again. If you cannot get accustomed to it, change to niacinamide, which does not cause flush. Neither flush nor the other side effects are dangerous, but might be very inconvenient to some people.

Flush is more intensive if niacin is taken on an empty stomach, or with a hot drink, and is lessened if taken after meals or with cold milk. When Periactin is used to alleviate flush, the best time to give it is a few minutes after the flush begins. When flush is very inconvenient, slow release forms of niacin can be prescribed though they are more expensive.

Dryness of skinf or increased brownish color may be caused by niacin and nicotinamide. These are harmless and disappear in time.

About five people out of 100 get headaches. If this occurs, switch to slow release niacin or niacinamide.
A few people develop nausea and rarely even vomiting. Vomiting or nausea may increase during influenza infection. These can be remedied by Periactin or by using buffered niacin, or niacinamide.

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