New Onset Flushing due to Unauthorized Substitution of Niacin for Nicotinamide
December 2007 | Volume 6 | Issue 12 | Case Reports | 1220 | Copyright © December 2007
Monique Kademian MD, Mark Bechte MD, Matt Zirwas MD
Abstract
Nicotinamide is the amide form of niacin and has anti-inflammatory properties that have led to its use in the treatment
of several inflammatory dermatologic conditions, such as rosacea. Niacin has established its role in the prevention of coronary
artery disease. Cutaneous flushing is a well-known and often dose-limiting side effect of niacin therapy, which does
not occur with nicotinamide. We report a patient with rosacea who developed new onset flushing due to unauthorized
substitution of niacin for nicotinamide. The anti-inflammatory mechanisms of nicotinamide and flushing mechanisms of
niacin are discussed.