Nicotinamide

botanical

Best with a mealTake with food

What is it

Nicotinamide, also called niacinamide, is the amide form of vitamin B3 (niacin). It is one of the two main forms of vitamin B3, alongside nicotinic acid, and serves as a precursor to the coenzymes NAD+ and NADP+ that are essential for energy metabolism and cellular function.

How it works

Nicotinamide is converted in the body to NAD+ and NADP+, coenzymes involved in hundreds of redox reactions including those of cellular energy production, fatty acid synthesis, and antioxidant defense. Unlike its sibling nicotinic acid (niacin), nicotinamide does not cause the characteristic flushing reaction because it does not bind the same prostaglandin-mediated receptor. In dermatology, topical nicotinamide is widely used to support skin barrier function, reduce hyperpigmentation, and modulate sebum production. Oral nicotinamide has been studied for skin cancer prevention, particularly in people with prior nonmelanoma skin cancers, where it may modestly reduce recurrence. Nicotinamide also inhibits poly(ADP-ribose) polymerases (PARPs) at high doses, which has been investigated in inflammatory and autoimmune conditions. It supports normal skin, nervous system, and digestive function and prevents the deficiency syndrome pellagra.

Evidence for 6 uses

AI-assisted evidence assessment — talk to your doctor before relying on any single supplement.

Pellagra prevention/treatment

Grade A

Strong evidence

Nicotinamide reliably prevents and treats pellagra (the deficiency syndrome characterized by dermatitis, diarrhea, and dementia). This is a well-established medical use.

Nonmelanoma skin cancer prevention

Grade B

Good evidence

The ONTRAC trial showed 500 mg of nicotinamide twice daily for 12 months reduced new nonmelanoma skin cancers by about 23% in high-risk patients. Effects faded after stopping supplementation.

Skin barrier and pigmentation (topical)

Grade B

Good evidence

Topical nicotinamide (typically 2 to 5% in skincare) reduces hyperpigmentation, supports the skin barrier, and may modestly reduce sebum production. Multiple controlled trials support these uses.

Acne (topical)

Grade B

Good evidence

Topical nicotinamide at 4% has shown effects comparable to topical clindamycin in some inflammatory acne trials. It is widely used in dermatology formulations.

NAD+ support

Grade B

Good evidence

Nicotinamide is an established NAD+ precursor and reliably raises NAD+ levels at sufficient doses. It is older and less marketed than NMN or NR but biologically functional in the same pathway.

Type 1 diabetes prevention

Grade D

Mixed evidence

Early trials suggested possible benefit in delaying type 1 diabetes onset in high-risk relatives. Larger trials (ENDIT) did not confirm meaningful benefit. Not currently recommended for this use.

4 commercial forms

Nicotinamide (niacinamide)

Well-absorbed oral form; does not cause flushing.

Standard form for both supplementation and skincare. Preferred when flushing is undesirable.

Topical nicotinamide

Applied directly to skin; absorbed into the dermis.

Used for skin barrier, pigmentation, acne, and sensitive skin. Typical concentrations 2 to 10%.

Nicotinic acid (niacin)

Different form of B3 that causes characteristic flushing reaction.

Used at high doses for cholesterol management. Not interchangeable with nicotinamide for all uses.

Nicotinamide riboside (NR)

Distinct molecule that raises NAD+ via a separate pathway.

Marketed as a 'newer' NAD+ precursor; more expensive than nicotinamide with overlapping effects.

Dosage

The RDA for niacin (expressed as niacin equivalents) is 16 mg per day for men and 14 mg per day for women. Nicotinamide can be used to meet this requirement. The Tolerable Upper Intake Level from supplements is 35 mg per day for adults in the US (based on flushing/hepatotoxicity concerns from niacin, though nicotinamide does not flush). Therapeutic doses for skin cancer prevention have used 500 mg twice daily. For general support, doses of 50 to 500 mg daily are common.

When and how to take it

WHEN: Nicotinamide can be taken at any time of day. Most users take it with a meal. HOW: Take with food to support absorption and minimize GI upset. Splitting larger doses (e.g., 500 mg twice daily) is reasonable for therapeutic use. Unlike nicotinic acid, no special precautions for flushing are needed. Topical nicotinamide is applied to clean skin, typically once or twice daily.

Food sources

Food	Amount	%DV
Chicken breast	3 oz	88%
Tuna	3 oz	70%
Turkey	3 oz	64%
Salmon	3 oz	55%
Beef liver	3 oz	91%
Brown rice	1 cup cooked	33%
Peanuts	1 oz	25%
Fortified breakfast cereals	1 serving	25%

Safety

Nicotinamide does not cause flushing like nicotinic acid. Common side effects at higher doses can include nausea, headache, and gastrointestinal upset. At very high doses (3,000 mg or more daily), liver toxicity has been reported. Long-term high-dose use may affect glucose tolerance and homocysteine metabolism. There is some emerging concern that very high NAD+ precursor intake might accelerate methylation depletion or alter immune signaling.

Who should be cautious

Pregnant and breastfeeding women should not exceed RDA amounts without medical guidance; therapeutic doses are not established as safe in pregnancy. People with liver disease should avoid high doses. Those with diabetes should monitor blood glucose, as high doses may affect glucose tolerance. People with kidney disease, gout, or low blood pressure should consult a clinician. Take care when combining with other B3 sources to avoid exceeding upper limits.

Interactions

Nicotinamide may interact with carbamazepine and primidone (anticonvulsants), increasing their blood levels. It may potentiate the effects of blood pressure medications and diabetes drugs. Concurrent use with statins should be monitored. At high doses, nicotinamide can affect methyl donor balance, potentially affecting medications metabolized via methylation pathways.

Frequently asked questions

What's the difference between niacin and nicotinamide?⌄

Both are forms of vitamin B3. Niacin (nicotinic acid) causes the characteristic flushing reaction and is used at high doses for cholesterol. Nicotinamide does not cause flushing and is preferred for skin uses, pellagra prevention, and general supplementation.

Does nicotinamide raise NAD+?⌄

Yes. Nicotinamide is a direct precursor in the NAD+ salvage pathway and reliably raises NAD+ levels. It is much less expensive than NMN or NR while supporting the same pathway.

Can nicotinamide prevent skin cancer?⌄

In high-risk individuals (those with prior nonmelanoma skin cancers), 500 mg twice daily reduced new skin cancers in clinical trials. Effects fade after stopping. Consult a dermatologist for personalized advice.

Is topical niacinamide effective for skin?⌄

Yes. Topical nicotinamide (2 to 10%) has strong evidence for skin barrier support, reducing hyperpigmentation, and managing acne. It is widely used in dermatology and skincare.

How much is safe daily?⌄

RDA is 14 to 16 mg/day. The supplement Upper Intake Level is 35 mg/day in the US, though much higher therapeutic doses (500 to 1,000 mg) are used safely under supervision. Very high doses can affect liver function.

References

NIH Office of Dietary Supplements - Niacin — ODS link
Wikidata: Nicotinamide — Wikidata link
PubChem: Nicotinamide (CID 936) — PubChem link

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Disclaimer: These statements have not been evaluated by the FDA. This page is educational, not a substitute for personalized medical advice. Evidence grades are AI-assisted assessments — talk to your doctor before starting any new supplement, especially if you're pregnant, breastfeeding, on medications, or managing a chronic condition.