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This safety information outlines potential risks and important precautions associated with the use of nicotinamide multivitamins. Review these details carefully and consult your healthcare provider if you have any questions or concerns.

• Liver Health Risks: Taking doses of 500 mg or more of nicotinamide daily can result in serious liver issues. Individuals with a history of liver problems are at heightened risk. Regular monitoring through blood tests may be necessary. Immediately seek medical attention if you experience symptoms such as abdominal pain or swelling, yellowing of the skin or eyes, changes in stool color to clay-like, or severe stomach pain, as these may indicate liver damage.

• Anemia Concealment: The folic acid present in nicotinamide multivitamins can mask pernicious anemia, a condition arising from low vitamin B12 levels. If you have a known vitamin B12 deficiency, it is crucial to inform your healthcare provider, and avoid using this multivitamin in isolation.

• Caution for Kidney and Liver Conditions: If you have a history of kidney or liver problems, be cautious when taking nicotinamide multivitamins that contain copper. Excess copper can lead to stomach upset, further liver and kidney damage, and may impact your brain and nervous system.

There are no specific contraindications listed for this medication. Always ensure to discuss your medical history with your healthcare provider before starting any new supplement or medication.

Common side effects:

• Diarrhea
• Easy bruising or bleeding
• Nausea
• Vomiting
• Upset stomach
• Heartburn
• Dizziness
• Sleepiness
• Headaches

Serious side effects:

• Allergic reactions (rash, hives, difficulty breathing, swelling of the face, lips, tongue, or throat)
• Liver damage (severe stomach pain, yellowing of the skin or eyes, nausea, vomiting, loss of appetite)

Nicotinamide, a form of vitamin B3, is generally safe when taken at recommended doses. However, it can interact with certain medications and substances, potentially affecting their effectiveness or increasing the risk of side effects. It's important to be aware of these interactions and consult with a healthcare provider before starting nicotinamide, especially if you're on other medications.

Anticonvulsants: Nicotinamide may interfere with the metabolism of anticonvulsant drugs like Primidone and Carbamazepine. This interference can lead to higher levels of these medications in the blood, increasing the risk of side effects. If you're taking anticonvulsants, it's crucial to discuss nicotinamide supplementation with your doctor to ensure safe and effective use.

Statins: Combining nicotinamide with statin medications, which are used to lower cholesterol, may increase the risk of muscle-related side effects, such as muscle pain or weakness. This combination should be approached with caution, and any unusual symptoms should be reported to a healthcare professional promptly.

Blood Thinners: Nicotinamide might enhance the effects of anticoagulant medications, leading to an increased risk of bleeding. If you're on blood thinners, it's essential to monitor for signs of excessive bleeding and consult your doctor before adding nicotinamide to your regimen.

Diabetes Medications: High doses of nicotinamide can affect blood sugar levels, potentially interfering with diabetes management. If you have diabetes, closely monitor your blood glucose levels and discuss any changes in your medication or supplement routine with your healthcare provider.

Alcohol: Consuming alcohol while taking nicotinamide can exacerbate certain side effects, such as flushing and itching. It's advisable to limit or avoid alcohol intake during nicotinamide supplementation to minimize these effects.

Bile Acid Sequestrants: Medications like Cholestyramine, used to lower cholesterol, can bind to nicotinamide in the digestive tract, reducing its absorption. To prevent this interaction, it's recommended to take nicotinamide at least 4 to 6 hours before or after these medications.

Other Considerations: Nicotinamide may also interact with other medications, including certain antibiotics and blood pressure drugs. Always inform your healthcare provider about all the medications and supplements you're taking to avoid potential interactions.

In summary, while nicotinamide offers various health benefits, it's essential to be mindful of its potential interactions with other substances. Consulting with a healthcare professional before starting nicotinamide, especially if you're on other medications, will help ensure its safe and effective use.