Hepatic Toxicity from Large Doses of Vitamin B₃(Nicotinamide)

NICOTINAMIDE, the amide derivative of nicotinic acid (vitamin B3) functions metabolically as the precursor for nicotinamide adenine dinucleotide (NAD). It has also been used therapeutically to treat schizophrenia, apparently without toxicity.1 2 3 However, its precursor, nicotinic acid, which is the dietary form of the vitamin, has occasionally been associated with abnormalities of liver function when used in large doses in the treatment of hypercholesterolemia (3 to 10 g per day).4 5 6 7 8 9 10 11 12 13 The following case demonstrates that nicotinamide may cause major hepatic injury.Case ReportA 35-year-old graduate student was admitted in September, 1972, to the University of Chicago Hospitals with . . .