Vetdrugs 2.0Niacinamide, also called nicotinamide, is the amide form of vitamin B3. It is used nutritionally to correct deficiency and empirically as an adjunct for selected immune-mediated skin disorders, usually with a tetracycline. Its dermatologic use is distinct from the lipid-lowering application of nicotinic acid, or niacin, in human medicine.
Group
Vitamin and dermatologic anti-inflammatory
Mechanism of Action
Niacinamide supplies a precursor for NAD and NADP, cofactors essential to cellular energy transfer and redox reactions. Replacement corrects metabolic consequences of vitamin B3 deficiency. Proposed dermatologic effects include modulation of inflammatory-cell activity and mediator production, although the precise mechanisms contributing to clinical benefit in combination with tetracyclines remain incompletely defined.
Dose Rates
Dogs
| Use / stage | Dose | Route | Schedule | Instructions |
|---|---|---|---|---|
| Immune-mediated skin disease | Reference only | PO | Reported example for a roughly 10-kg dog: niacinamide 500 mg plus tetracycline 500 mg every 8 hours, later tapered to every 12 then 24 hours. For dogs under 10 kg, the reported starting amount is 250 mg of each. This combined, weight-qualified taper is not a universal fixed dose. | |
| Immune-mediated skin disease | 100 mg/animal | PO | Every 8 h | Dogs under 5 kg. Combine with the same milligram amount of tetracycline; reassess tolerance and skin response. |
| Immune-mediated skin disease | 250 mg/animal | PO | Every 8 h | Dogs 5-10 kg. Combine with the same milligram amount of tetracycline; reassess tolerance and skin response. |
| Immune-mediated skin disease | 500 mg/animal | PO | Every 8 h | Dogs over 10 kg; one alternative includes exactly 10 kg in the higher group. Combine with the same milligram amount of tetracycline; reassess tolerance and skin response. |
Indications
- Treatment of vitamin B3 deficiency in veterinary patients.
- Adjunctive treatment of selected canine cutaneous lupus disorders, including discoid lupus erythematosus, commonly with a tetracycline.
- Adjunctive treatment of selected immune-mediated dermatoses, including some pemphigus, vasculitis or sterile inflammatory skin disorders, with variable disease-specific evidence.
- Adjunctive treatment of selected canine symmetric lupoid onychodystrophy cases within a combination dermatologic plan.
Adverse effects
- Vomiting, anorexia, lethargy and diarrhea.
Toxicity
Excess niacinamide most often causes gastrointestinal upset; animal overdose information is limited.
Preparations
| Preparation | Form | Strength | Route |
|---|---|---|---|
| Niacinamide (Vitamin B3) 50 mg | Tablet | 50 mg / tablet | PO |
| Niacinamide (Vitamin B3) 100 mg | Tablet | 100 mg / tablet | PO |
| Niacinamide (Vitamin B3) 125 mg | Tablet | 125 mg / tablet | PO |
| Niacinamide (Vitamin B3) 250 mg | Tablet | 250 mg / tablet | PO |
| Niacinamide (Vitamin B3) 500 mg | Tablet | 500 mg / tablet | PO |
Monitoring and Administration
Check CBC periodically during combination treatment. Dermatologic experience is mainly empirical and typically combines niacinamide with tetracycline.
Clinical improvement may take 6-8 weeks. Dermatologic protocols may substitute doxycycline 5 mg/kg orally daily for tetracycline. One taper begins after control at 90-120 days, removing one daily administration each month, eventually every other day for 30-60 days; do not flatten this into a single fixed course.
Avoid strong-acid or alkaline mixtures for niacinamide.