Over-the-counter medication · Vitamin B3 (Lipid-Modifying)

niacin

Also sold as Niaspan, Slo-Niacin. This medicine is for children ages 4 and up who don't get enough fluoride in their drinking water.

Data updated 2026-05-15

11,382
FDA reportsModerately reported
21
InteractionsSeveral interactions
3
Recall records

What the data shows

niacin (Niaspan) is an over-the-counter Vitamin B3 (Lipid-Modifying), reported less often than most tracked drugs (11,382 FDA reports), with 21 documented drug interactions.

Reporting volume reflects how widely a drug is used and studied, not how dangerous it is, a FAERS report documents a temporal association, never proof of cause.

niacin (Niaspan) is an over-the-counter Vitamin B3 (Lipid-Modifying). This medicine is for children ages 4 and up who don't get enough fluoride in their drinking water.

This medicine is a multivitamin with fluoride. It helps prevent tooth decay and provides essential vitamins.

Drug Pricing (NADAC)

Generic Price

$0.22/unit

Generic Available

Yes (9 manufacturers)

Pricing data from NADAC (CMS), effective December 18, 2024. Compare all drug costs →

Compare with Another Drug → Full Side Effects Report →

What it does

This medicine is for children ages 4 and up who don't get enough fluoride in their drinking water.

Common side effects

No common side effects listed.

Key warnings

There are no serious warnings listed for this medication.

The sections below are summarized in plain English from niacin's FDA-approved prescribing information. They describe what the official label says, and are not personal medical advice.

How It Works

The fluoride in this medicine strengthens your teeth to protect them from decay. The vitamins help your body work properly and stay healthy.

Side Effects (from patient reports)

Based on 11,382 FDA adverse event reports.

Most-reported reactions

Adverse reactions in FAERS for niacin, by number of reports

reports

What this shows Bars show how often each reaction was reported, not how likely it is to happen, a report records a temporal association, never proof that the drug caused it.

Source FDA Adverse Event Reporting System (FAERS) As of 2025

Reports over time

Adverse-event reports filed for niacin each year to the FDA Adverse Event Reporting System (FAERS).

02004006008001,0001,200 20042007201020132016201920222025 284

Year-to-year volume tracks usage, prescribing, and scrutiny, not a change in per-patient risk. Source: FDA FAERS.

Where niacin sits

niacin has more FDA adverse-event reports than 42% of the drugs FAERS tracks. A high position reflects how widely a drug is used and watched, not how dangerous it is.

fewest reports most reports

Percentile across all drugs PlainMeds tracks by FAERS report volume. The dot is niacin; the line is the median (50th percentile).

FDA Adverse Event Report Analysis

Detailed analysis of 11,382 reports from the FDA Adverse Event Reporting System (FAERS). Reports span 2004–2025.

Total Reports

11,382

Reports Mentioning Death

745

6.5% of reports — not proof of cause

Hospitalization Reports

3,202

Top Indication

Product Used For Unknown Indication

Gender Distribution

Female 4,580 (43%)
Male 6,137 (57%)

Age Distribution

0–17 43
18–44 571
45–64 2,698
65–74 2,198
75+ 1,711

Most Reported Adverse Reactions (FAERS)

# Reaction Reports
1 FATIGUE 750
3 NAUSEA 671
4 DIARRHOEA 630
5 DIZZINESS 546
6 DYSPNOEA 530
7 DRUG HYPERSENSITIVITY 495
8 PAIN 489
9 HEADACHE 473
10 ASTHENIA 441
11 FALL 380
12 PAIN IN EXTREMITY 375
13 ARTHRALGIA 373
14 RASH 348
15 VOMITING 346
16 PRURITUS 341

Reactions in Death Reports

DEATH 264
RENAL FAILURE 60
FALL 55
MYOCARDIAL INFARCTION 46
DYSPNOEA 44
PNEUMONIA 42
CARDIAC FAILURE CONGESTIVE 41
ASTHENIA 40
VOMITING 38
CARDIAC FAILURE 34

Reactions in Hospitalization Reports

NAUSEA 222
MYOCARDIAL INFARCTION 215
DYSPNOEA 214
FALL 209
PNEUMONIA 209
DIARRHOEA 207
FATIGUE 202
DIZZINESS 184
ASTHENIA 180
PAIN 180

Source: FDA FAERS (Adverse Event Reporting System) Reports are voluntary and do not establish causation

Serious Warnings

There are no serious warnings listed for this medication.

Known Drug Interactions

Niacin Clinical Impact: Cases of myopathy and rhabdomyolysis have been observed with concomitant use of lipid modifying dosages of niacin ( > 1 gram/day niacin) with atorvastatin. Intervention: Consider if the benefit of using lipid modifying dosages of niacin concomitantly with atorvastatin outweighs the increased risk of myopathy and rhabdomyolysis.

Mechanism: Taking high doses of niacin along with atorvastatin can increase your risk of developing severe muscle pain or damage.

moderate ezetimibe

Niacin Clinical Impact: Cases of myopathy and rhabdomyolysis have been observed with concomitant use of lipid modifying dosages of niacin-containing products (≥1 gram/day niacin) with ezetimibe and simvastatin. In a clinical trial (median follow-up 3.9 years) of patients at high risk of CVD and with well-controlled LDL-C levels on simvastatin 40 mg/day with or without ezetimibe 10 mg/day, there was no incremental benefit on cardiovascular outcomes with the addition of lipid-modifying doses of niacin Intervention: Concomitant use of ezetimibe and simvastatin with lipid-modifying dosages of...

Mechanism: Combining these drugs increases the chance of developing serious muscle problems. Research also shows that adding niacin to this treatment might not provide extra heart health benefits for some patients.

Niacin Clinical Impact: Cases of myopathy and rhabdomyolysis have been observed with concomitant use of lipid modifying dosages of niacin-containing products (≥1 gram/day niacin) with VYTORIN. In a clinical trial (median follow-up 3.9 years) of patients at high risk of CVD and with well-controlled LDL-C levels on simvastatin 40 mg/day with or without ezetimibe 10 mg/day, there was no incremental benefit on cardiovascular outcomes with the addition of lipid-modifying doses of niacin Intervention: Concomitant use of VYTORIN with lipid-modifying dosages of niacin is not recommended in Chinese...

Mechanism: Taking high doses of niacin with this drug increases the risk of muscle damage and may not provide extra heart benefits.

moderate fluvastatin

Limit fluvastatin dose to 20 mg ( 2.5 , 7.2 ) Concomitant lipid-lowering therapies: Use with fibrates or lipid-modifying doses (≥ 1 g/day) of niacin increases the risk of adverse skeletal muscle effects. 7.5 Niacin The risk of skeletal muscle effects may be enhanced when fluvastatin sodium is used in combination with lipid-modifying doses (≥ 1 g/day) of niacin; a reduction in fluvastatin sodium dosage should be considered in this setting [see Warnings and Precautions ( 5.1 )].

Mechanism: Combining these drugs increases the chance of experiencing muscle pain or damage.

moderate lovastatin

Gemfibrozil Other fibrates Niacin (nicotinic acid) (≥ 1 g/day) Other Drug Interactions Cyclosporine The risk of myopathy/rhabdomyolysis is increased by concomitant administration of cyclosporine (see WARNINGS , Myopathy/Rhabdomyolysis ).

Mechanism: Using niacin along with lovastatin increases the risk of serious muscle breakdown and pain.

Check all your medications →

This is a plain-language summary of FDA-label interaction records and does not provide individual medication-combination directions.

Common Questions

What age is this medicine for?
This medicine is for children 4 years and older.
How often should my child see the dentist?
Children taking this medicine should have dental checkups twice a year.
What if my child's water has some fluoride?
This medicine is for areas where drinking water has less than 0.6 ppm of fluoride. Talk to your doctor or dentist about the right amount of fluoride for your child.
Can I give this to my baby?
No, do not give this chewable tablet to children under 4 years old.
Does this replace brushing?
No, you still need to brush your teeth regularly and practice good oral hygiene.
What vitamins are in this medicine?
This medicine contains Vitamins A, C, D, E, thiamine, riboflavin, niacin, vitamin B6, vitamin B12, and folate.
Is this medicine over-the-counter?
No, this is a prescription medicine.
What do the tablets look like?
The tablets are round, yellowish/cream with orange and yellow speckles, and have "M164" on one side.
How many tablets are in a bottle?
Bottles contain either 90 or 100 tablets.
What should I do if my child swallows too many tablets?
Call your doctor or poison control center right away.
Does niacin interact with other medications?
The registry has 21 documented interaction rows for niacin. Notable source-record pairings include atorvastatin, ezetimibe, ezetimibe/simvastatin. These rows are not a complete medication review.
What drug class is niacin?
niacin belongs to the Vitamin B3 (Lipid-Modifying) drug class. It is available over the counter (OTC). This medicine is for children ages 4 and up who don't get enough fluoride in their drinking water.
What pregnancy or breastfeeding source fields are listed for niacin?
The FDA label for niacin contains product-specific pregnancy or breastfeeding language. PlainMeds does not apply that source text to an individual.
Has niacin been recalled?
There are 3 recalls associated with niacin products. Failed Dissolution Specifications: During 12-month long-term stability testing, subject lot was out of specification (low) for stage 3 dissolution at the 24-hour timepoint. Check the recalls section below for full details and affected products.

Active Recalls

Class II May 29, 2026

Failed Dissolution Specifications: During 12-month long-term stability testing, subject lot was out of specification (low) for stage 3 dissolution at the 24-hour timepoint.

Golden State Medical Supply Inc.

Class II May 27, 2026

Failed Dissolution Specifications: during 12M LT stability testing OOS low for Stage 3 dissolution at the 24-hour timepoint.

Lannett Company Inc.

Class II October 10, 2025

Failed Dissolution Specifications

Lannett Company Inc.

Other drugs grouped near niacin - same-class peers and common alternatives.

Compare niacin vs alirocumab side-by-side →

Compare beyond drug class

Nationwide peers by FAERS volume & death-report share

Two PlainMeds-derived comparison paths for niacin: nearest FDA FAERS report volume and nearest death-report share among drugs with at least 1,000 logged reports, excluding same-class neighbors listed above. Counts reflect reporting volume, not proven individual harm.

Medication Guides

What the FDA Data Shows for niacin

The FDA label for niacin (sold under brand names such as Niaspan, Slo-Niacin) classifies it as an over-the-counter product in the Vitamin B3 (Lipid-Modifying) class. This medicine is for children ages 4 and up who don't get enough fluoride in their drinking water. Labeling covers dosing, contraindications, and monitoring requirements derived from clinical trials.

Post-market surveillance from the FDA Adverse Event Reporting System (FAERS) captures real-world experience. For this drug, FAERS contains 11,382 voluntary reports. The database also lists 21 documented drug interactions derived from FDA labeling, with the top-flagged interaction rated moderate severity. NADAC pricing from CMS shows a generic unit cost of $0.22.

Report counts do not establish causation, a FAERS entry documents a temporal association, not proof that the drug produced the outcome. Widely prescribed medications naturally accumulate more reports than niche therapies, so raw totals must be interpreted alongside total exposure. Shortage status, recall history (currently 3 recall records on file), and patent information are separate source-record fields. This page is a public FDA/CMS registry and does not provide medical, treatment, substitution, or medication-change directions.

Data Sources

Drug labeling: FDA Drug Labels (SPL/DailyMed). Adverse events: FDA Adverse Event Reporting System (FAERS). Pricing: CMS National Average Drug Acquisition Cost (NADAC).

FAERS reports are voluntary and do not establish causation. Drug interactions are derived from FDA labeling and clinical references. This registry does not provide medication decisions.

Last updated: September 30, 2024

PlainMeds is rendered directly from FDA openFDA/FAERS extracts, DailyMed labels, and CMS drug-pricing files, no number is typed in by an editor. FAERS counts, recalls, shortages, and price figures on this page are queried live from those federal extracts. See our editorial standards & corrections policy, the methodology behind these numbers, or report a data error. Data current as of 2026-05-15. Primary sources: openFDA / FAERS, DailyMed and CMS Part B ASP.

Data currency: FDA FAERS adverse-event reports through 2025, CMS NADAC acquisition-cost pricing effective December 2024, compiled from the source snapshot dated . See our methodology for per-source dates and refresh cadence. Spot a figure that looks wrong? Report a data issue.

All federal data sources used on this page