Niacinamide and nicotinamide are one in the same; this "amide" is a form of vitamin B-3, or niacin. Important differences do exist, however, between niacin and niacinamide. The niacin and niacinamide you obtain from your diet act similarly, but niacin and niacinamide supplements offer different medical benefits. They pose similar risks including stomach ulcers and liver damage.
Your diet includes small amounts of niacin and niacinamide, or nicotinamide. Peanuts, yeast, beets and fish supply both forms of vitamin B-3. Some foods in your diet, including chicken, turkey and eggs, contain tryptophan, an enzyme that converts to niacin in your bloodstream with the help of vitamin B-6. (See Reference 3) A healthy diet includes about 14 mg to 16 mg of B-3. Few people in the United States and other Western countries suffer from vitamin B-3 deficiencies, but persons who drink excessive amounts of alcohol may to absorb this vitamin from their diets.
Prescription-strength niacin is used to treat high cholesterol. You need to take high amounts of niacin -- 500 mg to 3,000 mg per day -- to reduce lipids in your bloodstream. You should not attempt to lower your cholesterol with over-the-counter niacin or without supervision from your doctor. If you take more than 100 mg of niacin a day, you may experience a condition called skin flushes in which your face and chest turn red and your skin burns, itches or tingles. To prevent skin flushes, take an aspirin 30 minutes before you take niacin. You should also gradually increase your dose of niacin, so your body can adjust to niacin in your system. You can also ask your doctor about a timed-release formula, which can prevent flushing.
Niacinamide, or nicotinamide, is less likely to produce skin flushes, but is not a substitute for niacin. It cannot treat cholesterol, but may help delay the progression of type 1 diabetes, according to the University of Maryland Medical Center. Niacinamide may also help treat arthritis. Niacinamide may also treat attention-deficit hyperactivity disorder, age-related memory loss, schizophrenia, acne and alcohol dependence, but evidence is insufficient to claim effectiveness, notes MedlinePlus. You can purchase nicotinamide without a prescription, but it may prove dangerous to self-medicate with this supplement. If you think niacinamide may help you, ask your doctor about possible risks and benefits as well as proper dosage.
Both niacin and niacinamide pose serious health risks to long-term users. These include loss of vision, irregular heartbeat, gout, stomach ulcers and liver damage. Timed-release formulas of niacin increase your risk of liver damage. Niacin may cause excessive blood glucose elevations in persons with type 2 diabetes and worsen kidney disease. Taking large doses of niacin may increase your risk for strokes, according to a National Institutes of Health study, which ended prematurely amid safety concerns. The study found that persons who took 2,000 mg of niacin daily experienced greater improvements in cholesterol levels than those who did not the supplements, but also suffered more than twice as many strokes -- and as many heart attacks -- as persons who did not take niacin to treat cholesterol. The planned five-year study ended 18 months early in May.