27.11.2020

Nicotinic acid

Nicotinic acid and its derivative nicotinamide, nikethamide constitute a group of water-soluble vitamins PP. These chemically and biologically related compounds in the body is easily transformed into each other, therefore have the same vitamin activity. Other names nicotinic acid – Niacin (formerly known as), vitamin PP(protivopodagricescie), nicotinamide.

In clinical practice, nicotinic acid and nicotinamide are used as medicines. However, pharmaco-therapeutic properties of these drugs are different.
Nicotinic acid has the following effects:

  • vasodilatory effect (“the effect of ignition”), cardiotonicescoe, increases blood circulation;
  • has antiholetsaticeski effect – reduces the breakdown of fats;
  • has hepatoprotective and detoxifying effect, but in high doses long-term use of nicotinic acid occurs fatty degeneration of the liver;
  • is neurotropic drug;
  • improves heart and blood vessels.

Nicotinic acid has a beneficial effect on fat metabolism, reduces cholesterol in the blood of patients with atherosclerosis, dilates blood vessels (when taking doses exceeding 75 mg), helps with vertigo, eliminates ringing in the ears.

Nicotinic acid drugs used for the prevention and cure of pellagra, with neuritis, hepatitis, chronic vascular disease, mainly affecting the leg arteries (endarteritis).

Niacin prevents heart attacks, reduces depression, eases headaches, improves the digestive tract. She is a positive effect in mild forms of diabetes, gastric ulcer and duodenal ulcer, enterocolitis, weak healing wounds and ulcers, infectious diseases.

The role of nicotinic acid in biological processes

The biological role of nicotinic acid is associated with its participation in the construction of two coenzymes – NAD (nicotinamide adenine dinucleotide) and NADP (nicotinamide adenine dinucleotide phosphate), forming part of the major redox enzymes. Coenzymes (cofactors) are organic natural compounds necessary for the implementation of catalytic action of enzymes. Coenzymes function as carriers of electrons or atoms from one substrate to another.

Vitamin PP attaches to proteins and creates together with them, several hundred different enzymes. Enzymes nicotinic acid form a “bridge” by which the hydrogen atoms are in the “furnace”. Trillions of “furnace” fueled in body cells and promote the release of energy from carbohydrates, fats and proteins from food.

Niacin is directly involved in the processes of biological oxidation and energy metabolism. As a component OVER and NADP, it promotes the release of energy from food, DNA synthesis, regulates the processes of cellular respiration.
Nicotinic acid is involved in the following biological processes:

  • cellular respiration, cellular energy;
  • the blood circulation;
  • carbohydrate, fat, and protein metabolism;
  • mood;
  • sleep;
  • cardiac activity;
  • control cholesterol;
  • muscles;
  • connective tissue;
  • the production of gastric juice;
  • the function of the digestive tract.

Nicotinic acid raises the use in the body vegetable proteins, normalizes the secretory and motor function of the stomach, improves the secretion and composition of pancreatic juice, normalizes the liver.

Almost all of the cells and liquid environments of an organism nicotinic acid presented in the form of nicotinamide.

Foods that contain nicotinic acid

The main natural source of nicotinic acid in the human body are products of animal origin:

  • animal organs – liver, kidney, muscle, heart;
  • some species of fish – sardines, mackerel, tuna, salmon, halibut, swordfish, cod.

Rich in Niacin cereals, wholemeal bread, rice and wheat bran, dried apricots, mushrooms, almonds, green peas, tomatoes, red bell pepper, potatoes, soybeans. Excellent source to fill the lack of nicotinic acid, Baker’s yeast, brewer’s yeast.

Table 1 provides products in which nicotinic acid is contained in the largest quantity.
Table 1

Product name The nicotinic acid content per 100 g edible portion of the product
Dry yeast 40 – 50 mg
Peanuts 8 -12 mg
Kidney The 5.7 – 7.3 mg
Liver 9 -12 mg
Heart 5 mg
Meat products (meat cutlet) 2,5 – 2,8 mg
Poultry 6 -10 mg
Veal 6 mg
Salmon 6 -7 mg
Tuna 10.3 mg
Herring 3.9 mg
Cod 2,3 mg
Halibut 2 mg
Beef The 4.7 – 5.4 mg
Mushrooms 4,6 mg
Coffee 2 -10 mg
Legumes 2 -3 mg
Potatoes 1.3 mg

Vitamin value of food depends not only on the amount of content nicotinic acid, but from forms in which it resides. Thus, in legumes it is in easily digestible form, and from grain (rye, wheat) vitamin practically not absorbed.

In animal tissues Niacin is mostly in the form of nicotinamide in plants as nicotinic acid. The vitamin e is absorbed in the small intestine and are consumed by the body.

Nicotinic acid is one of the most stable in respect of storage, cooking, preservation of vitamins. High temperature during cooking and roasting almost no effect on its content in the product. Sustainable vitamin PP and to the effects of light, oxygen, alkalis. He almost loses biological activity upon freezing and drying foods. During processing, the overall loss of nicotinic acid does not exceed 15 – 20 %.

Partially nicotinic acid can be synthesized from the essential amino acid tryptophan. However, this process is ineffective – dozens of molecules of tryptophan is formed only one molecule of vitamin. However, foods rich in tryptophan (milk, egg) can compensate for insufficient intake of nicotinamide in the diet.

The daily requirement for vitamin

Nicotinic acid children and adolescents every day required:

  • 5 – 6 mg under one year of age;
  • 10 – 13 mg for children from 1 year to 6 years;
  • 15 – 19 mg in age from 7 to 12 years;
  • 20 mg teenagers from 13 to 15 years.

An adult is required for every 1000 consumed calories about 6.6 mg vitamin. That is the daily requirement of nicotinic acid for adults is 15 to 25 mg.
Increased need for vitamin PP is needed:

  • those who are engaged in heavy physical labor;
  • the elderly;
  • patients with recent severe trauma and burns;
  • persons who use alcohol and drugs;
  • people suffering from debilitating chronic diseases, including malignant tumors, pancreatic failure, cirrhosis, sprue;
  • with nervous stress;
  • small children born with metabolic disorders (congenital disorder caused by abnormalities in the chromosome set);
  • pregnant and lactating women.

To loss of nicotinic acid leads to excessive consumption of sugar, sweets, sugary drinks. Nicotine reduces the absorption of vitamin PP. Therefore, people suffering from addiction to nicotine, may also require additional admission.

To deficiency of tryptophan and Niacin can lead to prolonged use of large doses of leucine.

Hypovitaminosis and hypervitaminosis

When there is insufficient intake of nicotinic acid in humans are early symptoms of hypovitaminosis: General fatigue, lethargy, apathy, decreased performance, insomnia, loss of appetite, weight loss, headaches, disorders of consciousness, memory loss, digestive disorders, irritability, depression.

Secondary insufficiency of nicotinic acid is found in a number of diseases of the gastrointestinal tract, neuritis, allergic dermatitis, lead poisoning, benzene, and thallium.

Late symptoms of insufficient acid the disease pellagra.

In mammals, the state of hypervitaminosis (ultra-high dose of vitamin RR) call failed. Stocks of nicotinic acid do not accumulate in tissues. The excess is immediately excreted in the urine. The high content of nicotinic acid may be accompanied by unpleasant feeling “skin heat”.

Diagnostics of security of an organism nicotinic acid

The measure of security of the human body vitamin e is excretion of the main products of the metabolism of nicotinic acid – N-methylnicotinamide and methyl-2-pyridon-5-carboxamide. Normally a day with urine it is allocated 7 to 12 mg.

Reducing emissions from urine acid lack of providing the body with vitamin e and opportunities for the development of vitamin deficiency. The concentration of metabolites of nicotinic acid and nicotinamide increases dramatically when excessive flow into the body.

Of particular value is the study of the quantitative content of N-metilnikotinamida after load of nicotinic acid or nicotinamide. This is the only criterion for the definition of security of an organism in this vitamin. The level of the vitamin or its coenzyme forms in the blood can not be decisive, since even in severe pellagra their content differs little from the content in healthy individuals.

Laboratory tests to identify deficiency of nicotinic acid is a urine test №1 on metilnikotinamid and urine analysis for 2-pyridon/No. 1 for metilnikotinamid.

The test results are not always convincing.

By chemical methods the quantitative content of nicotinic acid is the reaction of the determination of nicotinic acid with bromine cyanide.

Nicotinic acid and nicotinamide in cardiovascular diseases

One of the main causes of damage and cell death during oxygen starvation (acute ischemia) is a developing insufficiency of power supply. It is related to increased energy expenditure (work of the detoxification system, activation of transport adenozintrifosfata) and insufficient formation of biological molecules that can store and transfer energy during the reaction in connection with the damage of mitochondrial membranes, and other.

The concentration of substances involved in energy metabolic processes, changes dramatically. During ischemia in the brain at the molecular level is developing a cascade of physiological and pathophysiological reactions:

  1. Reduced blood flow to the brain. Accordingly decreases the delivery of oxygen from blood stream to cells. And since oxygen is involved in reactions of formation of energy, develops anoxia – hypoxia state. The cell loses the ability to oxidize a number of energy substrates.
  2. The increase of oxygen deficiency is accompanied by a decrease in the content of adenosine triphosphate (ATP) – energy source.
  3. In the latter stages of oxygen starvation, the level of energy deficiency becomes sufficient to run the basic mechanisms, leading to disruption of vital functions and cell death.
  4. Rapidly increasing concentrations of adenosine monophosphate (AMP). And this is an additional mechanism of destruction of cell membranes.
  5. Quickly develops a violation of energy metabolism. This leads to necrotic cell death.
  6. Changing the state of membrane structures and receptors triggers a single molecular mechanism, aimed at the response of brain tissue to damaging effects. Acute reduction of cerebral blood flow (cerebral ischemia) activates a complex genetic programs that lead to successive transformation of the genetic information of a large number of genes.
  7. The first reaction of brain tissue to a decrease of cerebral blood flow is decreased synthesis of matrix RNA and proteins – the reaction of poly(ADP-ribosyl)funding – modification of proteins. In this reaction involves the enzyme poly(ADP-ribose) polymerase (PARP).
  8. A donor of ADP-ribose is nicotinamide dinucleotide (NAD). The enzyme poly(ADP-ribose) polymerase (PARP) starts a very active (500 times more) to consume nicotinamide, greatly reducing its content inside the cell. As well as the nicotinamide dinucleotide regulates vital processes in the cell, and its deficiency causes cell death by necrosis variant.

The use of pharmacological brain protection reduces the risk of cerebral ischemia during temporary cessation of blood flow by support vessel. Drugs used for this purpose, the inhibitory (inhibitory) activity of the cellular enzyme poly(ADP-ribose) polymerase. Prevented sharp fall in the level of nicotinamide increased the survival of cells. It reduces tissue damage associated with ischemic stroke and myocardial infarction.

Among the active inhibitors (substances that suppress during the fermentation process) is nicotinamide. The structure and action it is close to nicotinic acid, is involved in redox processes in the body. Nicotinamide has a high selective effect against the enzyme poly(ADP-ribose) polymerase. He also has a number of nonspecific effects:

  • acts as antioxidant;
  • affects metabolism of glucose, lipids and nucleotides;
  • inhibits the overall synthesis of DNA, RNA and protein.

Nicotinamide prevents the development of severe metabolic disorders in the brain, activates the systems of energy metabolism in the cell, contributing to the preservation of the energy status of the cell.

Combined preparations containing nicotinic acid, widely used in cerebrovascular disorders, myocardial infarction, obliteriruuschem endarteritis, Raynaud’s disease, that is, in all cases where the microcirculation and collateral (roundabout) circulation is actually the only way to preserve the functional abilities of tissues.

Experimental and clinical data show that vitamin e relaxes spasm of the coronary vessels angina are successfully used nicotinic acid in the composition of drugs Nikoverin and Nikoshpan.

Activating specific enzymes – tissue fibrinase, nicotinic acid promotes the activity of the blood to dissolve intravascular blood clots.

Nicotinic acid lowers the level of cholesterol in the blood

One of the warning events associated with acute disorders of cerebral circulation, is reducing the level of cholesterol in the blood. Nicotinic acid prevents the release of fatty acids and thus lowers the level of cholesterol in the blood.

As a hypolipidemic remedy nicotinic acid is used since 1955. In high dose it has diverse effects on lipid metabolism:

  • inhibits lipolysis in adipose tissue that restricts the delivery of free fatty acids in the liver, as a result, inhibits the hepatic synthesis of triglycerides and lipoproteins of very low density (VLDL);
  • increases the breakdown of VLDL in the blood;
  • reduces blood levels of low density lipoproteins (LDL), depleting their predecessors – lipoproteins of very low density;
  • increases the level of high density lipoproteins (HDL).

Nicotinic acid in doses of 3 to 6 g per day reduces the amount of cholesterol, low-density lipoprotein by 15 – 25% within 3 to 5 weeks of treatment, reduces the level of triglycerides (fat molecules) lipoprotein very low density to 20 to 80% after 1 – 4 days, increases the content of cholesterol of high density lipoproteins by 10 to 20%, prevents lipoprotein (a).

Patients much better tolerate nicotinic acid when taken in dosage forms with prolonged action. This Nicobid Temples (microencapsulated tablets with fast and slow release), Slo-Niacin (nicotinic acid compound with polihale), Enduracin (matrix of tropical wax containing nicotinic acid).

Only accept nicotinic acid in a daily dose of 3 g or in combination with other drugs leads to a reduction in the incidence of nonfatal myocardial infarction, stroke, need for surgical intervention on the heart and blood vessels. Patients receiving nicotinic acid, there have been signs of regression of coronary atherosclerosis, reducing the frequency of progression of atherosclerotic lesions.

Cardiotonicescoe action of nicotinic acid

Repeated use of nicotinic acid in the damaged myocardium reduced content of pyruvic and lactic acids, at the same time increases the content of glycogen and adenosine triphosphate.

The improvement of microcirculation due to capillary dilation increases the oxygenation of the myocardium. As a result of the normalization of biochemical processes and improves the contractile activity of the myocardium (cardiac effect of nicotinic acid).

Nicotinic acid potentiates the action of drugs of plant origin, providing therapeutic doses of antiarrhythmic and cardiotonic action of cardiac glycosides. Drugs used to treat heart failure. Especially effective is the use of nicotinic acid in combination with digitalis glycosides.

Hepatotropic effect of vitamin e

Nicotinic acid effect on liver function. Hepatotropic effect is to stimulate secretion and excretion of bile, stimulation glycogenolysis and protein-educational of liver function.
Nicotinic acid is shown:

  • at various intoxications of a professional nature – poisoning by aniline, benzene, carbon tetrachloride, hydrazine;
  • when the household poisoning;
  • when drug intoxication barbiturates, antituberculosis agents, sulfonamides;
  • in toxic hepatitis.

Under the action of nicotinic acid is enhanced detoxifying ability of the liver increases the formation of paired glucuronic acids formed in the process of detoxification; replaced toxic products of metabolism and foreign toxic compounds.

Neurotropic action of nicotinic acid

Called neurotropic drugs that act on the Central and peripheral nervous system. Nicotinic acid participates in the biosynthesis of hormones that affect the human psyche.

The “happiness hormone” serotonin is formed from tryptophan. Serotonin affects human sleep and mood. As nicotinic acid essential for energy production in the cells of the body, with its deficiency, a significant proportion of tryptophan is converted to nicotinic acid. The more tryptophan is consumed to obtain energy, the less remains for calm nerves and good sleep. Lack of serotonin leads to insomnia, poor concentration, depression, nervousness to the point of depression, hallucinations, and sometimes schizophrenia.

Nicotinic acid is the only vitamin that is indirectly involved in the hormonal metabolism in the human body. Its neurotropic properties are manifested by the increase of inhibitory processes. The increase of inhibitory processes under the action of nicotinic acid has a beneficial effect on the body as a whole: increased efficiency, reduced number of inappropriate reactions.

Nicotinic acid is used in the treatment of neurotic and psychotic conditions, alcoholic delirium (disruption of consciousness), chronic alcoholism. It potentiates the effect of neuroleptics and barbiturates reduces the effect of caffeine and amphetamine.

Nicotinamide belongs to the drugs mixed actions with a wide range of applications. He is part of the drug Citoflavin. This is a balanced complex components of effective combination which has a synergistic regulatory effect on all major metabolic pathway in the Central nervous system, in varying degrees, compromised by cerebral ischemia.

Cytoflavin reduces the degree of neurological deficit and accelerates the recovery of function in ischemic stroke. The drug affects the main pathophysiological processes that occur when ischemic damage neuronal structures of the brain:

  • restores antioxidant protection factors;
  • activates energy processes and reactions;
  • inhibits the reaction of the oxidative stress, increasing the ability of cells to utilize glucose and oxygen;
  • stimulates protein synthesis within cells.

Many thanks to the above effects, improving coronary and cerebral blood flow, stabilization of metabolic activity in cells of the Central system, which is clinically manifested by the reduction in neurologic deficit and recovery of bodily functions.

Nicotinamide is a combination of metabolic drug Comarnic (producer – company World Medicine, UK). The drug is indicated for the symptomatic treatment of complications of diabetes mellitus – diabetic polyneuropathy.

Nicotinamide improves nerve conduction and blood flow in the nerves in diabetes, reduces the oxidation of lipids, formation of free radicals and secondary lipid oxidation products. The medication has multiple effects and low toxicity at high doses in the treatment of patients, which is confirmed by the results of numerous studies.

Pellagra (deficiency of nicotinic acid): symptoms and treatment

Pellagra (from the Italian pelle agra rough skin) is a disease associated with inadequate intake of or incomplete assimilation of nicotinic acid to them. The basis of disease is the violation of energy cells and their ability to actively divide.

In the past, pellagra developed where the main food was corn. In this cereal the culture of nicotinic acid is contained in trudnootdelyaemoy form, it is poor in tryptophan, which is able to synthesize the vitamin. The main regions of occurrence of pellagra was the South of Europe, Africa, Latin America, and the southern States of the USA. In tsarist Russia the disease was found in Bessarabia (Moldova), to a lesser extent in Georgia.

The main reason for the development of insufficiency of nicotinic acid have people in our country are chronic diseases of the gastrointestinal tract (enteritis, colitis) associated with the violation of its suction.

The causes of the disease

The cause of the disease is not only a low content in the food of nicotinic acid, but:

  • lack of tryptophan;
  • the high content in the diet of leucine, which inhibits the synthesis of conferment NADP in the body;
  • low kofermentov pyridoxine;
  • the presence of grain products niacytin and Niacinamide and related forms of nicotinic acid, not digestible by the body.

In children, pellagra usually develops in an unbalanced diet with a predominance of carbohydrates. In very rare cases, the disease develops in breastfed infants, due to insufficient content in the diet of nursing mothers vitamins.

Pathological processes during a disease

In pellagra affects the skin, gastrointestinal tract and nervous system. The severity of the process depends on the form and stage of disease.
Changes in the skin manifested in the form of vast areas of red-brown color, filled with blood, with sharp boundaries lesions. The skin swells, is condensed. In the later stages of the disease begins atrophy of the epidermis.

In the mouth appear erosion or ulcer. Swollen bright red tongue with painful ulcerations later becomes a varnish. In the surface epithelium of the pharynx and esophagus, the mucosa of the small and large intestine occur atrophic changes.

Stomach, pancreas and liver reduced in size. The mucous membrane of the stomach anemic, with sporadic hemorrhages, folds weak. Inhibits the secretion of digestive glands, there Akhil – lack of hydrochloric acid and enzyme pepsin in the gastric juice. In the liver observed fatty degeneration of its working cells of hepatocytes.

In the brain and spinal cord and in the peripheral nervous system detects degenerative changes in narocito with signs of neuronophagia – damaged or degenerative changes nerve cells are destroyed and removed from the body by the phagocytes cells of the immune system.

Significant violations of metabolism and function of many organs leads to dystrophic and degenerative changes in almost all organs and tissues. Affects the kidneys, lungs, heart, spleen.

The symptoms of pellagra

Pellagra occurs in the school and adolescence, in early childhood, very rarely. Basically ill adults aged 20 – 50 years.
The clinical picture of pellagra is characterized by three main manifestations:

  • dermatitis – skin lesions on the symmetric parts available sunlight (hence the name of the disease);
  • diarrhea is a disorder of the gastrointestinal tract;
  • dementia – a mental disorder with memory loss, dementia, delirium.

The signs of the disease usually occurs late winter. Weak patients 3 – 5 times a day or more. Stool without blood and mucus, watery, putrid odor.
Further, there is a burning sensation in the mouth and strong salivation. Swollen, cracked lips. On the gums and under the tongue sores appear. Characteristic changes of the language. Initially, his back is covered with a coating of black-brown color, the edges and tip are bright red. Gradually the redness goes to the whole surface of the tongue, it becomes smooth and shiny.
Then there pelagicheskie erythema: in open areas (face, neck, back of hands and feet) skin under the action of sunlight reddens, swells and itches. Sometimes blisters are formed, which burst and leave moisture. In a few days is pityriasis peeling. By reducing inflammation in the affected skin remains persistent grayish-brown pigmentation, rarely occurring type the depigmentation of vitiligo.

Disturbed function of peripheral nerves and the Central nervous system. Appears dizziness, headaches. Apathy gives way to depression. Develop psychosis, psychoneurosises, in severe cases, there are hallucinations, convulsions, develops mental retardation.

In early childhood the classic symptoms of pellagra is not so expressed. Is dominated by inflammation of the tongue, disorders of the gastrointestinal tract, redness of the skin. Mental changes are rare.

A severe complication of pellagra encephalopathy (organic brain damage) with psychotic reactions.

Diagnosis of the disease

Diagnosis is based on characteristic clinical manifestations of the disease, data on the nature of nutrition, biochemical research. For pellagra characterized by the content of NI – methylnicotinamide in daily urine below 4 mg, the nicotinic acid content is below 0.2 mg. Reduced content in the blood and urine of other b vitamins.

Treatment

All patients with fresh and recurrent manifestations of pellagra are to be hospitalized.

Treatment of patients with insufficiency of intake of nicotinic acid include a diet rich in vitamin e that contains enough protein. In mild forms of vitamin deficiency vitamins are administered in tablets. Patients suffering from deficiency of nutrient absorption in the small intestine, they are administered injection.
Recommended daily dose for treatment – 300 mg divided into 2 – 3 admission. The treatment continues for 3 – 4 weeks.

Therapeutic doses of nicotinic acid it is preferable to introduce in the form of nicotinamide, which has significantly fewer side effects than nicotinic acid.

Mental disorders prescribe low doses of neuroleptics (chlorpromazine, frenolon, triftazin) in combination with antidepressants (amitriptyline) and tranquilizers (seduksen), which is administered intramuscularly or intravenously. In cases of development of organic psychosyndrome prescribed high doses of thiamine or nootropil in the form of repeated courses.

As in pellagra, the symptoms of deficiency of other b vitamins, and the amino acid tryptophan in the treatment plan include the introduction of the drug complex of vitamin B.

After the start of treatment the symptoms of disorders of the gastrointestinal tract disappear after a few days. Signs of dementia and dermatitis improved significantly during the first weeks of therapy. If pellagra became chronic, for recovery requires a longer period of treatment, but the appetite and General physical condition of the patient quickly improved.

Prevention

A varied balanced diet with adequate dietary intake of foods rich in Niacin enrichment of corn flour and grits, wheat flour premium and first grades nicotinic acid, health education of the population.

Secondary pellagra

The occurrence of pellagra is described in patients suffering from diseases of the digestive system analogital (lack of hydrochloric acid) for cancer of the esophagus, ulcers, cancer and syphilitic lesions of the stomach and duodenal ulcer, chronic ulcerative colitis, tuberculosis, after a dysentery, after operations on the organs of the digestive system, chronic alcoholism, treatment of tuberculosis with isoniazid.

Nicotinic acid drugs

In clinical practice actually use nicotinic acid and its derivatives form slow release Niaspan and Enduracin. In the United States used a fixed combination of nicotinic acid and lavastine – Advisor. Forms of slow release Niacin better tolerated but are less efficient in reducing lipids.

Nicotinic acid: instructions for use
Pharmacological action

Nicotinic acid is a specific protivopellagricheskimi means (vitamin PP). It improves carbohydrate metabolism, has a vasodilator effect, including on the brain vessels, has hypolipidemic activity. Nicotinic acid in 3 to 4 grams per day (high doses) reduces triglycerides and low-density lipoprotein of blood, reduces the ratio of cholesterol/phospholipids in the lipoproteins of low density. Has detoxification properties.

Dosage forms

Nicotinic acid is available in form of tablets and solution for injection.
Subcutaneous and intramuscular administration of vitamin painful. Intravenous solution should be administered slowly as it can be severe drop in blood pressure.

Composition

One tablet contains: nicotinic acid 0.05 g – active components; glucose, stearic acid – excipients.
One milliliter of solution for injection contains: Niacin 10 mg – active agent; sodium hydrogen carbonate; water for injection, excipients.

Testimony

Prevention and treatment of pellagra (vitamin PP).

Complex therapy of ischemic disorders of cerebral circulation, obliterating diseases of vessels of extremities (obliterating endarteritis, Raynaud’s disease), and kidney complications of diabetes such as diabetic polyneuropathy, microangiopathy.

Liver disease – acute and chronic hepatitis, gastritis with low acidity, neuritis of the facial nerve, various intoxication (occupational, medicinal, alcoholic), nonhealing wounds and ulcers.

Contraindications

The drug is contraindicated in the following cases:

  • hypersensitivity to drugs;
  • ulcers disease stomach and duodenal ulcer in the acute stage;
  • severe arterial hypertension;
  • gout;
  • hyperuricemia, nephrolithiasis, liver cirrhosis, decompensated diabetes mellitus;
  • pregnancy and the breastfeeding period.
The method of using nicotinic acid and dosing

Applied on prescription.
Tablets of nicotinic acid is taken orally after meals.
As antiallergicheskie means prescribed:

  • adults – nicotinic acid 0.1 g 2 – 4 times a day (maximum daily dose – 0.5 g);
  • children from of 0.0125 to 0.05 g 2 – 3 times a day, depending on age.

The course of treatment 15 – 20 days.
Adults with ischemic disorders of cerebral circulation, vascular spasm of limbs, gastritis with low acidity, neuritis of the facial nerve, wounds and ulcers nicotinic acid is recommended to appoint in a dose of 0,05 – 0,1 g, daily dose – 0.5 g. Course of treatment – 1 month.

Side effects

Possible allergic reactions, dizziness, facial flushing, a feeling of rush to the head, paresthesia (sensation of numbness, loss of sensation, pins and needles, tingling). In this case, you should reduce the dose or stop the drug.

Long-term use of nicotinic acid in high doses may develop fatty liver, hyperuricemia, increase in liver transaminases and alkaline phosphatase, decrease of glucose tolerance.

Overdose

Overdose is unlikely.
Nicotinic acid in persons with individual intolerance can cause redness of the face and upper half of the body, dizziness, a feeling of rush of blood to the head, urticaria, paresthesia. These phenomena are by themselves and do not require special treatment.

Control therapy cautions

To prevent complications from the liver with long-term use of nicotinic acid in large doses is recommended to include in the diet foods rich in methionine (cottage cheese) or use methionine, lipoic acid, Essentiale and other lipotropics.

With caution should use of nicotinic acid in case of gastritis with hyperacidity, gastric ulcer and duodenal ulcer. In the treatment of vitamin, especially high doses, should be monitored closely for liver function.

Interaction with other drugs

Consult a doctor if nicotinic acid is used simultaneously with other drugs.

Pharmaceutical incompatibility. Should not be mixed with a solution of thiamine chloride (thiamine destruction).

Potentiates the action of fibrinolytic agents, antispasmodics and cardiac glycosides, enhances the toxic hepatotropic influence of alcohol.

Care must be taken when combining with antihypertensives (may increase hypotensive effect), anticoagulants, acetylsalicylic acid in connection with risk of development of hemorrhage.

Reduces the toxicity of neomycin and prevents them induced a decrease in the concentration of cholesterol and high-density lipoproteins. Weakens the toxic effect of barbiturates, antituberculosis agents, sulfonamides.

Oral contraceptives and isoniazid slows down the conversion of tryptophan to nicotinic acid and thus can enhance the need for nicotinic acid.

Antibiotics may increase the flushing caused by nicotinic acid.

Nicotinic acid is available without a prescription.

Nicotinamide

Indications of nicotinamide – hypovitaminosis and avitaminosis PP, as well as the state increased need for vitamin PP:

  • inadequate and unbalanced nutrition (including parenteral);
  • malabsorption, including on the background of dysfunction of the pancreas;
  • quick weight loss;
  • diabetes mellitus;
  • prolonged fever;
  • gastrectomy;
  • disease Hartnup;
  • diseases of the hepatobiliary region – acute and chronic hepatitis, cirrhosis;
  • hyperthyroidism;
  • chronic infection;
  • diseases of the gastrointestinal tract, Hypo – and anatsidnyh gastritis, enterocolitis, colitis, celiac disease, persistent diarrhea, tropical sprue, Crohn’s disease;
  • malignant tumors;
  • diseases of the oropharyngeal region;
  • prolonged stress;
  • pregnancy (especially with nicotine and drug dependence, multiple pregnancy);
  • lactation.

As a vasodilator nicotinamide is not used. Hypolipidemic effect of nicotinamide is not.

In connection with the neutral reaction of a solution of nicotinamide is the local reaction to injections. In contrast to nicotinic acid, the drug has not expressed vasodilatory action, therefore, the use of nicotinamide phenomenon of ignition is not observed.

The drug is administered orally and injectable.

Nicotinic acid for hair

When applied to the scalp nicotinic acid dilates peripheral blood vessels, increasing blood circulation, improves the transportation of oxygen and minerals, increases in tissue metabolism, prevents hair loss and stimulates their rapid growth.

Instructions for use of solution for hair indicates that the remedy in the application of nicotinic acid stops the hair loss, the hair becomes thick, shiny and silky. Niacin also supports normal hair pigmentation, being a preventive remedy against gray hair.
Part of the funds Niacin with regular use:

  • awakens the dormant hair follicles and promotes hair growth by stimulating microcirculation;
  • restores and regenerates damaged follicles;
  • prevents hair loss, strengthening the roots and preventing compaction of the collagen around the hair root;
  • promotes the production of melanin – the pigment that makes the curls shiny, retains its color, prevents premature graying of hair.

The drug does not dry the skin in the case of multiple use, as proven by dermatological tests.

The method of using nicotinic acid: a tube-dropper to open directly before use. The contents of the tube to apply directly after shampooing on the scalp, evenly distributing acid across the surface with massaging movements. Do not rinse the applied tool.

A slight tingling sensation and reddening of the scalp after application due to increased microcirculation and is normal.

Use nicotinic acid 1 every 3 days. The recommended course of 14 treatments. It can be repeated every three months.

Despite all the advantages, wider use of nicotinic acid in clinical practice were found. This is due to the many side effects accompanying the ingestion of vitamin e in high doses.

International nonproprietary name The trade name of the drug Price Release form Manufacturer
Nicotinic acid Nicotinic acid 23 RUB. 50 mg tablets, 50 pieces</td Russia
43./td> Solution for injections 1 %, 10 vials</td Russia
185 RUB. The topical solution hair 10 ampoules</td Russia
Cytoflavin (Inosine+Nicotinamide+Riboflavin+Succinic acid) 395 RUB. Pills 50 pieces</td Russia
Comarnic 661 RUB. Lifelist for solution preparation 187, 125 mg, 3 pieces</td UK

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