- Explain to interested patients that excessive doses of niacin may be toxic to the heart, liver, and other body systems.
- Caution patients that niacin does not rid the body of evidence of drug abuse.
PHILADELPHIA, April 12 -- Those who try to foil urine drug tests with massive doses of niacin -- it doesn't work -- may wind up in a hospital emergency department.
Life-threatening adverse reactions beyond just the typical skin flushing and itchiness included liver toxicity, acidosis, and even disrupted heart rhythms at niacin doses 100 to 500 times the 15-mg daily recommended value, said Manoj K. Mittal, M.D., of the Children's Hospital of Philadelphia, and colleagues.
Four such cases -- two adults and two teenagers -- were seen in emergency departments in two years in the university health care system after trying to dodge a screen for illegal drugs, they reported online in the Annals of Emergency Medicine. What's more, Dr. Mittal added, niacin overdosing is an exercise in futility in trying to fool the tests.
While there is no biological basis for niacin's putative drug clearing effect, the myth may have gotten started by individuals who took the vitamin's "flushing" and metabolism effects out of context, Dr. Mittal and colleagues said.
