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Type Accommodation and the title of the report in the subject line of e-mail. In addition to its use as a nutritional supplement, niacin nicotinic acid or vitamin B3 is medically prescribed to treat hyperlipidemia and hypercholesterolemia. Use of niacin in low doses usually le to few adverse drug reactions ADRs ; however, at larger doses, niacin can cause skin flushing, itching, and occasionally more serious effects 1. The annual report of the American Association of Poison Control Centers documented 3, reports of exposures to niacin 2.
A review of call records indicated various uses of niacin, including attempts to alter or mask of urine drug tests, although no scientific evidence exists that ingestion of niacin can alter a drug test result. The identified 18 persons who reported nonsuicidal, intentional, nonmedical reasons for using niacin, including eight who specified altering drug test as their reason for using niacin. Ten other persons, among an additional 18 who offered no reason for niacin use, were categorized as possible users of niacin to try to alter drug test because of their ages or the amount of niacin ingested.
Clinicians, especially those whose patients include teens and young adults, should Can niacin flush your system drugs aware of the potential use of niacin in attempts to defeat urine drug tests. RMPDC staff members searched their database for telephone calls reporting niacin exposures during January--September Calls regarding niacin exposures were divided into six : 1 unintentional dosing errors in therapeutic users, 2 ADRs after therapeutic use, 3 pediatric unintentional exposures, 4 suicide attempts, 5 ADRs with no reason given for niacin use, and 6 ADRs after nonsuicidal, intentional, nonmedical use.
Data collected included the person's age, sex, circumstances of exposure, symptoms, and outcome. A total of 92 calls 72 from persons at home and 20 from health-care providers reported exposures to niacin. Among the 18 persons who said their ADRs resulted from nonsuicidal, intentional, nonmedical use of niacin, Can niacin flush your system drugs median age, excluding three adults of unknown ages, was 18 years range: years. Eight of the 18 persons said they took niacin 1, mg, mg to alter or mask a drug screening; eight others said they took niacin mg, mg to "purify, cleanse, or flush" their bodies; and two said they used niacin as a diet pill.
Calls regarding the 18 persons who either said their ADRs resulted from attempts to alter drug test or who were categorized as possible users of niacin for that purpose came from all five states covered by RMPDC. Twelve calls came from Colorado, two from Idaho, and one each from Hawaii, Montana, and southern Nevada; one call came from California via a manufacturer's hotline telephone.
Among the 28 who either gave a nonmedical reason for niacin use 18 persons or who stated no reason but were categorized as possible users of niacin to alter drug test 10 personsthe most common ADRs reported were tachycardia, flushed skin, rash, nausea, and vomiting. Thirteen of the 28 were treated at or referred to a health-care facility. No deaths were reported. Editorial Note:. Niacin is well established as a medical treatment for hyperlipidemia 3 and available by prescription in mg to mg tablets or capsules.
The initial recommended therapeutic daily dose is mg, three times a day, titrated to a maximum daily dose of 1, mg 4. Extended-release niacin tablets and capsules at mg, mg also are available by prescription, usually in a dose of mg at bedtime, to a maximum of 2, mg per day. The therapeutic use of niacin often is limited by dermatologic and gastrointestinal ADRs e.
Hepatotoxicity is a rare but serious adverse effect, usually associated with chronic use 5. No scientific evidence indicates that taking niacin can alter a urine drug test result. However, readily accessible information on the Internet lists ingestion of niacin as a way to Can niacin flush your system drugs detection of tetrahydracannabinol THCthe main psychoactive ingredient of marijuana. An Internet search on the words "niacin" and "marijuana" can produce tens of thousands of .
In addition to sales as a prescription drug, niacin is sold over the counter in mg to mg tablets and generally is regarded as a safe nutritional supplement with well-known dermatologic and gastrointestinal ADRs that usually are self-limited and resolve with supportive care 1. Death from acute overdose has not been reported, and a minimum lethal dose has not been established 6.
However, severe effects in some patients have been reported. A report in press on use of niacin to defeat urine drug tests describes four cases of niacin toxicity that included hepatotoxicity, metabolic acidosis, variations in blood glucose, neutropenia, and Can niacin flush your system drugs effects 7. Two of the four patients had life-threatening ADRs; one had taken 5, mg of niacin during a hour period, and the other had taken 2, mg during a hour period.
The findings in this report are subject to at least four limitations. First, the data were collected retrospectively from the RMPDC database; although a specific data set was gathered for each case, persons might have misrepresented the circumstances of their niacin use, leading to misclassification, underreporting of dosages, or inaccurate reporting of symptoms.
Third, poison center data might not be representative of all niacin exposures; patients with less severe or no symptoms from niacin use would not contact a poison center. Finally, RMPDC is a regional poison center, and the use of niacin to attempt to alter or mask drug test might be a regional phenomenon. Further research of national poison center data can provide additional information regarding nonmedical use of niacin.
Public health measures such as school-based education and authoritative Internet communications might help prevent ADRs if directed at those who are prompted to misuse niacin by claims that are not substantiated scientifically.
This report underscores the importance of taking medications in appropriate doses and for approved indications as directed by a health-care provider. With the Internet now a common source of medical information, clinicians can expect to encounter patients with unusual ADRs resulting from nonscientific drug use 8 and should familiarize themselves with these effects and counsel their patients accordingly. Use of trade names and commercial sources is for identification only and does not imply endorsement by the U.
Department of Health and Human Services. CDC is not responsible for the content of s found at these sites. This conversion may have resulted in character translation or format errors in the HTML version. An original paper copy of this issue can be obtained from the Superintendent of Documents, U. Contact GPO for current prices. Use of Niacin in Attempts to Defeat Urine Drug Testing Five States, January--September In addition to its use as a nutritional supplement, niacin nicotinic acid or vitamin B3 is medically prescribed to treat hyperlipidemia and hypercholesterolemia.
Editorial Note: Niacin is well established Can niacin flush your system drugs a medical treatment for hyperlipidemia 3 and available by prescription in mg to mg tablets or capsules. References CDC. Niacin intoxication from pumpernickel bagelsNew York.
MMWR ; Clin Toxicol ; JAMA ; Temple BR. Medical toxicology. Cardiovascular drugs. Toxicity from the use of niacin to beat urine drug screening. Ann Emerg Med. In press. Cone EJ. Ephemeral profiles of prescription drug and formulation tampering: evolving pseudoscience on the Internet.
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Toxicity from the use of niacin to beat urine drug screening