Toxicity From the Use of Niacin to Beat Urine Drug Screening

Manoj K. Mittal*, Todd Florin, Jeanmarie Perrone, João H. Delgado, Kevin C. Osterhoudt

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

28 Scopus citations


Niacin (vitamin B3) is promoted for rapidly clearing the body of drugs of abuse, such as cocaine and cannabis, and is alleged to interfere with urine drug screening. We present 4 cases of such novel use associated with significant adverse effects. Two cases had isolated skin manifestations, whereas the other 2 presented with life-threatening manifestations, including nausea, vomiting, dizziness, hepatotoxicity, metabolic acidosis, and hypoglycemia evolving into hyperglycemia. One patient also had profound neutrophilia and QTC-interval prolongation. All patients improved after cessation of the drug use and supportive treatment. Health care providers should be aware of these potential adverse effects of niacin and of the misguided use of this vitamin by patients seeking to interfere with urine drug screening.

Original languageEnglish (US)
Pages (from-to)587-590
Number of pages4
JournalAnnals of Emergency Medicine
Issue number5
StatePublished - Nov 1 2007

ASJC Scopus subject areas

  • Emergency Medicine


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