Niacinamide Lowers Blood Phosphate Levels

I have seen haidut mention this a few times, and I noticed it had not been posted in the forum. (Correct me if I have got this wrong so this can be deleted)

Use of Nicotinamide to Treat Hyperphosphatemia in Dialysis Patients

Drugs R D. 2013 Sep; 13(3): 165–173.
Published online 2013 Sep 3. doi: 10.1007/s40268-013-0024-6
PMCID: PMC3784056
Use of Nicotinamide to Treat Hyperphosphatemia in Dialysis Patients
Aurélie Lenglet, Sophie Liabeuf, Pauline Guffroy, Albert Fournier, Michel Brazier, and Ziad A. Massy




"Although hyperphosphatemia is not an approved indication for NAM, recent clinical studies have confirmed the drug’s effectiveness in reducing blood phosphate levels in dialysis patients. In fact, NAM may be an interesting alternative to phosphate binders for the treatment of hyperphosphatemia, given (1) the drug’s attractive mechanism of action (blockade or inhibition of the intestinal transport); (2) its potential cost-effectiveness; and (3) the limited number of tablets required to achieve good compliance.

In terms of adverse drug reactions, NAM-related gastrointestinal adverse events appear only at a daily dose of between 1 and 2 g and can often be resolved while therapy continues. Thrombocytopenia is a serious adverse event requiring treatment discontinuation and needs to be evaluated more precisely. The balance between NAM’s potential benefits and harmful effects must be assessed before widespread use of this drug in the management of hyperphosphatemia in dialysis patients can be considered. Previous studies have been limited by short follow-up periods and small sample sizes. Thus, long-term studies are needed to validate NAM’s tolerance, safety, and efficacy in dialysis patients."