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The most common side effects of niacin are: stomach upset, flushing, headache, reduced blood pressure upon standing (orthostatic hypotension), vomiting, diarrhea, itching and ; tingling sensations of the extremities. Flushing may be reduced by taking 325 mg of aspirin 30 minutes before the niacin and by increasing the dose of niacin slowly.
Some interactions may increase your risk of side effects (such as flushing), while others can cause an unsafe drop in blood pressure. Medications that may lead to potentially negative niacin interactions include beta blockers, bile acid sequestrants, nitrates, and diabetes medicines. An Overview of Niacin Interactions.