From the Guidelines
Niacin (Nicotinic Acid) does not have a well-established association with tongue swelling.
Adverse Effects of Niacin
- The provided evidence primarily discusses the use of niacin in the context of lowering LDL cholesterol and raising HDL cholesterol, as well as its side effects such as skin flushing, hepatotoxicity, hyperuricemia, and hyperglycemia 1.
- None of the evidence directly links niacin to tongue swelling, suggesting that this is not a commonly recognized or reported side effect.
Safety Recommendations for Niacin
- The 2013 ACC/AHA guideline on the treatment of blood cholesterol recommends monitoring patients on niacin for adverse effects such as hepatotoxicity, hyperglycemia, and hyperuricemia, but does not mention tongue swelling as a potential side effect 1.
- The guideline also suggests starting niacin at a low dose and titrating up to a higher dose to minimize adverse effects, but again, does not mention tongue swelling 1.
Conclusion Based on Available Evidence
Given the lack of evidence linking niacin to tongue swelling, it is reasonable to conclude that niacin is not typically associated with this side effect. However, as with any medication, patients should be monitored for any unusual or unexpected side effects, including tongue swelling, and healthcare providers should exercise caution when prescribing niacin, especially in patients with a history of adverse reactions to medications 1.
From the FDA Drug Label
The following additional adverse reactions have been identified during post-approval use of niacin extended-release: Hypersensitivity reactions, including anaphylaxis, angioedema, urticaria, flushing, dyspnea, tongue edema, larynx edema, face edema, peripheral edema, laryngismus, and vesiculobullous rash;
Tongue swelling (also known as tongue edema) is a reported adverse reaction in the postmarketing experience of niacin extended-release, as stated in the drug label 2.
From the Research
Niacin and Tongue Swelling
- There is no direct evidence in the provided studies that suggests niacin (nicotinic acid) causes tongue swelling 3, 4, 5, 6, 7.
- The studies primarily focus on the effects of niacin on lipid metabolism, cardiovascular health, and skin conditions, but do not mention tongue swelling as a potential side effect.
- Common side effects of niacin mentioned in the studies include cutaneous flushing, gastrointestinal disturbances, and hepatotoxicity 3, 5, but tongue swelling is not listed as a known side effect.
- It is possible that tongue swelling may be a rare or undocumented side effect of niacin, but based on the available evidence, there is no clear link between niacin and tongue swelling.