Editing Niacin (section)

====Liver damage====
Niacin in medicinal doses can cause modest elevations in serum [[transaminase]] and unconjugated [[bilirubin]], both biomarkers of liver injury. The increases usually resolve even when drug intake is continued.<ref name=LiverTox2014>{{cite book |title = IN: LiverTox: Clinical and Research Information on Drug-Induced Liver Injury (Internet) |chapter = Niacin |publisher=National Institute of Diabetes and Digestive and Kidney Diseases |pmid=31643504 |date=February 2014 |location = Bethesda, MD }}</ref><ref name="bil1" /><ref name="bil2" /> However, less commonly, the sustained release form of the drug can lead to serious [[hepatotoxicity]], with onset in days to weeks. Early symptoms of serious liver damage include nausea, vomiting and abdominal pain, followed by [[jaundice]] and [[Itch|pruritus]]. The mechanism is thought to be a direct toxicity of elevated serum niacin. Lowering dose or switching to the immediate release form can resolve symptoms. In rare instances the injury is severe, and progresses to liver failure.<ref name=LiverTox2014 />