What is one contraindication for prescribing niacin?

One major contraindication for prescribing niacin is active liver disease. Niacin, also known as vitamin B3, has been shown to affect liver function, especially at higher doses. It can lead to hepatotoxicity, which can exacerbate existing liver conditions and potentially lead to further complications such as liver failure. Consequently, for patients with any form of active liver disease, including hepatitis or cirrhosis, the use of niacin is contraindicated to prevent deterioration of liver function.

Other conditions, while they may require caution in niacin use, do not constitute an outright contraindication. For instance, patients with hypertension, diabetes, or heart failure can often be managed with niacin, but careful monitoring and dosage adjustments might be needed to mitigate any adverse effects, such as increased blood sugar levels in diabetic patients or fluid retention in those with heart failure. However, in the presence of active liver disease, the risks of using niacin significantly outweigh the potential benefits, making it a clear contraindication.