Nicotinamide Dosing for Skin Cancer Prevention in High-Risk Patients

Safety and Efficacy

• The European Food Safety Authority guidelines indicate that the upper safety limit for nicotinamide is approximately 900 mg/day for adults, though the preventive dose of 1000 mg/day has proven safe in clinical trials 1
• Increased digestive side effects, such as nausea, vomiting, and diarrhea, may occur with nicotinamide but are generally mild 1
• No flushing occurs with nicotinamide, unlike nicotinic acid 1

Alternative Strategies for Special Populations

• For immunosuppressed organ transplant recipients, alternative chemopreventive strategies, such as systemic retinoids or capecitabine, should be considered instead 2

Practical Implementation and Sun Protection

• Nicotinamide should be combined with sun protection measures, including SPF ≥15 sunscreen, protective clothing, and sun avoidance from 10 AM-4 PM, as it is not a substitute for UV protection 3, 4