Amost all the reports on the treatment of pellagra with nicotinic acid refer to unpleasant, but harmless, reactions. Fouts, Helmer, Lepkovsky and Jukes1 treated three cases of pellagra with 500 mg. and one case with 1 Gm. of nicotinic acid. A sensation of heat and tingling on the skin was noted in all four cases. These sensations appeared within ten minutes, lasted from ten to twenty minutes, and were accompanied by dilatation of the peripheral blood vessels and slight, temporary fall in blood pressure.
The Smiths and Ruffin2 observed a marked flushing of the face, neck, chest and arms a few minutes after intramuscular injection of 60 mg. of nicotinic acid, which lasted for fifteen minutes. A similar reaction followed the intravenous administration of approximately 12 mg. They note that the pulse, respiration and blood pressure were not affected and that there was no discomfort except for a
SEBRELL WH, BUTLER RE. A REACTION TO THE ORAL ADMINISTRATION OF NICOTINIC ACID. JAMA. 1938;111(25):2286–2287. doi:10.1001/jama.1938.02790510034009