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if a patient is on blood pressure-lowering drugs (such as beta blockers, alpha-1 blockers, or vasodilators), niacinamide injections could lead to an additive drop in blood pressure

Williamson, L

The risk for complications rises if you: Have kidney, heart, or liver disease Have ever had a heart attack, stroke, or diabetic ketoacidosis Drink regularly or binge drink Take certain other medications, such as methazolamide (for glaucoma), and anti-seizure drugs like topiramate (Topamax, in Qsymia), zonisamide (Zonegran), and others Metformin is a generic drug that is inexpensive, OMahony notes

Some individuals may experience temporary bruising, redness, or mild discomfort at the injection site

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J., Nguyen, S