Guide
nicotinamide riboside (NR) and medications: what to check
No dedicated trial has tested nicotinamide riboside combined with a specific prescription medication. The largest safety trial excluded people taking blood-pressure or cholesterol-lowering drugs, so there's no trial data covering those combinations either way.
No dedicated human trial has tested nicotinamide riboside combined with a specific prescription medication. The largest safety trial screened out people taking blood-pressure or cholesterol-lowering medications before it even started, which means the reassuring safety data from that trial doesn't extend to those combinations.
Blood pressure and cholesterol medications
The largest controlled trial of nicotinamide riboside (140 adults, up to 1,000 mg/day for 8 weeks) specifically excluded people already using antihypertensive or lipid-lowering medications (PMID 31278280). That's a research-screening decision, not a documented interaction — but it means there's no trial data on taking nicotinamide riboside alongside either type of drug. Separately, nicotinamide riboside taken alone did not raise LDL cholesterol in that trial, which is worth knowing if you're already managing cholesterol with medication — though it's not the same as a tested combination (PMID 31278280). Ask a doctor or pharmacist before combining nicotinamide riboside with a statin, such as atorvastatin, or with any blood-pressure medication.
Alcohol and a history of substance use
The same 140-person trial excluded people who drank more than 2 alcoholic servings a day or had a recent history of alcohol or drug abuse (PMID 31278280). That's an absence of trial data on combining nicotinamide riboside with regular alcohol use, not a documented warning — ask a doctor if this applies to you.
Antidepressants, diabetes medications, and blood thinners
We found no dedicated trial testing nicotinamide riboside against an antidepressant, a diabetes medication such as metformin, or a blood thinner. That's an absence of evidence, not evidence of safety — ask a doctor or pharmacist before combining nicotinamide riboside with any prescription medication, including these.
Other supplements
Nicotinamide riboside is sometimes sold blended with other ingredients, such as pterostilbene or resveratrol. One trial of a nicotinamide-riboside-and-pterostilbene combination product found a dose- and time-dependent rise in LDL cholesterol that wasn't seen when nicotinamide riboside was tested alone (PMID 31278280) — a reason to know what else is in a blended product before combining it with anything you're already taking. See how to choose a good nicotinamide riboside (NR) for more on reading a blended label.
Questions people ask
Does nicotinamide riboside interact with any medications?
No dedicated nicotinamide-riboside-plus-drug trial exists for any specific medication. The largest safety trial specifically excluded people on blood-pressure or cholesterol medication, so there's no trial data on those combinations — ask a doctor or pharmacist before combining nicotinamide riboside with a prescription medication.
Can I take nicotinamide riboside with a statin, like atorvastatin?
No dedicated trial has tested this combination. The largest NR safety trial excluded people already on cholesterol-lowering medication, so there's no direct evidence either way — ask a doctor or pharmacist before combining them.
Can I take nicotinamide riboside with blood pressure medication?
No dedicated trial has tested this combination, and people on antihypertensive medication were excluded from the largest safety trial. Ask a doctor before combining them.
Is nicotinamide riboside a blood thinner?
No trial we reviewed measured its effect on blood clotting. If you take a blood thinner, ask a doctor before adding any new supplement.
What should you not take with nicotinamide riboside?
There's no trial-documented combination to specifically avoid, but ask a doctor or pharmacist before combining it with a blood-pressure medication, a cholesterol-lowering medication, or any other prescription drug, since none of these has been tested together.
Related reading: nicotinamide riboside (NR) side effects, who should not take nicotinamide riboside (NR)?, and how much nicotinamide riboside (NR) should you take a day?
Sources
- Safety and Metabolism of Long-term Administration of NIAGEN (Nicotinamide Riboside Chloride) in a Randomized, Double-Blind, Placebo-controlled Clinical Trial of Healthy Overweight Adults A 2019 randomized, placebo-controlled trial of 140 adults found nicotinamide riboside raised blood NAD+ dose-dependently at 100-1,000 mg/day over 8 weeks with no reports of flushing and no rise in LDL cholesterol or homocysteine, unlike the other forms of vitamin B3.
*These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.