Because of Western medicine just things to be careful of. Possible interactions include: Alcohol. Taking niacin with alcohol might increase the risk of liver damage and worsen niacin side effects, such as flushing and itching. Allopurinol (Zyloprim). If you're taking niacin and have gout, you might need to take more of this gout medicine to control your gout. Anticoagulant and anti-platelet drugs, herbs and supplements. These types of drugs, herbs and supplements reduce blood clotting. Taking niacin with them might increase your risk of bleeding. Blood pressure drugs, herbs and supplements. Niacin might have an additive effect when you take blood pressure drugs, herbs or supplements. This could increase your risk of low blood pressure (hypotension). Chromium. Taking niacin with chromium might lower your blood sugar. If you have diabetes and take niacin and chromium, closely monitor your blood sugar levels.