 Large, pharmaceutical doses of the nicotinic acid are used under medical supervision as a treatment for hypercholesterolemia.High doses of nicotinic acid are also associated with a potential for adverse effects, most commonly a niacin flush reaction that is characterized by redness or flushing of the skin, sensations of heat, itching, and tingling.The nicotinamide vitamer of vitamin B3 does not exhibit the same therapeutic effect for treatment of hypercholesterolemia, but also does not cause a niacin flush reaction and is not associated with the same adverse effects as nicotinic acid.