Objective:
To provide guidelines on the cautious use of nicotinamide as a neuroprotective agent specifically for patients with open-angle glaucoma.
Approach:
- High doses of nicotinamide (≥3 g/day) have shown improvements in retinal function in early human trials, indicating potential benefits for glaucoma patients.
- Two cases of drug-induced liver injury (DILI) were reported in glaucoma neuroprotection trials associated with high-dose nicotinamide, raising safety concerns.
- Nicotinamide is not approved as a glaucoma treatment, which limits its clinical application.
- Safety concerns arise from high doses exceeding the recommended daily intake, necessitating careful monitoring.
Key Findings:
Interpretation:
While nicotinamide shows potential as a neuroprotective agent, its safety at high doses is uncertain, necessitating caution and further research.
Limitations:
Conclusion:
The AGS and AAO recommend cautious use of nicotinamide due to potential serious side effects, particularly at high doses, and emphasize the need for monitoring in clinical practice.
Sources:
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