acipimox: clinical use

Prescribing considerations

• Reserve for an appropriate lipid disorder after dietary and other non-pharmacological measures have been addressed.
• May be used as an alternative or adjunct following inadequate response to statin or fibrate treatment.
• Cardiovascular morbidity or mortality reduction has not been established.
• Assess renal function because acipimox is cleared almost entirely unchanged in urine and can accumulate in renal impairment.
• Use statin or fibrate combinations cautiously and investigate unexplained musculoskeletal symptoms.

Contraindications and cautions

• Hypersensitivity to acipimox or an excipient
• Peptic ulceration
• Severe renal impairment

Monitoring

• Baseline and periodic lipid profile to confirm response
• Renal function before and during treatment
• Hepatic function during treatment
• Muscle symptoms, particularly with statin or fibrate co-treatment

Clinical pharmacology

Acipimox is a nicotinic acid derivative and HCA2 agonist that suppresses adipose-tissue lipolysis. It is rapidly absorbed, is not significantly protein-bound or metabolised, and is eliminated almost completely unchanged in urine.

Formulation and product differences

• The selected product is a hard gelatin oral capsule containing powder.
• The capsule contains gelatin and is essentially sodium-free.
• Store in the original container below 30°C and protect from moisture.