Acipimox

Registered South African indications:

• Familial hypercholesterolaemia
• Familial combined hyperlipidaemia
• Familial hypertriglyceridaemia
• Sporadic hypertriglyceridaemia

Contraindications

• Hypersensitivity to the active ingredient or any of its excipients
• Severe renal impairment
• Pregnancy
• Breastfeeding

Cautions

• Moderate renal impairment
• Hepatic impairment
• Cardiac disease
• Concomitant use with statins

Forms avail. in SA and covered in this monograph: cap

Familial hypercholesterolaemia
Familial combined hyperlipidaemia
Familial hypertriglyceridaemia
Sporadic hypertriglyceridaemia

• Oral (cap): Initial 250mg, 8-12hrly with meals; Max: 1200mg/24hrs

Acipimox should only be initiated after non-pharmacological interventions have failed

Not indicated for use in children

Pregnancy 

• Contraindicated 
• There is only limited experience to date of administration of acipimox to humans, therefore, epidemiological data is not available
• Animal studies have shown reproductive toxicity at high doses
• Taking into account the present experience of administration to humans of acipimox and that the safety of acipimox in human pregnancy has not yet been ascertained, it is recommended, therefore, that acipimox not be administered to women who are, or may be pregnant.

Breastfeeding 

• Contraindicated 
• In the absence of animal data on the levels of acipimox excreted in milk, acipimox should not be administered to women who are breastfeeding

Fertility 

• No human data on the effect of acipimox on fertility are available. In rats, there was no effect on mating or fertility with acipimox treatment

Renal Impairment

• Moderate: Caution; dose adjustment recommended
• Severe: Contraindicated  

Hepatic Impairment

• Caution; no information available

Elderly

• No dose adjustment recommended

Porphyria Information 

• Not yet classified (NC)
  

Central Nervous System Disorders

• Headache
• Asthenia
• Feeling hot
• Malaise

Cardiovascular Disorders

• Flushing
• Vasodilatation

Respiratory Disorders

• Bronchospasm

Gastrointestinal Disorders

• Dyspepsia
• Abdominal pain
• Nausea
• Diarrhoea

Musculoskeletal Disorders

• Myositis
• Myalgia
• Arthralgia

Skin and Subcutaneous Tissue Disorders

• Urticaria
• Angioedema
• Pruritus
• Rash
• Erythema

Immune, Blood and Lymphatic System Disorders

• Anaphylactiod reactions

Sensory Disorders

• Dry, gritty eyes

• Statins
• Fibrates

• Renal function
• Hepatic function

Acipimox inhibits the release of fatty acids from adipose tissue and reduces blood concentrations of very low-density lipoproteins and low-density lipoproteins with subsequent overall reduction in trigyceride and cholesterol levels. It also increases high-density lipoprotein levels.

Capsule 250mg 

• Olbetam (Pfizer) originator