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CARDIOVASCULAR SYSTEM › LIPID MODIFYING AGENTS › LIPID MODIFYING AGENTS, PLAIN › Nicotinic acid and derivatives
acipimox
C10AD06
Adult Dosing
- Hyperlipidemia: 250 mg orally 2 to 3 times daily with meals
- Dose adjustment may be necessary in renal impairment (creatinine clearance < 50 mL/min)
Pediatric Dosing
- Safety and efficacy in pediatric patients have not been established
Indications
- Treatment of primary hypertriglyceridemia (Type IV hyperlipidemia)
- Treatment of mixed hyperlipidemia (Type IIb hyperlipidemia) when other agents are inadequate
Mechanism of Action
- Niacin derivative acting as an agonist for the G-protein coupled receptor GPR109A
- Inhibits lipolysis in adipose tissue, leading to decreased levels of free fatty acids
- Reduces hepatic VLDL and triglyceride synthesis and secretion
- Increases HDL-cholesterol levels
Contraindications
- Hypersensitivity to acipimox or niacin derivatives
- Active peptic ulcer disease
- Severe renal impairment
- Acute myocardial infarction
Adverse Reactions
- Flushing and sensation of warmth
- Pruritus and rash
- Gastrointestinal discomfort, nausea, and abdominal pain
- Headache and dizziness
- Transient elevations in liver transaminases
Drug Interactions
- HMG-CoA reductase inhibitors (statins): increased risk of myopathy and rhabdomyolysis
- Bile acid sequestrants: may decrease absorption of acipimox if given concomitantly
- Antihypertensive agents: potential for enhanced hypotensive effect
Curated Content: Needs Vetting Before Put to Clinical Use