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Indications and Dosage
Oral
Fredrickson type IIb hyperlipoproteinaemia, Fredrickson type IV hyperlipoproteinaemia Adult: As an alternative or adjunct in patients who have not responded adequately to other treatments (e.g. statins, fibrates): Usual dose: 250 mg bid or tid. Dose is individualised based on the patient's plasma triglyceride and cholesterol levels. Dosing recommendations may vary among individual products and between countries (refer to specific product guidelines).
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Renal Impairment
Dosing recommendations may vary among individual products and between countries (refer to specific product guidelines).
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Administration
Should be taken with food. Take w/ or after meals.
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Contraindications
Active peptic ulcer. Severe renal impairment (CrCl <30 mL/min). Pregnancy and lactation. Contraindications may vary among individual products (refer to specific product labelling for detailed information).
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Special Precautions
Patient with acute haemorrhage; heart failure. Management with dietary changes and other non-pharmacological treatments (e.g. exercise, weight reduction, smoking or alcohol cessation) should be attempted prior to initiating treatment. Hepatic and mild to moderate renal impairment.
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Adverse Reactions
Significant: Pruritus, flushing, erythema, rash.
Eye disorders: Eye irritation, dry eyes. Gastrointestinal disorders: Dyspepsia, upper abdominal pain, nausea, diarrhoea. General disorders and administration site conditions: Asthenia, malaise, feeling hot. Immune system disorders: Anaphylactoid reaction. Musculoskeletal and connective tissue disorders: Myalgia, arthralgia, myositis. Nervous system disorders: Headache. Respiratory, thoracic and mediastinal disorders: Bronchospasm. Skin and subcutaneous tissue disorders: Urticaria, angioedema. Vascular disorders: Vasodilation. |
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Monitoring Parameters
Monitor lipid profile, liver and kidney function at baseline and periodically during therapy.
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Drug Interactions
May enhance the myopathic (rhabdomyolysis) effect of statins and fibrates.
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Action
Description:
Mechanism of Action: Acipimox lowers blood cholesterol by inhibiting the release of fatty acids from adipose tissue and reducing serum levels of VLDL and LDL with a subsequent overall lowering of triglyceride and cholesterol levels. Additionally, it increases HDL concentrations during treatment. Pharmacokinetics: Absorption: Rapidly and completely absorbed from the gastrointestinal tract. Time to peak plasma concentration: Approx 2 hours. Metabolism: Not significantly metabolised. Excretion: Via urine (mainly unchanged). Elimination half-life: Approx 2 hours. |
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Chemical Structure
 Source: National Center for Biotechnology Information. PubChem Compound Summary for CID 5310993, Acipimox. https://pubchem.ncbi.nlm.nih.gov/compound/Acipimox. Accessed May 26, 2022. |
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Storage
Store below 30°C. Protect from moisture.
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MIMS Class
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ATC Classification
C10AD06 - acipimox ; Belongs to the class of nicotinic acid and derivatives. Used in the treatment of hyperlipidemia.
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References
Anon. Acipimox. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 13/01/2022. Buckingham R (ed). Acipimox. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 13/01/2022. Joint Formulary Committee. Acipimox. British National Formulary [online]. London. BMJ Group and Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 13/01/2022. Olbetam 250 mg Capsules (Pfizer Limited). MHRA. https://products.mhra.gov.uk. Accessed 13/01/2022. Pfizer New Zealand Limited. Olbetam 250 mg Capsule data sheet 3rd May 2019. Medsafe. http://www.medsafe.govt.nz. Accessed 13/01/2022.
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