Acipimox

How it works

It inhibits lipolysis in adipose tissue, reducing the flux of free fatty acids to the liver and thereby lowering triglyceride and VLDL production.

Prescribing in practice

• Cutaneous flushing, itching and a sensation of warmth are common, particularly at the start of treatment, and may limit tolerability.
• Take with or after food to improve gastrointestinal tolerability and reduce flushing.
• Dose adjustment is needed in renal impairment as the drug is largely eliminated unchanged by the kidneys.

Monitoring

Monitor the fasting lipid profile to assess response and review renal function where impairment is suspected.

Counselling the patient

• Flushing and warmth are common when starting and usually settle with continued use.
• Take it with food, and continue your recommended diet alongside the medicine.

Evidence & guidelines

Acipimox is an established lipid-modifying agent used as an alternative or adjunct in hypertriglyceridaemia as described in the SPC.