Acipimox is used in the treatment of familial hyperlipidaemias of types IIb and IV especially those not responding to standard therapy such as statins and fibrates as well as patients who do not improve with lifestyle changes like diet, weight reduction and exercise.

Studies in patients with diabetes have shown that Acipimox (Olbetam) has little effect on glucose tolerance and dysglycemia.

Furthermore, compared to placebo, it did not lower LDL (low-density lipoprotein) levels and had no effect on HDL (high-density lipoprotein) levels. It reduces total cholesterol levels and triglyceride levels but has little effect on apolipoproteins AI, AII, or B levels. 

(Acipimox) Olbetam 250 mg dose in Adults

250 mg 2 to 3 times per day

Dose in Children:

It is not recommended for use in children.

Pregnancy Risk Category: N

• No information is available but the manufacturer advises avoiding its use in pregnancy and lactation. 

Olbetam 250 mg dose in kidney disease:

• If eGFR is less than 30 mL/minute/1.73 m2, avoid.
• If the eGFR is 30-60 mL/minute/1.73m2, lower the dosage to 250 mg once or twice daily.

Dose in Liver Disease:

• Avoid in case of extreme disease

Common side effects of olbetam:

Abdominal pain, dyspepsia, flushing, headache, malaise, and urticaria

Rare side effects of Acipimox:

• Pruritus
• Rash
• Diarrhoea
• Anaphylactoid reaction
• Arthralgia
• Bronchospasm
• Dry eyes
• Vasodilatation.
• Erythema
• Myalgia
• Myositis
• Nausea

Acipimox Contraindications:

• Peptic ulcer disease,
• Myocardial infarction,
• acute liver failure, and
• advanced renal disease.

Monitoring Parameters:

• Monitor lipid profile every 3 to 6 months.
• Monitor liver function tests.

How to administer?

• Like most drugs used to treat dyslipidemias, it should also be taken at bedtime. 

Mechanism of action (MOA) of Acipimox:

• Acipimox, which acts like niacin, inhibits the enzyme Triglyceride lipase.
• It is a niacin derivative and is used as a cholesterol-lowering agent. It lowers triglyceride and increases HDL cholesterol.
• There are fewer side effects than niacin. 

Internationally available brands:

• Nedios
• Olbemox
• Olbetam

Brands in Pakistan:

Olbetam (Pacific pharmaceuticals LTD)

            Capsules: 250 mg:

32 capsules pack