A nicotinic-acid-related lipid medicine
Acipimox
A nicotinic-acid-related medicine used to lower high triglycerides and cholesterol in selected people.
What is Acipimox?
Acipimox is a lipid-lowering medicine related to nicotinic acid (a form of vitamin B3), used to lower high levels of blood fats such as triglycerides and cholesterol, usually in people who cannot take or are not helped enough by other treatments. It works by reducing the release of fats from the body's stores. Its most noticeable effect is flushing (a warm, red, sometimes itchy feeling, often of the face), which is common at first but usually lessens with continued use. It is taken with food.
Education and reference only. This is a plain-language guide to Acipimox — it deliberately contains no doses. Doses depend on the person, the brand and the reason for treatment, and belong with your prescriber. Always check the BNF, the product labelling (SmPC) and follow medical advice.
What it is
Acipimox is a medicine related to nicotinic acid (niacin, a form of vitamin B3) used to lower high levels of fats in the blood, particularly triglycerides and cholesterol. It is generally used in people whose blood fats remain high despite diet and other measures, or who cannot take or are not helped enough by other lipid-lowering medicines. By lowering these blood fats it aims to reduce the long-term risks linked to them. It is taken by mouth as a capsule, usually with food.
How it works
Acipimox reduces the breakdown and release of stored fat from the body's fat tissue into the blood. With less fat reaching the liver, the liver makes fewer of the fat-carrying particles that raise triglyceride and cholesterol levels, so these blood fats fall. The flushing it can cause comes from the same family of effects as nicotinic acid: a temporary widening of small blood vessels in the skin, producing warmth and redness that usually eases as the body gets used to the medicine.
Company & origin
Originated / developed by: Pfizer.
A nicotinic-acid-related medicine used in the UK to lower high blood fats (triglycerides and cholesterol) in certain people.
What it treats
Conditions Acipimox is used for
Practical use
How to take Acipimox
General, dose-free guidance — always follow your prescriber's and the leaflet's specific instructions.
- Take it with food, which can reduce flushing and stomach upset.
- Swallow the capsules with a drink of water.
- Expect some flushing or warmth, especially at first; it usually lessens as your body gets used to the medicine.
- Keep taking it regularly as prescribed, alongside a healthy diet and lifestyle, even once you feel well.
- Tell your prescriber if flushing, stomach upset or other effects are troublesome.
Weighing it up
Advantages & disadvantages of Acipimox
Advantages
- Lowers high blood fats such as triglycerides and cholesterol.
- A useful option for people who cannot take, or are not helped enough by, other lipid-lowering medicines.
- Flushing, its most common effect, usually settles with continued use.
Disadvantages
- Commonly causes flushing, warmth and itching, particularly at the start.
- Can cause headache and stomach upset.
- Generally a second-line option rather than a first-choice lipid treatment.
Practical use
Good to know
The effect people notice most is flushing: a warm, red and sometimes itchy or tingling sensation, often in the face and upper body, which can happen soon after a dose. This is harmless and very common when starting, and it usually settles over days to weeks as your body adjusts; taking it with food can help. Other effects can include headache, an upset stomach or a feeling of warmth. It is used in selected people rather than as a first-choice treatment, and it works alongside, not instead of, a healthy diet, weight management and not smoking. People with stomach ulcers or significant kidney problems may not be able to take it, so your prescriber will check your background first.
Who should not take it / use with caution
- People with an active stomach or duodenal ulcer should not take it.
- It is used with caution, or avoided, in people with significant kidney problems.
- It is not used in pregnancy or breastfeeding unless a specialist advises.
Monitoring
- Blood tests to check that triglyceride and cholesterol levels are improving.
- Reviewing tolerability, particularly flushing and stomach effects.
- Checking kidney function and overall cardiovascular risk as part of treatment.
Side effects
- Flushing, warmth, redness and itching, especially when starting, usually easing over time.
- Headache, indigestion, nausea or stomach upset.
- Less often, a rash, tiredness or a general feeling of being unwell.
Key interactions
- Used together with statins, there may be a slightly greater chance of muscle effects, so any unexplained muscle pain should be reported.
- Other lipid-lowering medicines may be combined with it under medical guidance.
- Tell your prescriber about all your medicines, as the lipid-lowering plan is tailored to you.
Available as: Capsules taken by mouth, usually with food.
Answers
Acipimox: frequently asked questions
What is acipimox for?
It is a nicotinic-acid-related medicine used to lower high blood fats such as triglycerides and cholesterol, usually in people who cannot take or are not helped enough by other treatments.
Why do I feel hot and flushed after taking it?
Flushing, a warm, red and sometimes itchy feeling, is a common effect related to nicotinic acid. It is harmless and usually settles as your body gets used to the medicine.
Can I do anything to reduce the flushing?
Taking it with food can help, and the flushing usually lessens over days to weeks as you continue treatment.
Is it a first-choice treatment?
It is generally used as a second-line option in selected people, rather than as a first-choice lipid-lowering medicine.
Does it replace a healthy diet?
No. It works alongside a healthy diet, weight management and not smoking, rather than instead of them.
Authoritative sources
- BNF
- NICE CKS
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