Acipimox

Acipimox
Systematic (IUPAC) name


5-carboxy-2-methyl-1-oxidopyrazin-1-ium
Clinical data
Trade names	Olbetam
AHFS/Drugs.com	International Drug Names
Routes of administration	Oral
Legal status
Legal status	UK: POM (Prescription only)
Identifiers
CAS Number	51037-30-0^Y
ATC code	C10AD06 (WHO)
PubChem	CID 5310993
IUPHAR/BPS	1596
ChemSpider	4470534^Y
UNII	K9AY9IR2SD^Y
KEGG	D07190^Y
ChEMBL	CHEMBL345714^Y
Chemical data
Formula	C₆H₆N₂O₃
Molar mass	154.13 g·mol⁻¹
SMILES [O-][n+]1c(cnc(C(=O)O)c1)C
InChI InChI=1S/C6H6N2O3/c1-4-2-7-5(6(9)10)3-8(4)11/h2-3H,1H3,(H,9,10)^Y Key:DJQOOSBJCLSSEY-UHFFFAOYSA-N^Y
(verify)

Acipimox (trade name Olbetam in Europe) is a niacin derivative used as a hypolipidemic agent. It is used in low doses and may have less marked adverse effects, although it is unclear whether the recommended dose is as effective as are standard doses of nicotinic acid. Acipimox inhibits the production of triglycerides by the liver and the secretion of VLDL cholesterol, which leads indirectly to a modest reduction in LDL and increase in HDL cholesterol. Long-term administration is associated with reduced mortality, but unwanted effects limit its clinical use. Adverse effects include flushing (associated with prostaglandin D₂), palpitations, and gastrointestinal disturbances. Flushing can be reduced by taking aspirin 20 to 30 minutes before taking acipimox. High doses can cause disorders of liver function, impair glucose tolerance and precipitate gout.

Lipid modifying agents (C10)

GI tract

Cholesterol absorption inhibitors, NPC1L1	Ezetimibe SCH-48461

Bile acid sequestrants/resins (LDL)	Cholestyramine Colestipol Colestilan Colextran Colesevelam

Liver

Statins (HMG-CoA reductase, LDL)	Simvastatin^# Atorvastatin Fluvastatin Lovastatin Mevastatin Pitavastatin Pravastatin Rosuvastatin Cerivastatin^‡

Niacin and derivatives (HDL and LDL)	Niceritrol Niacin Nicofuranose Aluminium nicotinate Nicotinyl alcohol Acipimox

MTTP inhibitors (VLDL)	Dirlotapide Lomitapide Mitratapide

Blood vessels

Fibrates (PPAR)	Clofibrate^‡ Bezafibrate Aluminium clofibrate Gemfibrozil Fenofibrate Simfibrate Ronifibrate Ciprofibrate Etofibrate Clofibride Clinofibrate

CETP inhibitors (HDL)	Anacetrapib^† Dalcetrapib^§ Evacetrapib^§ Torcetrapib^§

Combinations

Other

^#WHO-EM
^‡Withdrawn from market
Clinical trials:
- ^†Phase III
- ^§Never to phase III

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