U.S. Department of Health & Human Services Divider Arrow National Institutes of Health Divider Arrow NCATS

Details

Stereochemistry ACHIRAL
Molecular Formula C6H6N2O3
Molecular Weight 154.1234
Optical Activity NONE
Defined Stereocenters 0 / 0
E/Z Centers 0
Charge 0

SHOW SMILES / InChI
Structure of ACIPIMOX

SMILES

CC1=[N+]([O-])C=C(N=C1)C(O)=O

InChI

InChIKey=DJQOOSBJCLSSEY-UHFFFAOYSA-N
InChI=1S/C6H6N2O3/c1-4-2-7-5(6(9)10)3-8(4)11/h2-3H,1H3,(H,9,10)

HIDE SMILES / InChI

Molecular Formula C6H6N2O3
Molecular Weight 154.1234
Charge 0
Count
Stereochemistry ACHIRAL
Additional Stereochemistry No
Defined Stereocenters 0 / 0
E/Z Centers 0
Optical Activity NONE

Acipimox (5-methylpyrazinecarboxylic acid 4-oxide) is a new lipolysis inhibitor that has a distant chemical relationship with nicotinic acid (NA). The anti-lipolytic action of acipimox is mediated through suppression of intracellular cyclic AMP levels, with the subsequent decrease in cyclic AMP-dependent protein kinase activity, leading to the reduced association of hormone-sensitive lipase with triacylglycerol substrate in the lipid droplet of adipocytes. Acipimox has been identified as an agonist at G-protein coupled nicotinic acid HM74A and HM74B receptors. Acipimox (Olbetam) is indicated for the treatment as alternative or adjunct treatment to reduce triglyceride levels in patients who have not responded adequately to other treatments such as statin or fibrate treatment for hypertriglyceridaemia (Fredrickson type IV hyperlipoproteinaemia) and hypercholesterolaemia and hypertriglyceridaemia (Fredrickson type IIb hyperlipoproteinaemia).

Originator

Curator's Comment: # Pfizer

Approval Year

TargetsConditions

Conditions

ConditionModalityTargetsHighest PhaseProduct
Primary
OLBETAM

Approved Use

Olbetam is indicated as alternative or adjunct treatment to reduce triglyceride levels in patients who have not responded adequately to other treatments such as statin or fibrate treatment for: • hypertriglyceridaemia (Fredrickson type IV hyperlipoproteinaemia); • hypercholesterolaemia and hypertriglyceridaemia (Fredrickson type IIb hyperlipoproteinaemia). Olbetam should be used after other measures have been taken such as dietary changes and other non-pharmacological treatment (e.g. exercise, weight reduction). It has not been shown that treatment of hyperlipoproteinaemia with acipimox leads to a reduction of cardiac morbidity or mortality.
Primary
OLBETAM

Approved Use

Olbetam is indicated as alternative or adjunct treatment to reduce triglyceride levels in patients who have not responded adequately to other treatments such as statin or fibrate treatment for: • hypertriglyceridaemia (Fredrickson type IV hyperlipoproteinaemia); • hypercholesterolaemia and hypertriglyceridaemia (Fredrickson type IIb hyperlipoproteinaemia). Olbetam should be used after other measures have been taken such as dietary changes and other non-pharmacological treatment (e.g. exercise, weight reduction). It has not been shown that treatment of hyperlipoproteinaemia with acipimox leads to a reduction of cardiac morbidity or mortality.
Cmax

Cmax

ValueDoseCo-administeredAnalytePopulation
3.51 μg/mL
250 mg single, oral
dose: 250 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
ACIPIMOX plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: FEMALE / MALE
food status: FASTED
1.03 μg/mL
250 mg single, oral
dose: 250 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
ACIPIMOX plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: FEMALE / MALE
food status: FASTED
0.5 μg/mL
250 mg single, oral
dose: 250 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
ACIPIMOX plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: FEMALE / MALE
food status: FASTED
4.68 μg/mL
250 mg single, oral
dose: 250 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
ACIPIMOX plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: FEMALE / MALE
food status: FASTED
2.31 μg/mL
250 mg single, oral
dose: 250 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
ACIPIMOX plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: FEMALE / MALE
food status: FASTED
0.43 μg/mL
250 mg single, oral
dose: 250 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
ACIPIMOX plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: FEMALE / MALE
food status: FASTED
3.858 μg/mL
250 mg single, oral
dose: 250 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
ACIPIMOX plasma
Homo sapiens
population: HEALTHY
age: UNKNOWN
sex: MALE
food status: FASTED
AUC

AUC

ValueDoseCo-administeredAnalytePopulation
12.84 μg × h/mL
250 mg single, oral
dose: 250 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
ACIPIMOX plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: FEMALE / MALE
food status: FASTED
3.8 μg × h/mL
250 mg single, oral
dose: 250 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
ACIPIMOX plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: FEMALE / MALE
food status: FASTED
1.66 μg × h/mL
250 mg single, oral
dose: 250 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
ACIPIMOX plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: FEMALE / MALE
food status: FASTED
14.07 μg × h/mL
250 mg single, oral
dose: 250 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
ACIPIMOX plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: FEMALE / MALE
food status: FASTED
7.32 μg × h/mL
250 mg single, oral
dose: 250 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
ACIPIMOX plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: FEMALE / MALE
food status: FASTED
1.77 μg × h/mL
250 mg single, oral
dose: 250 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
ACIPIMOX plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: FEMALE / MALE
food status: FASTED
13.345 μg × h/mL
250 mg single, oral
dose: 250 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
ACIPIMOX plasma
Homo sapiens
population: HEALTHY
age: UNKNOWN
sex: MALE
food status: FASTED
T1/2

T1/2

ValueDoseCo-administeredAnalytePopulation
1.406 h
250 mg single, oral
dose: 250 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
ACIPIMOX plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: FEMALE / MALE
food status: FASTED
1.467 h
250 mg single, oral
dose: 250 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
ACIPIMOX plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: FEMALE / MALE
food status: FASTED
2.236 h
250 mg single, oral
dose: 250 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
ACIPIMOX plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: FEMALE / MALE
food status: FASTED
1.487 h
250 mg single, oral
dose: 250 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
ACIPIMOX plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: FEMALE / MALE
food status: FASTED
1.468 h
250 mg single, oral
dose: 250 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
ACIPIMOX plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: FEMALE / MALE
food status: FASTED
1.348 h
250 mg single, oral
dose: 250 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
ACIPIMOX plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: FEMALE / MALE
food status: FASTED
1.39 h
250 mg single, oral
dose: 250 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
ACIPIMOX plasma
Homo sapiens
population: HEALTHY
age: UNKNOWN
sex: MALE
food status: FASTED
Doses

Doses

DosePopulationAdverse events​
1200 mg 3 times / day multiple, oral
Highest studied dose
Dose: 1200 mg, 3 times / day
Route: oral
Route: multiple
Dose: 1200 mg, 3 times / day
Sources:
unhealthy, ADULT
Health Status: unhealthy
Age Group: ADULT
Sex: M
Food Status: UNKNOWN
Sources:
Other AEs: Flushing, Itching...
Other AEs:
Flushing
Itching
Sources:
1200 mg single, oral
Highest studied dose
Dose: 1200 mg
Route: oral
Route: single
Dose: 1200 mg
Sources:
healthy, ADULT
Health Status: healthy
Age Group: ADULT
Sex: M
Food Status: FASTED
Sources:
AEs

AEs

AESignificanceDosePopulation
Flushing
1200 mg 3 times / day multiple, oral
Highest studied dose
Dose: 1200 mg, 3 times / day
Route: oral
Route: multiple
Dose: 1200 mg, 3 times / day
Sources:
unhealthy, ADULT
Health Status: unhealthy
Age Group: ADULT
Sex: M
Food Status: UNKNOWN
Sources:
Itching
1200 mg 3 times / day multiple, oral
Highest studied dose
Dose: 1200 mg, 3 times / day
Route: oral
Route: multiple
Dose: 1200 mg, 3 times / day
Sources:
unhealthy, ADULT
Health Status: unhealthy
Age Group: ADULT
Sex: M
Food Status: UNKNOWN
Sources:
Overview

OverviewOther

Other InhibitorOther SubstrateOther Inducer






Drug as perpetrator​

Drug as perpetrator​

TargetModalityActivityMetaboliteClinical evidence
no [IC50 >133 uM]
no [IC50 >133 uM]
no [IC50 >133 uM]
no [IC50 >133 uM]
no
no
no
no
no
Drug as victim

Drug as victim

TargetModalityActivityMetaboliteClinical evidence
no
Tox targets

Tox targets

TargetModalityActivityMetaboliteClinical evidence
PubMed

PubMed

TitleDatePubMed
Effects of growth hormone and free fatty acids on insulin sensitivity in patients with type 1 diabetes.
2009-09
The second-meal phenomenon in type 2 diabetes.
2009-07
Free fatty acids inhibit growth hormone/signal transducer and activator of transcription-5 signaling in human muscle: a potential feedback mechanism.
2009-06
Banting Lecture. From the triumvirate to the ominous octet: a new paradigm for the treatment of type 2 diabetes mellitus.
2009-04
Endoplasmic reticulum stress: another link between obesity and insulin resistance/inflammation?
2009-03
Diabetes treatment.
2009-03
Effects of prolonged fasting and sustained lipolysis on insulin secretion and insulin sensitivity in normal subjects.
2009-03
Extremely short duration high intensity interval training substantially improves insulin action in young healthy males.
2009-01-28
American College of Endocrinology Pre-Diabetes Consensus Conference: part three.
2008-12
Atrial natriuretic peptide induces postprandial lipid oxidation in humans.
2008-12
Butyrate ingestion improves hepatic glycogen storage in the re-fed rat.
2008-10-10
Changes in triglyceride levels over time and risk of type 2 diabetes in young men.
2008-10
Short-term flexibility of myocardial triglycerides and diastolic function in patients with type 2 diabetes mellitus.
2008-09
Increase in endoplasmic reticulum stress-related proteins and genes in adipose tissue of obese, insulin-resistant individuals.
2008-09
Effects of statins on high-density lipoproteins: a potential contribution to cardiovascular benefit.
2008-08
The lowering of hepatic fatty acid uptake improves liver function and insulin sensitivity without affecting hepatic fat content in humans.
2008-08
AAS, growth hormone, and insulin abuse: psychological and neuroendocrine effects.
2008-06
Glucose-insulin therapy, plasma substrate levels and cardiac recovery after cardiac ischemic events.
2008-04
Dose-response effects of free fatty acids on amino acid metabolism and ureagenesis.
2008-03
Inflammation and lipid accumulation in xanthoma disseminatum: Therapeutic considerations.
2008-02
Orlistat in the prevention of diabetes in the obese patient.
2008
Human visceral adipose tissue and the plasminogen activator inhibitor type 1.
2007-11
Inhibition of lipolysis stimulates peripheral glucose uptake but has no effect on endogenous glucose production in HIV lipodystrophy.
2007-08
Intense [18F]FDG tongue uptake in a case of acipimox-related angio-oedema during FDG-PET myocardial viability study.
2007-08
HIV-associated adipose redistribution syndrome (HARS): etiology and pathophysiological mechanisms.
2007-06-27
Effects on insulin secretion and insulin action of a 48-h reduction of plasma free fatty acids with acipimox in nondiabetic subjects genetically predisposed to type 2 diabetes.
2007-06
Dose-response effects of free fatty acids on glucose and lipid metabolism during somatostatin blockade of growth hormone and insulin in humans.
2007-05
Nicotinic acid receptor subtypes and their ligands.
2007-05
Comparison of rat and dog models of vasodilatation and lipolysis for the calculation of a therapeutic index for GPR109A agonists.
2007-04-11
Short-term manipulation of plasma free fatty acids does not change skeletal muscle concentrations of ceramide and glucosylceramide in lean and overweight subjects.
2007-04
Paradoxical changes in muscle gene expression in insulin-resistant subjects after sustained reduction in plasma free fatty acid concentration.
2007-03
Reduced plasma free fatty acid availability during exercise: effect on gene expression.
2007-03
Growth hormone-induced insulin resistance is associated with increased intramyocellular triglyceride content but unaltered VLDL-triglyceride kinetics.
2007-03
Combination therapy with acipimox enhances the effect of growth hormone treatment on linear body growth in the normal and small-for-gestational-age rat.
2006-12
No low-fat diet for the failing heart?
2006-11-14
Free fatty acid depletion acutely decreases cardiac work and efficiency in cardiomyopathic heart failure.
2006-11-14
Improved triglycerides and insulin sensitivity with 3 months of acipimox in human immunodeficiency virus-infected patients with hypertriglyceridemia.
2006-11
Inhibition of lipolysis does not affect insulin sensitivity to glucose uptake in the mourning dove.
2006-07
Potential role of new therapies in modifying cardiovascular risk in overweight patients with metabolic risk factors.
2006-06
Free fatty acids decrease circulating ghrelin concentrations in humans.
2006-05
Impact of diabetes mellitus on prediction of clinical outcome after coronary revascularization by 18F-FDG SPECT in patients with ischemic left ventricular dysfunction.
2006-01
[Effects of atorvastatin and acipimox on the lipid spectrum of blood plasma, endothelial function and a clinical course of unstable angina pectoris].
2006
Acute inhibition of lipolysis does not affect postprandial suppression of endogenous glucose production.
2005-12
Effect of a sustained reduction in plasma free fatty acid concentration on intramuscular long-chain fatty Acyl-CoAs and insulin action in type 2 diabetic patients.
2005-11
Effects of GH replacement therapy in adults on serum levels of leptin and ghrelin: the role of lipolysis.
2005-10
Inhibition of adipose tissue lipolysis increases intramuscular lipid use in type 2 diabetic patients.
2005-10
Inhibition of adipose tissue lipolysis increases intramuscular lipid and glycogen use in vivo in humans.
2005-09
[The pharmacokinetics and bioequivalence of acipimox sustained-release tablets after a single and multiple oral administration in healthy dogs].
2005-05
The effects of exercise and adipose tissue lipolysis on plasma adiponectin concentration and adiponectin receptor expression in human skeletal muscle.
2005-03
Plasma adiponectin is modestly decreased during 24-hour insulin infusion but not after inhibition of lipolysis by Acipimox.
2005
Patents

Sample Use Guides

The recommended dosage is one 250 mg capsule 2 or 3 times daily to be taken with or after meals. The lower dose is advised in type IV and the higher dose in types IIA and IIB hyperlipoproteinaemias.
Route of Administration: Oral
In Vitro Use Guide
Curator's Comment: Acipimox inhibits forskolin-stimulated intracellular cAMP accumulation in human HM74b-expressing cells and activate GTP gamma S binding in a dose-dependent manner.
Unknown
Substance Class Chemical
Created
by admin
on Mon Mar 31 17:58:35 GMT 2025
Edited
by admin
on Mon Mar 31 17:58:35 GMT 2025
Record UNII
K9AY9IR2SD
Record Status Validated (UNII)
Record Version
  • Download
Name Type Language
OLBETAM
Preferred Name English
ACIPIMOX
INN   MART.   MI   WHO-DD  
INN  
Official Name English
ACIPIMOX [MI]
Common Name English
5-METHYLPYRAZINE-2-CARBOXYLIC ACID-4-OXIDE
Systematic Name English
NSC-759818
Code English
acipimox [INN]
Common Name English
ACIPIMOX [MART.]
Common Name English
Acipimox [WHO-DD]
Common Name English
Classification Tree Code System Code
NCI_THESAURUS C98151
Created by admin on Mon Mar 31 17:58:35 GMT 2025 , Edited by admin on Mon Mar 31 17:58:35 GMT 2025
WHO-VATC QC10AD06
Created by admin on Mon Mar 31 17:58:35 GMT 2025 , Edited by admin on Mon Mar 31 17:58:35 GMT 2025
WHO-ATC C10AD06
Created by admin on Mon Mar 31 17:58:35 GMT 2025 , Edited by admin on Mon Mar 31 17:58:35 GMT 2025
Code System Code Type Description
PUBCHEM
5310993
Created by admin on Mon Mar 31 17:58:35 GMT 2025 , Edited by admin on Mon Mar 31 17:58:35 GMT 2025
PRIMARY
WIKIPEDIA
ACIPIMOX
Created by admin on Mon Mar 31 17:58:35 GMT 2025 , Edited by admin on Mon Mar 31 17:58:35 GMT 2025
PRIMARY
EPA CompTox
DTXSID2046202
Created by admin on Mon Mar 31 17:58:35 GMT 2025 , Edited by admin on Mon Mar 31 17:58:35 GMT 2025
PRIMARY
MESH
C027696
Created by admin on Mon Mar 31 17:58:35 GMT 2025 , Edited by admin on Mon Mar 31 17:58:35 GMT 2025
PRIMARY
RXCUI
16817
Created by admin on Mon Mar 31 17:58:35 GMT 2025 , Edited by admin on Mon Mar 31 17:58:35 GMT 2025
PRIMARY RxNorm
SMS_ID
100000092318
Created by admin on Mon Mar 31 17:58:35 GMT 2025 , Edited by admin on Mon Mar 31 17:58:35 GMT 2025
PRIMARY
NCI_THESAURUS
C72982
Created by admin on Mon Mar 31 17:58:35 GMT 2025 , Edited by admin on Mon Mar 31 17:58:35 GMT 2025
PRIMARY
ChEMBL
CHEMBL345714
Created by admin on Mon Mar 31 17:58:35 GMT 2025 , Edited by admin on Mon Mar 31 17:58:35 GMT 2025
PRIMARY
MERCK INDEX
m1372
Created by admin on Mon Mar 31 17:58:35 GMT 2025 , Edited by admin on Mon Mar 31 17:58:35 GMT 2025
PRIMARY Merck Index
FDA UNII
K9AY9IR2SD
Created by admin on Mon Mar 31 17:58:35 GMT 2025 , Edited by admin on Mon Mar 31 17:58:35 GMT 2025
PRIMARY
DRUG CENTRAL
76
Created by admin on Mon Mar 31 17:58:35 GMT 2025 , Edited by admin on Mon Mar 31 17:58:35 GMT 2025
PRIMARY
NSC
759818
Created by admin on Mon Mar 31 17:58:35 GMT 2025 , Edited by admin on Mon Mar 31 17:58:35 GMT 2025
PRIMARY
EVMPD
SUB05237MIG
Created by admin on Mon Mar 31 17:58:35 GMT 2025 , Edited by admin on Mon Mar 31 17:58:35 GMT 2025
PRIMARY
CAS
51037-30-0
Created by admin on Mon Mar 31 17:58:35 GMT 2025 , Edited by admin on Mon Mar 31 17:58:35 GMT 2025
PRIMARY
DRUG BANK
DB09055
Created by admin on Mon Mar 31 17:58:35 GMT 2025 , Edited by admin on Mon Mar 31 17:58:35 GMT 2025
PRIMARY
ECHA (EC/EINECS)
256-928-3
Created by admin on Mon Mar 31 17:58:35 GMT 2025 , Edited by admin on Mon Mar 31 17:58:35 GMT 2025
PRIMARY
INN
3809
Created by admin on Mon Mar 31 17:58:35 GMT 2025 , Edited by admin on Mon Mar 31 17:58:35 GMT 2025
PRIMARY
Related Record Type Details
ACTIVE MOIETY