1 Introduction
Epidemiological data have identified elevated low-density lipoprotein cholesterol levels as a common risk factor for cardiovascular disease. Niacin has usually been recommended to control lipid levels as monotherapy in patients intolerant to statins (1-4). However, a high incidence of niacin-induced adverse events such as pruritus, flushing, gastrointestinal disorders and hepatobiliary disorders has been reported (5). Because of its lower incidence of adverse events than niacin, acipimox is used to reduce lipid levels instead of nicotinic acid under most circumstances (6). However, acipimox-induced hepatotoxicity might be ignored by physicians or clinical pharmacists. In addition, it is difficult to manage drug-induced hepatotoxicity in some cases owing to the lack of valid clinical biomarkers and limited treatment methods.
This study reported a rare case of acipimox-induced hepatocellular injury in a patient with hyperlipidemia, and it represents the first reported case confirmed by a positive rechallenge test.