Rationale: Drug-induced liver injury (DILI) is a prevalent and critical etiology of acute liver failure that often results in substantial health complications and mortality. Acipimox is a pharmacological agent used for lipid reduction, whereas telmisartan is prescribed for hypertension management. We report a case of severe DILI attributed to the concomitant use of acipimox and telmisartan, and we analyze the potential underlying mechanisms. Patient concerns: A 58-year-old female was admitted to our hospital with anorexia lasting >6 months. The patient had a history of taking oral antihypertensive medication (telmisartan) and lipid-lowering medications (atorvastatin and acipimox), with suspected DILI. Diagnoses: The patient was diagnosed with DILI. Interventions: After discontinuation of the suspected hepatotoxic agents telmisartan and acipimox, the patient received anti-inflammatory therapy with glucocorticoids along with hepatoprotective treatment including glutathione, S-adenosylmethionine, and bicyclol. Outcomes: The patient’s liver function has substantially normalized. Lessons: This study is the first to highlight a significant case of severe liver injury resulting from concurrent administration of acipimox and telmisartan, which is potentially influenced by factors such as age, sex, drug interactions, and genetic polymorphisms. This study aimed to emphasize the significance of implementing precise and individualized treatment strategies for managing drug combinations for patients with multiple comorbidities.
Liu et al. (2025) studied this question.