Fenofibrate

Introduction

  • Generic Name: Fenofibrate
  • Brand Names: Tricor, Lipofen, Fenoglide
  • Pharmacological Class: Fibric acid derivative (Fibrate)
  • Mechanism of Action: Reduces triglycerides and increases high-density lipoprotein (HDL) cholesterol levels by activating peroxisome proliferator-activated receptor alpha (PPARα). This action helps to enhance the oxidation of fatty acids and reduce lipid production in the liver.

Indications

  • Primary Use: Treatment of hypertriglyceridemia (high triglyceride levels) and mixed dyslipidemia.
  • Other Uses: Sometimes used in combination with statins to reduce LDL cholesterol (bad cholesterol) levels in patients at risk of cardiovascular disease.

Dosage

  • Adults: Varies depending on the formulation and specific patient conditions. Commonly, 145 mg once daily.
  • Elderly: No major adjustments necessary, but caution is advised due to potential side effects.
  • Children: Not recommended for use in children.

Administration

  • Method: Oral intake.
  • Precautions: Should be taken with meals to increase absorption.

Forms Available

  • Tablets: 48 mg, 145 mg
  • Capsules: 50 mg, 150 mg, 200 mg
  • Microcoated Tablets: 160 mg

Side Effects

  • Common: Gastrointestinal symptoms (abdominal pain, diarrhea, nausea), headache, back pain.
  • Less Common: Increased liver enzymes, muscle pain, fatigue.
  • Rare but Serious: Rhabdomyolysis (severe muscle damage), liver toxicity, severe allergic reactions.

Warnings

  • Black Box Warning: None.
  • Contraindications: Severe liver disease, including primary biliary cirrhosis and unexplained persistent liver enzyme abnormalities; gallbladder disease; severe renal impairment; nursing mothers.

Precautions

  • General: Monitor liver function and CK (creatine kinase) levels to detect early signs of muscle or liver damage.
  • Health Conditions: Use with caution in patients with pre-existing gallbladder disease, renal impairment, or hypothyroidism.

Interactions

  • Medications: Risk of muscle toxicity increases when used with statins, certain immunosuppressants, and other fibric acid derivatives.
  • Food: No significant food interactions, but consistency in diet helps manage cholesterol levels.

Monitoring Parameters

  • Lipid Levels: Regular monitoring of LDL, HDL, and triglycerides.
  • Liver Function Tests: Periodic liver enzyme tests recommended.
  • Kidney Function: Assess renal function, especially in patients with known renal issues.

Use in Children

  • Guidelines: Not typically prescribed due to lack of safety and efficacy data.

Use in Pregnancy

  • FDA Category: C. Should only be used if the potential benefit justifies the potential risk to the fetus.

Use in Elderly

  • Considerations: Initiate treatment at the lowest effective dose and monitor for muscle and liver side effects.

Use in Kidney Disease

  • Adjustments: Dose adjustment may be necessary in patients with renal impairment.

Use in Liver Disease

  • Caution: Avoid use in patients with significant liver disease due to the risk of further liver damage.

Patient Counselling Points

  • Medication Use: Importance of taking as prescribed, not discontinuing without consulting healthcare provider.
  • Side Effects: Alert patients to report any muscle weakness, tenderness, or symptoms of liver problems immediately.
  • Lifestyle: Discuss the importance of diet, weight control, and physical activity in managing lipid levels.

Table of Brand Names, Manufacturer, and Prices in USD

Brand NameManufacturerStrength/Dosage FormPrice (USD)
TricorAbbVie145 mg Tablet$2.50
LipofenKowa150 mg Capsule$2.00
FenoglideSantarus120 mg Tablet$1.80

15 FAQs with Answers

  1. What is Fenofibrate used for? – Primarily for reducing high triglyceride and bad cholesterol levels.
  2. How does Fenofibrate work? – By activating enzymes that help break down fats in the blood.
  3. Can Fenofibrate be taken with food? – Yes, taking it with meals can improve drug absorption.
  4. What are common side effects of Fenofibrate? – Gastrointestinal discomfort, headaches, and back pain.
  5. Is Fenofibrate safe during pregnancy? – It is categorized under FDA Pregnancy Category C. Use only if clearly needed.
  6. Can I stop taking Fenofibrate if my symptoms improve? – Continue taking Fenofibrate as prescribed; do not stop without consulting your doctor.
  7. How often should my cholesterol levels be checked? – Regular monitoring as recommended by your healthcare provider.
  8. What should I do if I experience muscle pain while taking Fenofibrate? – Report muscle pain or weakness to your doctor immediately as it may indicate serious muscle damage.
  9. Can Fenofibrate cause liver issues? – Yes, it can increase liver enzymes; liver function should be monitored.
  10. Is it safe to consume alcohol while taking Fenofibrate? – Alcohol can increase triglyceride levels and should be consumed in moderation.
  11. Can Fenofibrate be used in children? – It is not generally recommended for children.
  12. What dietary recommendations should I follow while taking Fenofibrate? – A diet low in cholesterol and fats is typically recommended.
  13. What other medications can interact with Fenofibrate? – Statins and certain immunosuppressants can interact, increasing the risk of muscle damage.
  14. Who should not take Fenofibrate? – Patients with severe liver or kidney disease, and nursing mothers should avoid it.
  15. How does Fenofibrate affect kidney function? – Patients with pre-existing kidney disease should be monitored closely as Fenofibrate may affect renal function.