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

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.