Trilipix
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Trilipix
SIDE EFFECTS
Clinical Trials Experience
Because clinical studies are conducted under widely varying conditions, adverse event rates observed in the clinical studies of a drug cannot be directly compared to rates in the clinical studies of another drug.
Trilipix (fenofibric acid)
Monotherapy
Treatment-emergent adverse events reported in 3% or more of patients treated with Trilipix during the randomized controlled trials are listed in Table 1 below.
Co-Administration Therapy with Statins (Double-blind Controlled Trials)
Treatment-emergent adverse events reported in 3% or more of patients treated with Trilipix co-administered with statins during the randomized controlled trials are listed in Table 1 below.
Table 1: Treatment-Emergent Adverse Events Reported in ≥ 3%
of Patients Receiving Trilipix or Trilipix Co-Administered with a Statin During
Double-Blind Controlled Studies [Number (%)]
| Adverse Event | Trilipix (N = 490) |
Low-Dose Statin (N = 493) |
Trilipix + Low-Dose Statin (N = 490) |
Moderate-Dose Statin (N = 491) |
Trilipix + Moderate-Dose Statin (N = 489) |
High-Dose Statin (N = 245) |
| Gastrointestinal Disorders | ||||||
| Constipation | 16 (3.3) | 11 (2.2) | 16(3.3) | 13 (2.6) | 15(3.1) | 6(2.4) |
| Diarrhea | 19(3.9) | 16(3.2) | 15(3.1) | 24 (4.9) | 18 (3.7) | 17 (6.9) |
| Dyspepsia | 18(3.7) | 13(2.6) | 13(2.7) | 17 (3.5) | 23 (4.7) | 6(2.4) |
| Nausea | 21 (4.3) | 18 (3.7) | 17(3.5) | 22 (4.5) | 27 (5.5) | 10(4.1) |
| General Disorders and Administration Site Conditions | ||||||
| Fatigue | 10 (2.0) | 13 (2.6) | 13(2.7) | 13 (2.6) | 16(3.3) | 5(2.0) |
| Pain | 17 (3.5) | 9(1.8) | 16 (3.3) | 8(1.6) | 7(1-4) | 8(3.3) |
| Infections and Infestations | ||||||
| Nasopharyngitis | 17(3.5) | 29 (5.9) | 23 (4.7) | 16(3.3) | 21 (4.3) | 9(3.7) |
| Sinusitis | 16 (3.3) | 4 (0.8) | 14 (2.9) | 8(1.6) | 17 (3.5) | 4(1.6) |
| Upper Respiratory Tract Infection | 26 (5.3) | 13(2.6) | 18(3.7) | 23 (4.7) | 23 (4.7) | 7 (2.9) |
| Investigations | ||||||
| ALT Increased | 6(1.2) | 2 (0.4) | 15(3.1) | 2(0.4) | 12 (2,5) | 4(1.6) |
| Musculoskeletal and Connective Tissue Disorders | ||||||
| Arthralgia | 19(3.9) | 22 (4.5) | 21 (4.3) | 21 (4.3) | 17(3.5) | 12 (4.9) |
| Back Pain | 31 (6.3) | 31(6.3) | 30(6.1) | 32(6.5) | 20(4,1) | 8(3.3) |
| Muscle Spasms | 8(1.6) | 18(3.7) | 12 (2.4) | 24 (4.9) | 15(3.1) | 6 (2.4) |
| Myalgia | 16(3.3) | 24 (4.9) | 17 (3.5) | 23 (4.7) | 15 (3.1) | 15(6.1) |
| Pain in Extremity | 22 (4.5) | 24(4.9) | 14(2.9) | 21(4.3) | 13 (2.7) | 9(3.7) |
| Nervous System Disorders | ||||||
| Dizziness | 20(4.1) | 8(1.6) | 19 (3.9) | 11 (2.2) | 16(3.3) | 2 (0.8) |
| Headache | 62 (12.7) | 64(13.0) | 64 (13.1) | 82 (16.7) | 58(11.9) | 32(13.1) |
| Low-dose statin = rosuvastatin 10 mg, simvastatin 20 mg, or
atorvastatin 20 mg Moderate-dose statin = rosuvastatin 20 mg, simvastatin 40 mg, or atorvastatin 40 mg High-dose statin = rosuvastatin 40 mg, simvastatin 80 mg, or atorvastatin 80 mg |
||||||
Co-Administration Therapy with Statins (Long-Term Exposure for up to 64 Weeks')
Patients successfully completing any one of the three double-blind, controlled studies were eligible to participate in a 5 2-week long-term extension study where they received Trilipix co-administered with the moderate dose statin. A total of 2201 patients received at least one dose of Trilipix co-administered with a statin in the double-blind controlled study or the long-term extension study for up to a total of 64 weeks of treatment. Additional treatment-emergent adverse events (not listed in Table 1 above) reported in 3% or more of patients receiving Trilipix co-administered with a statin in either the double-blind controlled studies or the long-term extension study are provided below.
Infections and Infestations
Bronchitis, influenza, and urinary tract infection.
Investigations
AST increased, blood CPK increased, and hepatic enzyme increased.
Musculoskeletal and Connective Tissue Disorders
Musculoskeletal pain.
Psychiatric Disorders
Insomnia.
Respiratory, Thoracic, and Mediastinal Disorders
Cough and pharyngolaryngeal pain.
Vascular Disorders
Fenofibrate
Fenofibric acid is the active metabolite of fenofibrate. Adverse events reported by 2% or more of patients treated with fenofibrate and greater than placebo during double-blind, placebo-controlled trials are listed in Table 2. Adverse events led to discontinuation of treatment in 5.0% of patients treated with fenofibrate and in 3.0% treated with placebo. Increases in liver tests were the most frequent events, causing discontinuation of fenofibrate treatment in 1.6% of patients in double-blind trials.
Table 2. Adverse Events Reported by 2% or More of
Patients Treated with Fenofibrate and Greater than Placebo During the Double-Blind,
Placebo-Controlled Trials
| BODY SYSTEM Adverse Event |
Fenofibrate* (N = 439) |
Placebo (N = 365) |
| BODY AS A WHOLE | ||
| Abdominal Pain | 4.6% | 4.4% |
| Back Pain | 3.4% | 2.5% |
| Headache | 3.2% | 2.7% |
| DIGESTIVE | ||
| Nausea | 2.3% | 1.9% |
| Constipation | 2.1% | 1.4% |
| INVESTIGATIONS | ||
| Abnormal Liver Tests | 7.5% | 1.4% |
| Increased AST | 3.4% | 0.5% |
| Increased ALT | 3.0% | 1.6% |
| Increased Creatine Phosphokinase | 3.0% | 1.4% |
| RESPIRATORY | ||
| Respiratory Disorder | 6.2% | 5.5% |
| Rhinitis | 2.3% | 1.1% |
| * Dosage equivalent to 135 mg Trilipix | ||
Postmarketing Experience
The following adverse events have been identified during postapproval use of fenofibrate: myalgia, rhabdomyolysis, pancreatitis, renal failure, muscle spasms, acute renal failure, hepatitis, cirrhosis, anemia, arthralgia, asthenia, and severely depressed HDL-cholesterol levels.
Because these events are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a casual relationship to drug exposure.
Read the Trilipix (fenofibric acid capsules) Side Effects Center for a complete guide to possible side effects »
DRUG INTERACTIONS
Coumarin Anticoagulants
Potentiation of coumarin-type anticoagulant effect has been observed with prolongation of the PT/INR.
Caution should be exercised when oral coumarin anticoagulants are given in conjunction with Trilipix. The dosage of the anticoagulant should be reduced to maintain the PT/INR at the desired level to prevent bleeding complications. Frequent PT/INR determinations are advisable until it has been definitely determined that the PT/INR has stabilized [see WARNINGS AND PRECAUTIONS].
Bile Acid Binding Resins
Since bile acid binding resins may bind other drugs given concurrently, patients should take Trilipix at least 1 hour before or 4 to 6 hours after a bile acid resin to avoid impeding its absorption.
Immunosuppressants
Immunosuppressants such as cyclosporine and tacrolimus can produce nephrotoxicity with decreases in creatinine clearance and rises in serum creatinine, and because renal excretion is the primary elimination route of drugs of the fibrate class including Trilipix, there is a risk that an interaction will lead to deterioration of renal function. The benefits and risks of using Trilipix with immunosuppressants and other potentially nephrotoxic agents should be carefully considered, and the lowest effective dose employed.
Colchicine
Cases of myopathy, including rhabdomyolysis, have been reported with fenofibrates co-administered with colchicine, and caution should be exercised when prescribing fenofibrate with colchicine.
Last reviewed on RxList: 9/14/2012
This monograph has been modified to include the generic and brand name in many instances.
Additional Trilipix Information
Trilipix - User Reviews
Report Problems to the Food and Drug Administration
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.
Cholesterol Management
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