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Fenofibrate

  • Medical and Pharmacy Editor: John P. Cunha, DO, FACOEP
    John P. Cunha, DO, FACOEP

    John P. Cunha, DO, FACOEP

    John P. Cunha, DO, is a U.S. board-certified Emergency Medicine Physician. Dr. Cunha's educational background includes a BS in Biology from Rutgers, the State University of New Jersey, and a DO from the Kansas City University of Medicine and Biosciences in Kansas City, MO. He completed residency training in Emergency Medicine at Newark Beth Israel Medical Center in Newark, New Jersey.

Brand Name: Tricor, Lofibra tablets, Fenoglide, Lipofen, Triglide

Generic Name: fenofibrate

Drug Class: Fibric Acid Agents

What Is Fenofibrate and How Does It Work?

Fenofibrate is used along with a proper diet to help lower "bad" cholesterol and fats (such as LDL, triglycerides) and raise "good" cholesterol (HDL) in the blood. It works by increasing the natural substance (enzyme) that breaks down fats in the blood. Fenofibrate belongs to a group of drugs known as "fibrates." Lowering triglycerides in people with very high triglyceride blood levels may decrease the risk of pancreas disease (pancreatitis). However, fenofibrate might not lower your risk of a heart attack or stroke. Talk to your doctor about the risks and benefits of fenofibrate.

In addition to eating a proper diet (such as a low-cholesterol/low-fat diet), other lifestyle changes that may help fenofibrate work better include exercising, losing weight if overweight, and stopping smoking. Consult your doctor for more details.

Fenofibrate is available under the following different brand names: Tricor, Lofibra tablets, Fenoglide, Lipofen, and Triglide.

Dosages of Fenofibrate:

Dosage Forms and Strengths

TriCor tablet

  • 48 mg
  • 145 mg

Lofibra tablet

  • 54 mg
  • 160 mg

Fenoglide tablet

  • 40 mg
  • 120 mg

Triglide tablet

  • 160 mg

Lipofen capsule

  • 50 mg
  • 150 mg

Dosage Considerations – Should be Given as Follows:

Pediatric: Safety and efficacy not established

TriCor

  • Hypercholesterolemia, mixed dyslipidemia: Initially, 145 mg orally once/day
  • Hypertriglyceridemia: Initially, 48-145 mg orally once/day
  • Titrate every 4-8 weeks up to no more than 145 mg orally once/day
  • Geriatric, initial: 48 mg/day; evaluate before increase dose

Triglide

  • Hypercholesterolemia, Mixed Dyslipidemia: initial 160 mg orally once/day
  • Hypertriglyceridemia: 50-160 mg orally once/day initially
  • Geriatric, initial: 50 mg/day

Lipofen

  • Hypercholesterolemia, Mixed Dyslipidemia: initial 150 mg orally once/day
  • Hypertriglyceridemia: initial 50-150 mg orally once/day
  • Geriatric, initial: No more than 50 mg/day

Lofibra tablets

  • Hypercholesterolemia, Mixed Dyslipidemia: 160 mg orally once/day
  • Hypertriglyceridemia: 54-160 mg orally once/day
  • Geriatric, initial: 54 mg/day

Fenoglide

  • Hypercholesterolemia, Mixed Dyslipidemia: 120 mg orally once/day
  • Hypertriglyceridemia: 40-120 mg orally once/day
  • Geriatric, initial: 40 mg/day

Dosage Considerations

Overdose management

  • Symptoms include GI distress
  • Treatment is supportive

Dosing Modifications

Renal impairment (CrCl less than 50 mL/min):

  • TriCor: Initial, 48 mg/day initially; evaluate before increase dose
  • Triglide: Initial, 50 mg/day
  • Lipofen: Initial, no more than 50 mg/day
  • Lofibra tablets: Initial, 54 mg/day
  • Fenoglide: Initial, 40 mg/day

Administration

  • TriCor, Triglide, and Lofibra tablets can be taken without regard to meals
  • Lipofen: Take with meals

SLIDESHOW

Lower Your Cholesterol, Save Your Heart See Slideshow

What Are Side Effects Associated with Using Fenofibrate?

Side effects associated with use of Fenofibrate, include the following:

Postmarketing side effects of fenofibrate reported include:

This document does not contain all possible side effects and others may occur. Check with your physician for additional information about side effects.

What Other Drugs Interact with Fenofibrate?

If your doctor has directed you to use this medication, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider or pharmacist first.

Severe interactions of fenofibrate include:

  • None

Serious Interactions of fenofibrate include:

Fenofibrate has moderate interactions with at least 26 different drugs.

Mild Interactions of fenofibrate include:

This information does not contain all possible interactions or adverse effects. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share this information with your doctor and pharmacist. Check with your health care professional or doctor for additional medical advice, or if you have health questions, concerns or for more information about this medicine.

QUESTION

What is cholesterol? See Answer

What Are Warnings and Precautions for Fenofibrate?

Warnings

  • This medication contains fenofibrate. Do not take Tricor, Lofibra tablets, Fenoglide, Lipofen, and Triglide if you are allergic to fenofibrate or any ingredients contained in this drug
  • Keep out of reach of children. In case of overdose, get medical help or contact a Poison Control Center immediately

Contraindications

Effects of Drug Abuse

  • No information provided

Short-Term Effects

  • See "What Are Side Effects Associated with Using Fenofibrate?"

Long-Term Effects

  • Cases of adrenal insufficiency reported with opioid use, more often following greater than one month of use; symptoms may include nausea, vomiting, anorexia, fatigue, weakness, dizziness, and low blood pressure; if adrenal insufficiency is diagnosed, treat with physiologic replacement doses of corticosteroids; wean patient off of opioid to allow adrenal function to recover and continue corticosteroid treatment until adrenal function recovers; other opioids may be tried as some cases reported use of a different opioid without recurrence of adrenal insufficiency
  • Chronic use of opioids may cause reduced fertility in females and males of reproductive potential; unknown whether effects on fertility are reversible
  • Abrupt withdrawal, particularly in patients on long-term, high-dose therapy, may precipitate status epilepticus; when discontinuing fenofibrate, gradual withdrawal essential; while being gradually withdrawn, simultaneous substitution of another anticonvulsant may be indicated.
  • See "What Are Side Effects Associated with Using Fenofibrate?”

Cautions

  • Cholelithiasis reported with use; discontinue if gallstones detected upon gallbladder studies
  • Rare myopathy, myositis, or rhabdomyolysis reported with use; monitor
  • Increase in hepatic transaminases reported; discontinue if enzyme levels persist 3 times above the upper limit of normal
  • Reversibly increases serum creatinine levels; consider monitoring renal function in patients at risk for renal impairment
  • Thrombocytopenia and agranulocytosis reported; monitor blood counts periodically during the first year of therapy
  • Associated with pulmonary embolism and deep venous thrombosis; use caution in patients with risk factors for venous thromboembolism (VTE)
  • Concomitant use with oral anticoagulants (monitor and adjust warfarin dose as needed)
  • May further increase risk for rhabdomyolysis when added to optimal HMG-CoA reductase inhibitor regimen to further decrease triglycerides and increase HDLs
  • Paradoxical decreases in HDL cholesterol (HDL-C) level reported
  • Rule out secondary causes of hyperlipidemia before initiating therapy
  • Withdraw therapy if no adequate response seen after 2-3 months
  • Use with caution in the elderly; dose adjustments may be necessary
  • Fenofibrate increases cholesterol excretion into bile, leading to risk of cholelithiasis; perform gallbladder studies if cholelithiasis suspected
  • Fibric acid derivatives as monotherapy or in combination with simvastatin have not been shown to significantly reduce cardiovascular mortality in major clinical studies

Pregnancy and Lactation

  • Use fenofibrate with caution during pregnancy if benefits outweigh risks. Animal studies show risk and human studies are not available, or neither animal nor human studies were done
  • It is unknown if fenofibrate is excreted in breast milk; it is not recommended for use while breastfeeding


SOURCE:
Medscape. Fenofibrate.
https://reference.medscape.com/drug/tricor-lofibra-tablets-fenofibrate-342451

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