Fenofibrate (tablet form)
Fenofibrate is a lipid‑lowering drug (fibrate class) that is most commonly sold in tablet (Tab) formulations. Below is a quick‑reference guide—feel free to let me know if you need details on a specific aspect (e.g., pediatric use, drug interactions, or how it works).
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1. What it is
- Generic name: Fenofibrate
- Common brand names: Tricor®, Lipofen®, Lipid‑Low, Fenofibrate tablets (generic versions also available).
- Form: Usually 200 mg or 300 mg tablets, taken orally.
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2. Indications
- Hypertriglyceridemia: Reduces triglyceride levels by ≥30 %–50 %.
- Mixed dyslipidemia: Lowers triglycerides and raises HDL‑C; may modestly lower LDL‑C.
- Prevention of pancreatitis: In patients with very high triglycerides (≥500 mg/dL).
- Secondary prevention: Often added to statin therapy when LDL‑C targets are not met.
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3. How it works
- Activates peroxisome proliferator‑activated receptor‑α (PPAR‑α) → ↑β‑oxidation of fatty acids → ↓VLDL synthesis → ↓triglycerides.
- Increases HDL‑C by promoting cholesterol efflux.
- Has a modest effect on LDL‑C through altered particle size and composition.
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4. Typical adult dosing
| Condition | Dose (mg) | Frequency | Notes |
|-----------|-----------|-----------|-------|
| Hypertriglyceridemia (≥200 mg/dL) | 200–300 mg once daily | 1×/day | Can start at 200 mg; titrate up to 300 mg if needed. |
| Very high TG (≥500 mg/dL) | 200–300 mg once daily | 1×/day | Aim for TG <500 mg/dL (or <200 mg/dL if pancreatitis risk). |
| Mixed dyslipidemia | 200–300 mg once daily | 1×/day | Often used with statins. |
| Pediatric use | 1 mg/kg/day (max 200 mg) | 1×/day | FDA‑approved for children 3 + years with homozygous FH. |
Take with a meal (preferably with a meal high in fat) to improve absorption. Some formulations can be taken on an empty stomach, but the fat meal maximizes bioavailability.
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5. Common side effects (≈5–15 % of patients)
- Gastro‑intestinal: Nausea, diarrhea, abdominal pain, dyspepsia.
- Muscle pain (myalgia): Rare but more likely when combined with statins.
- Liver enzyme elevation: Mild ALT/AST rises; rarely >3× ULN.
- Pruritus or rash (rare).
- Weight gain (usually minimal).
Severe but uncommon: Rhabdomyolysis (especially with statins), hepatic dysfunction, gallstones.
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6. Precautions & Contra‑indications
| Category | Key Points |
|----------|------------|
| Liver disease | Avoid if hepatic impairment (AST/ALT > 3× ULN). Monitor LFTs at 4–12 weeks and annually thereafter. |
| Renal impairment | Use cautiously; dose adjustment not required for mild–moderate CKD, but monitor renal function. |
| Pregnancy / Lactation | Category C. Use only if benefits outweigh risks; avoid during pregnancy unless essential. |
| Bariatric surgery | Reduced absorption in malabsorptive procedures; consider lower dose. |
| Alcohol | Limit alcohol intake; may increase risk of liver injury. |
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7. Drug interactions (watch‑out)
| Drug | Interaction | Why? |
|------|-------------|------|
| Statins (e.g., simvastatin, atorvastatin) | ↑myopathy risk, ↑LFT elevation | Both inhibit CYP450; additive lipid‑lowering effect. |
| Cyclosporine, Amiodarone | ↑fenofibrate levels | CYP3A4 inhibition. |
| Grapefruit juice | ↑CYP3A4 inhibition | ↑drug exposure. |
| Other lipid‑lowering agents (ezetimibe) | Additive lipid lowering | Generally safe. |
| Antacids | ↑ gastric pH → ↓ absorption | Take 1–2 hrs apart. |
Tip: If starting a new medication or supplement, mention fenofibrate to your prescriber to check interactions.
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8. Monitoring recommendations
- Baseline labs: LFTs (ALT/AST), creatine kinase (CK), lipid profile, fasting glucose.
- Follow‑up: LFTs at 4–12 weeks, then annually; CK if muscle pain develops.
- Lipid goal: Aim for TG < 200 mg/dL (or < 150 mg/dL if pancreatitis risk); HDL‑C > 40 mg/dL (men) / > 50 mg/dL (women).
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9. Storage & Handling
- Keep at room temperature (≤25 °C/77 °F).
- Protect from moisture & excess light.
- Keep out of reach of children and pets.
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10. Quick FAQ
Q: Can I take fenofibrate on an empty stomach?
A: Yes, but absorption is better with a fatty meal; you may notice more GI upset on an empty stomach.
Q: Will it cure my high cholesterol?
A: It’s a powerful triglyceride reducer and raises HDL‑C, but it does not replace lifestyle changes or statins for LDL‑C lowering.
Q: Is it safe with my statin?
A: It’s often prescribed together, but you should report any muscle aches and have LFTs checked.
Q: What if I miss a dose?
A: Take it as soon as you remember. If it’s almost time for your next dose, skip the missed one—do not double up.
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If you’d like deeper dives (e.g., pediatric dosing specifics, detailed interaction charts, or evidence‑based guidelines), just let me know!