Drug Action
Fibrates act by decreasing serum triglycerides; they have variable effect on LDL-cholestrol.
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Drug reference
Fibrates act by decreasing serum triglycerides; they have variable effect on LDL-cholestrol.
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Adjunct to diet and other appropriate measures in mixed hyperlipidaemia if statin contra-indicated or not tolerated | Adjunct to diet and other appropriate measures in severe hypertriglyceridaemia ▶BY MOUTH USING IMMEDIATE-RELEASE MEDICINES ▶Adult: 200 mg 3 times a day ▶BY MOUTH USING MODIFIED-RELEASE MEDICINES ▶Adult: 400 mg once daily, modified-release dose form is not appropriate in patients with renal impairment
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Gall bladder disease. hypoalbuminaemia. nephrotic syndrome. photosensitivity to fibrates
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Correct hypothyroidism before initiating treatment. risk factors for myopathy
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Fibrates are mainly used in those whose serum-triglyceride concentration is greater than 10 mmol/litre or in those who cannot tolerate a statin (specialist use).
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→Appendix 1: fibrates
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▶Common or very common Appetite decreased. gastrointestinal disorder ▶Uncommon Acute kidney injury. alopecia. cholestasis. constipation. diarrhoea. dizziness. erectile dysfunction. gastrointestinal discomfort. headache. muscle complaints . muscle weakness. nausea. photosensitivity reaction. skin reactions ▶Rare or very rare Cholelithiasis. depression. insomnia. interstitial lung disease. pancreatitis. pancytopenia. paraesthesia. peripheral neuropathy. rhabdomyolysis (increased risk in renal impairment). severe cutaneous adverse reactions (SCARs). thrombocytopenic purpura
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Manufacturers advise avoid—no information available.
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Manufacturer advises avoid—no information available. Cardiovascular system
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Manufacturer advises avoid in significant impairment (except in fatty liver disease).
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Avoid immediate-release preparations if eGFR less than 15 mL/minute/1.73 m2. Avoid modified- release preparations if eGFR less than 60 mL/minute/1.73 m2. Myotoxicity Special care needed in patients with renal disease, as progressive increases in serum creatinine concentration or failure to follow dosage guidelines may result in myotoxicity (rhabdomyolysis); discontinue if myotoxicity suspected or creatine kinase concentration increases significantly. Dose adjustments Reduce dose to 400 mg daily if eGFR 40–60 mL/minute/1.73 m2. Reduce dose to 200 mg every 1–2 days if eGFR 15–40 mL/minute/1.73 m2.
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Consider monitoring of liver function and creatine kinase when fibrates used in combination with a statin.
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There can be variation in the licensing of different medicines containing the same drug. Forms available from special-order manufacturers include: oral suspension Modified-release tablet CAUTIONARY AND ADVISORY LABELS 21, 25 ▶Bezalip Mono (Teva UK Ltd) Bezafibrate 400 mg Bezalip Mono 400mg modified-release tablets | 30 tablet P £7.63 DT = £7.63 ▶Fibrazate XL (Sandoz Ltd) Bezafibrate 400 mg Fibrazate XL 400mg tablets | 30 tablet P £6.87 DT = £7.63 Tablet CAUTIONARY AND ADVISORY LABELS 21 ▶Bezalip (Teva UK Ltd) Bezafibrate 200 mg Bezalip 200mg tablets | 100 tablet P £8.63 DT = £8.63
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200 mg 3 times a day
First-line fragment. Read the complete Indications and Dose section above.
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400 mg once daily, modified-release dose form is
First-line fragment. Read the complete Indications and Dose section above.
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