Drug Action
Fibrates act by decreasing serum triglycerides; they have variable effect on LDL-cholesterol.
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Drug reference
Fibrates act by decreasing serum triglycerides; they have variable effect on LDL-cholesterol.
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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 | Adjunct to statin in mixed hyperlipidaemia if triglycerides and HDL- cholesterol inadequately controlled in patients at high cardiovascular risk ▶BY MOUTH USING CAPSULES ▶Adult: Initially 200 mg daily, then increased if necessary to 267 mg daily, maximum 200 mg daily with concomitant statin, 267 mg capsules not appropriate for initial dose titration ▶BY MOUTH USING TABLETS ▶Adult: 160 mg daily
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DUE TO INTERACTIONS ▶Manufacturer advises max. dose 200 mg daily with concurrent use of a statin.
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Gall bladder disease. pancreatitis (unless due to severe hypertriglyceridaemia). photosensitivity to fibrates. photosensitivity to ketoprofen
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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 Abdominal pain. diarrhoea. flatulence. nausea. vomiting ▶Uncommon Cholelithiasis. embolism and thrombosis. headache. muscle complaints. muscle weakness. myopathy. pancreatitis. sexual dysfunction. skin reactions ▶Rare or very rare Alopecia. hepatic disorders. photosensitivity reaction ▶Frequency not known Fatigue. interstitial lung disease. rhabdomyolysis (increased risk in renal impairment). severe cutaneous adverse reactions (SCARs)
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Avoid—embryotoxicity in animal studies.
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Manufacturers advise avoid—no information available.
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Manufacturer advises avoid —no information available.
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Manufacturer advises use with caution in mild-to-moderate impairment; avoid if eGFR less than 30 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 Manufacturer advises max. 67 mg daily if eGFR 30–59 mL/minute/1.73 m2.
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Manufacturer advises monitor hepatic transaminases every 3 months during the first 12 months of treatment and periodically thereafter— discontinue treatment if levels increase to more than 3 times the upper limit of normal; monitor serum creatinine levels during the first 3 months of treatment and periodically thereafter—interrupt treatment if creatinine level is 50% above the upper limit of normal.
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There can be variation in the licensing of different medicines containing the same drug. Tablet CAUTIONARY AND ADVISORY LABELS 21 ▶Fenofibrate (Non-proprietary) Fenofibrate micronised 160 mg Fenofibrate micronised 160mg tablets | 28 tablet P £10.00 DT = £3.29 ▶Supralip (Mylan) Fenofibrate micronised 160 mg Supralip 160mg tablets | 28 tablet P £6.69 DT = £3.29 Capsule CAUTIONARY AND ADVISORY LABELS 21 ▶Fenofibrate (Non-proprietary) Fenofibrate micronised 67 mg Fenofibrate micronised 67mg capsules | 90 capsule P £23.30 DT = £23.23 Fenofibrate micronised 200 mg Fenofibrate micronised 200mg capsules | 28 capsule P £11.98 DT = £3.29 Fenofibrate micronised 267 mg Fenofibrate micronised 267mg capsules | 28 capsule P £21.75 DT = £2.84 ▶Lipantil Micro (Mylan) Fenofibrate micronised 67 mg Lipantil Micro 67 capsules | 90 capsule P £23.30 DT = £23.23 Fenofibrate micronised 200 mg Lipantil Micro 200 capsules | 28 capsule P £14.23 DT = £3.29 Fenofibrate micronised 267 mg Lipantil Micro 267 capsules | 28 capsule P £21.75 DT = £2.84 Combinations available: Simvastatin with fenofibrate, p. 218
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Initially 200 mg daily, then increased if
First-line fragment. Read the complete Indications and Dose section above.
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160 mg daily
First-line fragment. Read the complete Indications and Dose section above.
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