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 primary hypercholesterolaemia if statin contra-indicated or not tolerated | Adjunct to diet and other appropriate measures in severe hypertriglyceridaemia | Adjunct to diet and other appropriate measures in primary prevention of cardiovascular disease in men with hyperlipidaemias if statin contra-indicated or not tolerated ▶BY MOUTH ▶Adult: 1.2 g daily in 2 divided doses, maintenance 0.9–1.2 g daily
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History of gall-bladder or biliary tract disease including gallstones. photosensitivity to fibrates
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Correct hypothyroidism before initiating treatment. elderly. 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 Constipation. diarrhoea. fatigue . flatulence. gastrointestinal discomfort. headache. nausea. skin reactions. vertigo. vomiting ▶Uncommon Atrial fibrillation ▶Rare or very rare Alopecia. anaemia. angioedema. appendicitis. bone marrow failure. depression. dizziness. drowsiness. eosinophilia. gallbladder disorders. hepatic disorders. joint disorders. laryngeal oedema. leucopenia. muscle weakness. myalgia. myopathy. pain in extremity. pancreatitis. paraesthesia. peripheral neuropathy. photosensitivity reaction. sexual dysfunction. thrombocytopenia. vision blurred
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Manufacturers advise avoid unless essential— toxicity in animal studies.
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Manufacturer advises avoid—no information available.
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Manufacturer advises avoid.
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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 Initially 900 mg daily if eGFR 30–80 mL/minute/1.73 m2.
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▶Monitor blood counts for first year. ▶Monitor liver-function (discontinue treatment if abnormalities persist). ▶Consider monitoring creatine kinase if used in combination with a statin.
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There can be variation in the licensing of different medicines containing the same drug. Tablet CAUTIONARY AND ADVISORY LABELS 22 ▶Gemfibrozil (Non-proprietary) Gemfibrozil 600 mg Gemfibrozil 600mg tablets | 56 tablet P £45.38 DT = £45.31 ▶Lopid (Pfizer Ltd) Gemfibrozil 600 mg Lopid 600mg tablets | 56 tablet P £35.57 DT = £45.31 Capsule CAUTIONARY AND ADVISORY LABELS 22 Cardiovascular system ▶Lopid (Pfizer Ltd) Gemfibrozil 300 mg Lopid 300mg capsules | 100 capsule P £31.76 DT = £31.76 LIPID MODIFYING DRUGS › NICOTINIC ACID DERIVATIVES
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1.2 g daily in 2 divided doses, maintenance
First-line fragment. Read the complete Indications and Dose section above.
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