Fenofibrate
Fenofibrate
Tricor, Lipofen, Antara, Fenoglide, Lofibra, Triglide, Trilipix (fenofibric acid)
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Summary
Classes
Common uses
Severe hypertriglyceridemia (pancreatitis prevention)0, Mixed dyslipidemia (statin-adjunct in selected patients)0
Pharmacy
Starting dose
Varies by salt form and brand; e.g., Tricor 145 mg PO daily; reduce to 48 mg in renal impairment
Preparations
Multiple non-bioequivalent fenofibrate and fenofibric acid formulations: 48-200 mg
US FDA Max
Formulation-specific (e.g., 145 mg/d Tricor, 200 mg/d Lipofen)
Pharmacology
Routes
Oral
Onset
Triglyceride lowering at 4-8 weeks
Duration
24 hours
Half-life
~20 hours (fenofibric acid, the active metabolite)[1]
Bioavailability
Increased with food (varies by formulation; the micronized and nanocrystal forms are less food-dependent)[1]
Pregnancy
Limited data; generally avoided unless triglyceride pancreatitis risk is high.[citation needed]
Legal status
Rx-only in US
Purported mechanism
Fenofibrate is a prodrug hydrolyzed to fenofibric acid, a peroxisome proliferator-activated receptor α (PPARα) agonist; PPARα activation upregulates lipoprotein lipase and apolipoprotein A-I/A-II expression and downregulates apolipoprotein C-III, accelerating VLDL clearance and lowering plasma triglycerides 30-50%.0 Modest HDL rise; LDL effects mixed. Renally cleared; combination with statin carries elevated myopathy risk (greater for gemfibrozil than fenofibrate, but caution still warranted)[1].
References
- ↑ 1.0 1.1 1.2 FDA Prescribing Information, Tricor (fenofibrate), AbbVie, current revision. https://www.accessdata.fda.gov/drugsatfda_docs/label/2013/021656s029lbl.pdf