• With dietary therapy to decrease LDL cholesterol, total cholesterol, triglycerides, and apolipoprotein B in adult patients with hypercholesterolemia or mixed dyslipidemia.
• With dietary management in the treatment of severe hypertriglyceridemia (types IV and V hyperlipidemia) in patients who are at risk for pancreatitis and do not respond to nondrug therapy.

Contraindicated in:

• Hypersensitivity
• Hepatic impairment (including primary biliary cirrhosis)
• Pre-existing gallbladder disease
• Severe renal impairment
• Concurrent use of HMG-CoA reductase inhibitors
• Lactation: Lactation.

Use Cautiously in:

• Concurrent warfarin or HMG-CoA reductase inhibitor therapy
• OB: Safety not established in pregnancy
• Pedi: Safety and effectiveness not established in children
• Geri: Age-related ↓ in renal function may make older patients more susceptible to adverse reactions.

CV: arrhythmia, DEEP VEIN THROMBOSIS.

Derm: rash, DRUG REACTION WITH EOSINOPHILIA AND SYSTEMIC SYMPTOMS (DRESS), STEVENS-JOHNSON SYNDROME, TOXIC EPIDERMAL NECROLYSIS, urticaria.

GI: ↑liver enzymes, cholelithiasis, HEPATOTOXICITY, pancreatitis.

Metab: ↓HDL levels.

MS: rhabdomyolysis.

Neuro: fatigue/weakness, headache.

Resp: INTERSTITIAL LUNG DISEASE, PULMONARY EMBOLISM.
Misc: (INCLUDING ANAPHYLAXIS AND ANGIOEDEMA)HYPERSENSITIVITY REACTIONS .

Drug-Drug:

• ↑anticoagulant effects of warfarin.
• HMG-CoA reductase inhibitors↑ risk of rhabdomyolysis (concurrent use should be avoided).
• Absorption is ↓ by bile acid sequestrants (fenofibrate should be given 1 hr before or 4–6 hr after).
• ↑risk of nephrotoxicity with cyclosporine.
• Concurrent use with colchicine may ↑ risk of rhabdomyolysis

(Generic available)

• Capsules (Lipofen): 50 mg; 150 mg;
• Micronized capsules (Antara): 43 mg; 130 mg;
• Tablets (Fenoglide): 40 mg; 120 mg;
• Tablets (Tricor): 48 mg; 145 mg;

Primary Hypercholesterolemia/Mixed Dyslipidemia

• PO (Adults): Antara: 130 mg once daily; Fenoglide: 120 mg once daily; Tricor: 145 mg once daily; Lipofen: 150 mg once daily.

Hypertriglyceridemia

• PO (Adults): Antara: 43–130 mg once daily; Fenoglide: 40–120 mg once daily; Tricor: 48–145 mg once daily; Lipofen: 50–150 mg once daily.

Antara, Fenoglide, Lipofen, Tricor, Triglide

• Fenofibric acid primarily inhibits triglyceride synthesis.

• Lowering of cholesterol and triglycerides with subsequent decreased risk of pancreatitis.

Therapeutic Classification: lipid-lowering agents

Pharmacologic Classification: fibric acid derivatives

Absorption: Well absorbed (60%) after oral administration; absorption ↑ by food.

Distribution: Unknown.

Protein Binding: 99%.

Metabolism/Excretion: Rapidly converted to fenofibric acid, which is the active metabolite; fenofibric acid is metabolized by the liver. Fenofibric acid and its metabolites are primarily excreted in urine (60%).

Half-life: 20 hr.

Lipidil EZ, Lipidil Supra

(lowering of triglycerides)

• Instruct patient to take medication as directed, not to skip doses or double up on missed doses. Medication helps control but does not cure elevated serum triglyceride levels.
• Advise patient that this medication should be used in conjunction with diet restrictions (fat, cholesterol, carbohydrates, alcohol), exercise, and cessation of smoking.
• Instruct patient to notify health care professional if signs and symptoms of liver injury (jaundice, abdominal pain, nausea, malaise, dark urine, abnormal stool, pruritus), unexplained muscle pain, tenderness, or weakness occurs, especially if accompanied by fever or malaise.
• Instruct patient to notify health care professional of all Rx or OTC medications, vitamins, or herbal products being taken and to consult health care professional before taking other Rx, OTC, or herbal products.
• Advise patient to notify health care professional of medication regimen before treatment or surgery.
• Advise females of reproductive potential to notify health care professional promptly if pregnancy is planned or suspected and to avoid breastfeeding during and for at least 5 days after last dose of therapy.
• Emphasize the importance of follow-up exams to determine effectiveness and to monitor for side effects.

fen-o-FI-brate