Fenofibrate
Mechanism :
Fenofibrate is a lipid regulating agent available for oral administration. Fenofibric acid, the active metabolite of fenofibrate, produces reductions in total cholesterol, LDL cholesterol, apolipoprotein B, total triglycerides, and VLDL in treated patients. In addition, treatment with fenofibrate results in increases in high density lipoprotein (HDL) and apoproteins apo AI and apo AII. It acts by the activation of peroxisome proliferator activated receptor a.
Indication :
- Hyperlipidemia
- Familial hypercholesterolemia
Contraindications :
Renal and hepatic dysfunction, and gall bladder disease.
Dosing :
One capsule (67 mg) micronized fenofibrate/day/20 kg.
Adverse Effect :
Nausea, anorexia, gastric pain; headache, pruritus, urticaria, myopathy.
Interaction :
Warfarin: Enhanced effect.
HMG-COA reductase inhibitors: Increased risk of rhabdomyolysis.
Bile acid sequestrants: Elevation in liver enzymes.
Renal Dose :
Dose in Renal Impairment GFR (mL/min)
| 20-60 | 134 mg daily |
| 10-20 | 67 mg daily |
| <10 | Avoid |
Dose in Patients undergoing Renal Replacement Therapies
| CAPD | Unlikely to be dialysed. Avoid |
| HD | Not dialysed. Avoid |
| HDF/High flux | Unlikely to be dialysed. Avoid |
| CAV/VVHD | Unlikely to be dialysed. Dose as in GFR=10–20 mL/min |
Hepatic Dose :
Contraindicated in patients with hepatic dysfunction and with an unexplained persistent liver function abnormality. It is is also contraindicated in primary biliary cirrhosis.