Fenofibrate is an oral fibrate medication primarily prescribed to manage abnormal levels of fats in the blood, including cholesterol and triglycerides. It is available in various forms, such as capsules, delayed-release capsules, and tablets, and is typically taken once daily. It is often used with lifestyle adjustments, like a low-fat diet and regular exercise, to optimize its effects on lipid profiles.
What Fenofibrate Treats
Fenofibrate is mainly prescribed for primary hypercholesterolemia or mixed dyslipidemia, which involve elevated levels of low-density lipoprotein (LDL, “bad” cholesterol) and triglycerides, often accompanied by low levels of high-density lipoprotein (HDL, “good” cholesterol). It also addresses severe hypertriglyceridemia.
Fenofibrate works by activating peroxisome proliferator-activated receptor alpha (PPARĪ±) in the liver. PPARĪ± stimulates lipoprotein lipase, an enzyme that breaks down and clears triglycerides. It also reduces the liver’s production of very low-density lipoprotein (VLDL), a major carrier of triglycerides. Additionally, fenofibrate can increase the production of HDL cholesterol, contributing to a more favorable lipid balance.
Commonly Reported Effects and Side Effects
Patients taking fenofibrate often report positive changes in their lipid profiles, including reductions in total cholesterol, LDL cholesterol, and triglycerides, typically ranging from 46% to 54% for triglycerides. HDL cholesterol levels may also increase by approximately 19% to 22%.
Fenofibrate can cause various side effects. Common gastrointestinal issues include nausea, stomach pain, constipation, and diarrhea, though these are generally mild. Headaches, back pain, or muscle pain may also occur. Rarely, muscle pain can indicate rhabdomyolysis, a serious breakdown of muscle tissue that can affect kidney function.
Liver enzyme elevations are another commonly reported side effect, monitored through blood tests. Less common but more serious side effects include gallstones or pancreatitis. Rare allergic reactions can also occur, manifesting as rash, itching, swelling, or difficulty breathing.
Important Considerations Before Use
Before starting fenofibrate, a healthcare provider will assess a patient’s medical history. It is not recommended for individuals with severe kidney disease (including those on dialysis), active liver disease, or pre-existing gallbladder disease due to an increased risk of gallstone formation.
Patients should inform their doctor about all other medications and supplements they are taking. Fenofibrate can interact with certain drugs, such as statins, increasing the risk of muscle problems. It can also enhance the effect of blood thinners like warfarin, requiring careful monitoring of clotting times. Regular blood tests are necessary to monitor liver and kidney function, as well as lipid levels, to ensure the treatment is safe and effective.