Lipanthyl Supra (Fenofibrate)

• Fenofibrate is indicated for lipid disorders that involve elevated triglycerides and mixed dyslipidaemia, providing clinically relevant lipid improvements.
• Hypertriglyceridemia: lowers serum triglyceride concentrations, helping to reduce the risk of acute pancreatitis in patients with markedly elevated triglyceride levels.
• Mixed dyslipidemia: decreases triglycerides, modestly raises HDL‑cholesterol and may provide a small reduction in LDL‑cholesterol, contributing to a more favorable lipid profile.
• Primary hypercholesterolemia (adjunct therapy): used in combination with statins to achieve additional LDL‑cholesterol lowering when statin monotherapy does not reach target levels.

• Fenofibrate activates peroxisome proliferator‑activated receptor alpha (PPARα), a nuclear transcription factor that regulates genes involved in lipid metabolism. Activation of PPARα enhances β‑oxidation of fatty acids in liver and muscle, suppresses hepatic synthesis of triglycerides, and increases the expression of lipoprotein lipase, leading to accelerated clearance of triglyceride‑rich lipoproteins from the circulation. These combined actions lower plasma triglyceride levels and modestly raise high‑density lipoprotein cholesterol, contributing to an overall improvement in the atherogenic lipid profile.

Fenofibrate may cause a range of adverse reactions, which are generally classified by frequency and severity.

Common Side Effects

• Elevated liver enzymes: mild, transient increases in ALT or AST.
• Gastrointestinal discomfort: nausea, abdominal pain or dyspepsia.
• Muscle pain: myalgia without significant CK elevation.
• Headache: mild to moderate intensity.
• Elevated serum creatinine: mild, reversible increase in kidney function tests.
• Dizziness: transient sensation of light‑headedness.

Serious or Rare Side Effects

• Severe liver injury: marked hepatitis or hepatic failure.
• Rhabdomyolysis: muscle breakdown with high CK levels, potentially leading to renal impairment.
• Hypersensitivity reactions: skin rash, Stevens‑Johnson syndrome or anaphylaxis.

• When prescribing Fenofibrate, clinicians should observe several precautionary measures to minimise risk.
• Assess liver function: obtain baseline ALT/AST and monitor periodically.
• Evaluate renal function: check serum creatinine before initiation and during therapy.
• Monitor for muscle toxicity: advise patients to report unexplained muscle pain or weakness.
• Consider drug interactions: review concomitant medications that may increase risk of myopathy or liver injury.
• Pregnancy and lactation: use only if potential benefit justifies potential risk, as safety data are limited.
• Store at ambient temperature: keep below 25 °C in the original packaging, protect from moisture and direct sunlight.

Fenofibrate can interact with other medicines, altering its efficacy or increasing toxicity.

Major Interactions (Avoid)

• Statins (especially high‑dose simvastatin or lovastatin): increased risk of rhabdomyolysis.
• Cyclosporine: may raise fenofibrate plasma concentrations, enhancing adverse effects.
• Anticoagulants (warfarin): fenofibrate can potentiate anticoagulant effect, requiring closer INR monitoring.

Moderate Interactions (Monitor Closely)

• Gemfibrozil: additive risk of muscle toxicity, dose adjustment may be needed.
• Bile acid sequestrants (cholestyramine): may reduce fenofibrate absorption, consider separating dosing times.
• Thiazide diuretics: may increase serum creatinine, monitor renal function.