Lipanthyl Supra (Fenofibrate)

Fenofibrate is used to manage lipid disorders by reducing triglyceride and cholesterol concentrations.

• Hypertriglyceridemia: reduces very‑high triglyceride levels and lowers risk of pancreatitis.
• Mixed dyslipidemia: improves the overall lipid profile by decreasing triglycerides and modestly raising HDL‑cholesterol.
• Hypercholesterolemia (adjunct therapy): used together with statins to further lower LDL‑cholesterol when statin therapy alone is insufficient.

• Fenofibrate activates peroxisome proliferator‑activated receptor‑alpha (PPARα) in hepatic and peripheral tissues. Activation of PPARα up‑regulates genes involved in fatty‑acid β‑oxidation and lipoprotein lipase activity, while down‑regulating enzymes responsible for triglyceride synthesis. The net effect is increased clearance of triglyceride‑rich lipoproteins and reduced production of very‑low‑density lipoprotein, leading to lower plasma triglyceride and modest improvements in HDL‑cholesterol.

Fenofibrate may cause a range of adverse reactions, varying from mild to serious.

Common Side Effects

• Gastrointestinal discomfort: nausea, abdominal pain or dyspepsia.
• Elevated liver enzymes: mild, transient increases in ALT or AST.
• Muscle pain: myalgia without weakness.
• Headache: mild to moderate intensity.

Serious or Rare Side Effects

• Rhabdomyolysis: severe muscle breakdown with possible renal impairment.
• Hepatotoxicity: marked elevation of liver enzymes or jaundice.
• Severe allergic reactions: rash, angioedema or anaphylaxis.
• Gallstones: formation of biliary sludge or stones.

Before prescribing fenofibrate, clinicians should consider several precautionary measures to ensure safe use.

• Liver function: assess baseline hepatic enzymes and monitor periodically.
• Renal function: evaluate kidney function, especially in patients with chronic kidney disease.
• Muscle disorders: avoid in patients with a history of myopathy or concurrent statin therapy without monitoring.
• Pregnancy and lactation: use only if potential benefit justifies risk, as safety data are limited.
• Drug interactions: review concomitant medications that may increase risk of myopathy or affect lipid metabolism.
• Store at ambient temperature: keep below 25 °C, in the original packaging, protected from moisture and light.

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

Major Interactions (Avoid)

• Statins (especially high‑dose simvastatin): heightened risk of rhabdomyolysis.
• Anticoagulants (warfarin): may potentiate anticoagulant effect, requiring INR monitoring.
• Bile acid sequestrants (cholestyramine): reduce fenofibrate absorption, diminishing lipid‑lowering effect.

Moderate Interactions (Monitor Closely)

• CYP2C9 inhibitors (e.g., fluconazole): may increase fenofibrate plasma levels.
• Immunosuppressants (e.g., cyclosporine): can raise fenofibrate concentrations.
• Thyroid hormones (levothyroxine): may require dose adjustment of thyroid medication.