Lipanthylnano (Fenofibrate)

Fenofibrate acts on lipid metabolism pathways to improve abnormal blood lipid levels.

• Hypertriglyceridemia: reduces very‑low‑density lipoprotein triglycerides and lowers plasma triglyceride concentrations.
• Mixed dyslipidemia: decreases triglycerides while modestly raising high‑density lipoprotein cholesterol.
• Primary hypercholesterolemia (adjunct therapy): used together with statins to further improve lipid control when statin therapy alone is insufficient.

• Fenofibrate activates peroxisome proliferator‑activated receptor alpha (PPARα), a nuclear transcription factor that up‑regulates genes involved in fatty‑acid β‑oxidation and down‑regulates enzymes responsible for triglyceride synthesis, leading to increased clearance of triglyceride‑rich lipoproteins and modest increases in HDL‑cholesterol.

Common Side Effects

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

Serious or Rare Side Effects

• Rhabdomyolysis: severe muscle breakdown with potential renal failure.
• Severe liver injury: hepatitis or hepatic failure.
• Acute pancreatitis: inflammation of the pancreas presenting with abdominal pain and elevated enzymes.
• Anaphylactic reaction: rare but potentially life‑threatening hypersensitivity.
• Myopathy with renal impairment: muscle toxicity accompanied by reduced kidney function.

Fenofibrate should be used with careful clinical monitoring.

• Liver function monitoring: assess baseline and periodic hepatic enzymes.
• Renal function assessment: evaluate creatinine clearance before initiation and during therapy.
• Muscle disorder evaluation: inquire about myalgia or unexplained weakness.
• Statin co‑therapy review: consider dose adjustments or alternative agents to reduce myopathy risk.
• Contraindication in severe hepatic impairment: avoid use in patients with active liver disease.
• Store at below 25°C: keep in the original packaging, protect from moisture and direct sunlight.

Fenofibrate may interact with several medicines, requiring attention to co‑administration.

Major Interactions (Avoid)

• Gemfibrozil: markedly increases risk of myopathy and rhabdomyolysis.
• Cyclosporine: elevates fenofibrate plasma concentrations, enhancing toxicity.
• High‑dose statins (e.g., rosuvastatin ≥20 mg): synergistic risk of severe muscle injury.

Moderate Interactions (Monitor Closely)

• Warfarin: may potentiate anticoagulant effect, requiring INR monitoring.
• Oral hypoglycemics (e.g., sulfonylureas): can enhance hypoglycaemia; monitor glucose levels.
• Bile‑acid sequestrants (e.g., cholestyramine): may reduce fenofibrate absorption; separate dosing times.