Lipantil Micro (Fenofibrate)

• Fenofibrate acts on the lipid metabolism pathway and is indicated for several dyslipidaemic conditions.
• Hypertriglyceridemia: reduces plasma triglyceride concentrations.
• Mixed dyslipidemia: improves the overall lipid profile by lowering triglycerides and modestly raising HDL‑cholesterol.
• Primary hypercholesterolemia (adjunct therapy): used together with statins to enhance lipid control when statin therapy alone is insufficient.

• Fenofibrate activates the nuclear receptor peroxisome proliferator‑activated receptor‑α (PPARα). Activation increases fatty‑acid oxidation, decreases hepatic triglyceride synthesis, and enhances clearance of triglyceride‑rich lipoproteins, resulting in lowered plasma triglycerides and a modest increase in HDL‑cholesterol.

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

Common Side Effects

• Gastrointestinal discomfort such as nausea, abdominal pain or dyspepsia.
• Headache or dizziness.
• Muscle pain or weakness.
• Elevated liver enzymes.
• Skin rash or pruritus.
• Increased serum creatinine.

Serious or Rare Side Effects

• Rhabdomyolysis or severe myopathy, especially when combined with statins.
• Acute liver injury or hepatitis.
• Pancreatitis.
• Severe hypersensitivity reactions including Stevens‑Johnson syndrome.
• Renal failure secondary to muscle breakdown.
• Unexplained bleeding or severe thrombocytopenia.

• When prescribing Fenofibrate, clinicians should consider several safety measures.
• Monitor lipid levels: assess treatment efficacy regularly.
• Monitor liver function: obtain baseline and periodic liver enzyme tests.
• Assess renal function: adjust use in patients with impaired kidney function.
• Evaluate muscle symptoms: educate patients to report unexplained muscle pain or weakness.
• Review concomitant medications: avoid known major interacting drugs.
• Store at ambient temperature: keep in the original container, protect from moisture and light.

Fenofibrate interacts with several drug classes; awareness of interaction severity guides clinical decisions.

Major Interactions (Avoid)

• Gemfibrozil: markedly increases risk of myopathy.
• Cyclosporine: elevates fenofibrate plasma concentrations.
• Strong CYP2C8 inhibitors (e.g., gemfibrozil, clopidogrel): raise exposure and toxicity risk.
• HIV protease inhibitors: may increase fenofibrate levels.
• Bile‑acid sequestrants (e.g., cholestyramine): reduce oral absorption.

Moderate Interactions (Monitor Closely)

• Statins, particularly simvastatin: increased myopathy risk.
• Warfarin: potential alteration of INR.
• Oral contraceptives: may affect lipid parameters.
• Antihypertensives: monitor blood pressure changes.
• Thyroid hormone replacement: assess thyroid function tests.