Lipantil Supra (Fenofibrate)

Fenofibrate is a fibrate that lowers triglyceride‑rich lipoproteins and is used in several lipid disorders.

• Hypertriglyceridemia: reduces serum triglyceride concentrations and lowers pancreatitis risk.
• Mixed dyslipidemia: improves combined high triglycerides and low HDL‑cholesterol levels.
• Primary hypercholesterolemia (adjunct): adds LDL‑cholesterol reduction when combined with statin therapy.

• Fenofibrate activates peroxisome proliferator‑activated receptor alpha (PPARα), which up‑regulates genes involved in fatty‑acid oxidation, lipoprotein lipase activity, and clearance of triglyceride‑rich particles, leading to reduced plasma triglycerides and modest increases in HDL‑cholesterol.

Common Side Effects

• Gastrointestinal discomfort: nausea, dyspepsia, or abdominal pain.
• Headache: mild to moderate intensity.
• Muscle pain: occasional myalgia without laboratory abnormalities.
• Elevated liver enzymes: mild transaminase rise.
• Elevated serum creatinine: transient increase in renal markers.
• Skin rash: mild pruritic eruptions.

Serious or Rare Side Effects

• Rhabdomyolysis: severe muscle breakdown with potential renal failure.
• Hepatic failure: marked elevation of liver enzymes or jaundice.
• Severe allergic reactions: anaphylaxis or angioedema.
• Pancreatitis: acute inflammation of the pancreas.
• Significant increase in creatine kinase: may indicate muscle injury.
• Life‑threatening liver injury: rare but possible.

Before initiating therapy, consider the following precautions:

• Monitor liver function: check transaminases before and during treatment.
• Assess renal function: evaluate serum creatinine and eGFR regularly.
• Observe for muscle symptoms: report unexplained myalgia or weakness.
• Avoid in severe hepatic impairment: contraindicated in patients with marked liver disease.
• Use caution with concomitant statins: increased risk of myopathy.
• Store at room temperature: keep in the original container, protect from moisture and direct sunlight.

Fenofibrate may interact with several medicines; review patient medication lists carefully.

Major Interactions (Avoid)

• Gemfibrozil: markedly increases risk of myopathy and rhabdomyolysis.
• Cyclosporine: can raise fenofibrate plasma levels, enhancing toxicity.
• Anticoagulants (e.g., warfarin): may potentiate anticoagulant effect, requiring INR monitoring.

Moderate Interactions (Monitor Closely)

• Statins (especially simvastatin): increased myopathy risk; dose adjustment may be needed.
• Bile‑acid sequestrants: may reduce fenofibrate absorption; separate dosing times.
• Oral contraceptives: potential for altered hormone levels.
• Antidiabetic agents: may affect glycemic control.
• Niacin: combined use can increase hepatotoxicity risk.