Lipantil Supra (Fenofibrate (Nanonised))

• Fenofibrate is a lipid‑lowering agent that acts on triglyceride‑rich lipoproteins.
• Hyperlipidaemia: achieves a reduction in total cholesterol and low‑density lipoprotein (LDL‑C) concentrations, supporting guideline‑based lipid targets.
• Hypertriglyceridaemia: produces a marked decrease in serum triglyceride levels, helping to bring values within recommended limits.
• Mixed dyslipidaemia: improves the composite lipid profile by lowering triglycerides and LDL‑C while modestly increasing high‑density lipoprotein (HDL‑C).
• Adjunct to statin therapy: enhances triglyceride reduction in patients already receiving statins.

• Fenofibrate activates peroxisome proliferator‑activated receptor‑alpha (PPARα), a nuclear transcription factor that regulates genes involved in fatty‑acid oxidation and lipoprotein metabolism. Activation increases lipolysis, enhances clearance of triglyceride‑rich particles, and raises synthesis of apolipoprotein A‑I, leading to lowered plasma triglycerides and modest reductions in LDL‑C, with a slight increase in HDL‑C.

Fenofibrate is generally well tolerated, but adverse reactions can occur.

Common Side Effects

• Gastrointestinal discomfort, including nausea, abdominal pain or dyspepsia.
• Headache or dizziness.
• Elevated liver enzymes (transaminases).
• Mild muscle aches or weakness.
• Increased serum creatinine.
• Skin rash or pruritus.

Serious or Rare Side Effects

• Myopathy or rhabdomyolysis, especially when combined with statins.
• Severe liver injury or hepatitis.
• Gallstone formation.
• Acute pancreatitis.
• Anaphylactic or severe allergic reactions.
• Hemorrhagic events due to altered coagulation.

• Before prescribing Fenofibrate, clinicians should evaluate patient‑specific risk factors and monitor relevant parameters.
• Renal function: assess baseline kidney function and monitor periodically.
• Hepatic function: avoid use in patients with severe liver disease.
• Drug interactions: review concomitant medications, particularly statins and anticoagulants.
• Pregnancy and lactation: use only if clearly needed after risk‑benefit assessment.
• Cardiovascular disease: monitor for muscle symptoms and signs of rhabdomyolysis.
• Store at ambient temperature: keep below 25 °C, retain in the original container, and protect from moisture.

Fenofibrate may interact with several medicines; careful assessment is required.

Major Interactions (Avoid)

• Gemfibrozil: markedly increases risk of myopathy.
• Cyclosporine: raises fenofibrate plasma concentrations.
• Warfarin: may enhance anticoagulant effect.
• High‑dose statins (e.g., simvastatin): heightened myopathy risk.
• Protease‑inhibitor antiretrovirals: altered metabolism leading to toxicity.

Moderate Interactions (Monitor Closely)

• Thiazide diuretics: possible increase in serum creatinine.
• ACE inhibitors or ARBs: monitor renal function and electrolytes.
• Oral contraceptives: may elevate triglyceride levels.