Lipcor (Fenofibrate)

Fenofibrate is used to treat lipid disorders by targeting elevated triglyceride and cholesterol levels.

• Hypertriglyceridemia: lowers serum triglyceride concentrations, reducing the risk of pancreatitis and improving overall lipid profile in adults.
• Mixed dyslipidemia: decreases triglycerides and LDL‑cholesterol while modestly raising HDL‑cholesterol, helping achieve target lipid levels when used with statins.
• Primary hypercholesterolemia: used as adjunct therapy to statins to further lower LDL‑cholesterol in patients who have not reached guideline‑recommended targets.

• Fenofibrate activates the nuclear receptor peroxisome proliferator‑activated receptor‑alpha (PPARα) in liver and muscle cells. Activation of PPARα up‑regulates genes involved in fatty‑acid β‑oxidation and down‑regulates enzymes responsible for triglyceride synthesis. The resulting metabolic shift accelerates clearance of triglyceride‑rich lipoproteins, reduces hepatic VLDL production, and modestly increases HDL‑cholesterol, thereby improving the plasma lipid profile.

Fenofibrate may cause a range of adverse reactions, most of which are mild and reversible.

Common Side Effects

• Gastrointestinal upset: nausea, abdominal pain, or dyspepsia.
• Elevated liver enzymes: mild increases in ALT/AST.
• Muscle pain: mild myalgia without weakness.
• Headache: occasional tension‑type headaches.

Serious or Rare Side Effects

• Rhabdomyolysis: muscle breakdown with dark urine and high CK.
• Severe liver injury: jaundice or hepatitis.
• Acute renal failure: sudden decline in kidney function.

Before initiating therapy, clinicians should assess patient-specific risk factors and monitor relevant laboratory parameters.

• Liver function monitoring: check ALT/AST before treatment and periodically during therapy.
• Renal function assessment: evaluate creatinine clearance, especially in patients with pre‑existing kidney disease.
• Muscle toxicity vigilance: discontinue if unexplained muscle pain, weakness, or dark urine occurs.
• Drug interactions: avoid concurrent use with potent CYP3A4 inhibitors without monitoring.
• Pregnancy and lactation: use only if potential benefit justifies potential risk, as safety data are limited.
• Store at ambient temperature: keep below 25 °C in the original container, protect from moisture and light.

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

Major Interactions (Avoid)

• Cyclosporine: may increase fenofibrate plasma levels, raising toxicity risk.
• Gemfibrozil: combined fibrates significantly raise risk of myopathy and rhabdomyolysis.
• Strong CYP3A4 inhibitors (e.g., ketoconazole, clarithromycin): can elevate fenofibrate concentrations.

Moderate Interactions (Monitor Closely)

• Statins (especially simvastatin): increased risk of muscle toxicity; monitor CK.
• Anticoagulants (warfarin): fenofibrate may enhance anticoagulant effect; check INR.
• Bile‑acid sequestrants (cholestyramine): may reduce fenofibrate absorption; separate dosing by at least 1 hour.