Lipidil (Fenofibrate)

Fenofibrate is used to treat disorders of lipid metabolism that increase cardiovascular risk.

• Hypertriglyceridaemia: lowers very high triglyceride levels to reduce pancreatitis risk.
• Mixed dyslipidaemia: improves both triglyceride and LDL‑cholesterol concentrations while modestly raising HDL‑cholesterol.
• Primary hypercholesterolaemia (adjunct therapy): adds to statin treatment to further decrease LDL‑cholesterol when target levels are not achieved.

• Fenofibrate activates peroxisome proliferator‑activated receptor‑α (PPARα), a nuclear transcription factor that regulates genes involved in fatty acid oxidation and lipoprotein metabolism. Activation increases lipolysis of triglyceride‑rich particles, enhances clearance of very‑low‑density lipoproteins, and raises synthesis of apolipoprotein A‑I, leading to reduced plasma triglycerides and modest improvements in LDL‑ and HDL‑cholesterol.

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

Common Side Effects

• Gastrointestinal discomfort: nausea, abdominal pain, or dyspepsia.
• Headache: mild to moderate intensity.
• Elevated liver enzymes: transient increases in ALT or AST.
• Muscle pain: myalgia without severe weakness.
• Skin reactions: rash or pruritus.

Serious or Rare Side Effects

• Rhabdomyolysis: severe muscle breakdown with dark urine.
• Hepatotoxicity: significant liver injury or jaundice.
• Severe allergic reactions: anaphylaxis or angioedema.
• Gallstones: formation of biliary sludge or stones.
• Blood dyscrasias: thrombocytopenia or leukopenia.

When prescribing Fenofibrate, clinicians should consider several safety and handling precautions.

• Liver function monitoring: check baseline and periodic ALT/AST levels.
• Renal function assessment: adjust use in severe renal impairment.
• Muscle toxicity vigilance: discontinue if unexplained muscle pain or weakness occurs.
• Drug interactions: review concomitant statins or anticoagulants.
• Pregnancy and lactation: avoid use unless benefits outweigh risks.
• Store at ambient temperature: keep below 25 °C in original packaging, protect from moisture and light.

Fenofibrate can interact with other medicines, affecting efficacy or safety.

Major Interactions (Avoid)

• Statins (especially high‑dose simvastatin): increased risk of rhabdomyolysis.
• Anticoagulants (warfarin): enhanced anticoagulant effect, monitor INR.
• Bile acid sequestrants: reduced fenofibrate absorption, separate dosing times.

Moderate Interactions (Monitor Closely)

• CYP2C9 inhibitors (e.g., fluconazole): may raise fenofibrate plasma levels.
• Immunosuppressants (e.g., cyclosporine): potential for increased muscle toxicity.
• Thyroid hormones: may alter lipid response, monitor thyroid function tests.