Lipidil Supra (Fenofibrate)

• Fenofibrate acts on lipid metabolism pathways to modify abnormal blood lipid levels.
• Hypertriglyceridemia: reduces elevated triglyceride concentrations.
• Mixed dyslipidemia: improves overall lipid profile by lowering triglycerides and modestly raising HDL cholesterol.
• Primary hypercholesterolemia (adjunct): lowers LDL‑cholesterol when added to statin therapy.

• Fenofibrate activates peroxisome proliferator‑activated receptor alpha (PPARα), a nuclear transcription factor that up‑regulates genes involved in fatty‑acid oxidation, lipoprotein lipase activity and clearance of triglyceride‑rich lipoproteins, resulting in reduced plasma triglycerides and modest increases in HDL‑cholesterol.

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

Common Side Effects

• Gastrointestinal discomfort or nausea
• Abdominal pain or dyspepsia
• Headache
• Muscle pain or cramps
• Elevated liver enzymes (transient)
• Elevated serum creatinine

Serious or Rare Side Effects

• Rhabdomyolysis or severe myopathy
• Acute liver injury or hepatitis
• Severe allergic reactions (e.g., angioedema, Stevens‑Johnson syndrome)
• Pancreatitis
• Significant increase in creatine kinase levels
• Hemorrhagic complications when combined with anticoagulants

• Before initiating therapy, clinicians should consider several safety measures.
• Liver function assessment: evaluate baseline hepatic enzymes and avoid use in severe hepatic impairment.
• Renal function monitoring: adjust therapy in patients with moderate to severe renal insufficiency.
• Gallstone risk: assess history of cholelithiasis, as fenofibrate may promote gallstone formation.
• Statin co‑administration: monitor for myopathy when combined with statins, especially high‑dose regimens.
• Pregnancy and lactation: avoid use unless benefits clearly outweigh potential risks.
• Store at ambient temperature: keep in the original container, protect from moisture and direct sunlight.

Fenofibrate can interact with several medicines, requiring careful management.

Major Interactions (Avoid)

• Gemfibrozil: markedly increases risk of myopathy and rhabdomyolysis.
• Cyclosporine: may elevate fenofibrate plasma concentrations.
• Warfarin: can potentiate anticoagulant effect, increasing bleeding risk.

Moderate Interactions (Monitor Closely)

• Statins (especially high‑dose simvastatin or atorvastatin): monitor for muscle toxicity.
• Bile‑acid sequestrants (e.g., cholestyramine): may reduce fenofibrate absorption.
• Oral contraceptives: may increase triglyceride levels; monitor lipid profile.
• Antidiabetic agents (e.g., insulin, sulfonylureas): may require dose adjustment due to altered glucose control.