Fenofibrate is a lipid-regulating medication primarily used to treat hyperlipidemia and related cardiovascular diseases. This drug belongs to the class of fibrate derivatives and effectively reduces triglycerides and low-density lipoprotein (LDL) cholesterol levels in the blood, while increasing high-density lipoprotein (HDL) cholesterol. It works by modulating hepatic metabolic pathways to improve lipid metabolism abnormalities, reduce atherosclerosis risk, and consequently decrease the incidence of heart disease and stroke.
This medication is typically prescribed for patients who do not achieve target lipid levels through diet control and lifestyle modifications. Suitable candidates include those with familial hyperlipidemia, mixed hyperlipidemia, and lipid metabolism disorders caused by diabetes or obesity. Physicians may combine fenofibrate with other lipid-lowering agents based on the patient's medical history and blood lipid profile results.
The generic name of this drug is "Fenofibrate." Common brand names include:
Generic formulations typically contain fenofibrate as the main active ingredient. Patients should follow their healthcare provider’s instructions to select the appropriate dosage form and avoid self-changing medication specifications.
Fenofibrate belongs to the class of lipid-modulating drugs known as "Fibrates," which are used to regulate lipid metabolism. These drugs primarily act on peroxisome proliferator-activated receptor alpha (PPARα), promoting lipolysis and lipoprotein metabolism, and are commonly used to treat mixed hyperlipidemia.
In the drug classification system, it is categorized as a "lipid regulator," distinct from statins, mainly targeting triglycerides and HDL cholesterol. Physicians may choose to use fenofibrate alone or in combination with other lipid-lowering medications based on the patient's lipid profile.
The main indications for fenofibrate include:
It can also be used for lipid abnormalities in diabetic patients or as an adjunct to other lipid-lowering drugs such as statins. Before prescribing, physicians evaluate the patient's lifestyle, comorbidities, and liver and kidney functions to ensure safe medication use.
Mild side effects include:
Serious side effects requiring immediate medical attention:
Contraindications:
This medication carries a risk of hepatotoxicity and requires regular monitoring of liver function tests. If unexplained muscle pain, tea-colored urine, or jaundice occurs, the medication should be discontinued immediately and medical attention sought. Women who are breastfeeding should evaluate the risks before use.
The US FDA classifies fenofibrate as pregnancy category C. It should be avoided during early and mid-pregnancy. During breastfeeding, the drug may be secreted into breast milk; therefore, breastfeeding should be paused or alternative treatments considered during therapy. Women of childbearing age should use effective contraception while on this medication.
Special caution is needed when combining with the following medications:
Avoid concurrent use with high doses of alcohol or hepatotoxic drugs, as this may increase liver burden. Consult a healthcare provider before taking over-the-counter supplements (such as red yeast rice), as some may increase the risk of muscle side effects.
The common starting dose is 120-200 mg once daily, taken after meals to reduce gastrointestinal discomfort. The actual dose should be tailored based on:
Do not chew or break the tablets; swallow whole. During initial treatment, blood lipid and liver function tests should be performed every 4-12 weeks. The physician may adjust the dose based on efficacy. Elderly patients or those with impaired liver function should receive reduced doses.
If a dose is missed and less than 6 hours have passed, take it as soon as possible and resume the regular schedule. If it is close to the next dose, skip the missed dose and continue with the normal schedule the following day. Do not take a double dose to make up for a missed one.
Set reminders or use a pill organizer to prevent missed doses. If medication adherence remains a challenge, discuss dose adjustments or timing with your healthcare provider.
An overdose may cause:
If overdose is suspected, seek immediate medical attention and bring the medication container for reference. Emergency treatments may include gastric lavage, hemodialysis, or supportive care. Store medications out of children's reach to prevent accidental ingestion.
Is it necessary to take fenofibrate at a fixed time, and can it be taken with food?
It is recommended to take fenofibrate at a fixed time to maintain consistent drug levels. It can generally be taken with meals to reduce gastrointestinal discomfort. If stomach upset occurs, try taking it with a low-fat meal or as directed by your healthcare provider, but do not stop the medication without consulting your doctor.
What are common side effects of long-term fenofibrate use, and how can they be alleviated?
Common side effects include diarrhea, abdominal pain, or dizziness, which usually diminish as the body adjusts. If severe muscle pain or abnormal liver function occurs, discontinue and seek medical attention immediately. Mild discomfort can often be alleviated by dividing doses or dietary adjustments.
What drug interactions should be noted when using fenofibrate?
Using fenofibrate with anticoagulants (such as warfarin) may enhance anticoagulant effects; INR should be monitored regularly. When combined with statins, liver function should be carefully assessed to avoid excessive liver burden. Always inform your healthcare provider of all medications you are taking.
How long is the typical treatment cycle with fenofibrate? Can it be stopped independently?
The treatment usually lasts at least 3-6 months to observe lipid improvements. Do not stop medication on your own to prevent rebound effects. Your healthcare provider will adjust the treatment plan based on lipid levels and cardiovascular risk assessment. Regular follow-up and testing are essential.
How can diet and exercise enhance the effectiveness of fenofibrate?
Adopt a low-fat, high-fiber diet, reduce intake of trans fats and refined sugars, and engage in at least 150 minutes of moderate-intensity aerobic exercise weekly. Avoid excessive alcohol consumption, as it can increase liver workload and interfere with medication efficacy.
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