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Clofibrate (Atromid-S)
(kloh- FYE-brayt)
Pregnancy Category: C Atromid-S Claripex Novo-Fibrate (Rx)

Classification: Antihyperlipidemic agent

Action/Kinetics: Decreases triglycerides and VLDL; cholesterol and LDL are decreased less predictably and less effectively. Mechanism may be due to increased catabolism of VLDL to LDL and decreased synthesis of VLDL by the liver. Cholesterol formation is inhibited early in the biosynthetic chain; excretion of neutral streoids is increased. Peak plasma levels: 3-6 hr. t 1/2 plasma: 15 hr. Therapeutic effect: Onset, 2-5 days; maximum effect: 3 weeks. Triglycerides return to pretreatment levels 2-3 weeks after therapy is terminated. Hydrolyzed to the active p-chlorophenoxyisobutyric acid which is further metabolized and excreted in the urine. Drug may concentrate in fetal blood. LFTs should be performed during therapy.

Uses: Dysbetalipoproteinemia (type III hyperlipidemia) not responding to diet. Hyperlipidemia (types IV and V) with a risk of abdominal pain and pancreatitis not responding to diet.

Contraindications: Impaired hepatic or renal function, primary biliary cirrhosis, lactation, pregnancy, children.

Special Concerns: Use with caution in clients with gout and peptic ulcer. Reduced dosage may be required in geriatric clients due to age-related decreases in renal function.

Side Effects: GI: Nausea, dyspepsia, weight gain, gastritis, vomiting, bloating, flatulence, abdominal distress, stomatitis, loose stools, diarrhea, hepatomegaly, cholelithiasis, gallstones. CNS: Headaches, dizziness, fatigue, weakness, drowsiness. CV: Changes in blood-clotting time, arrhythmias, increased or decreased angina, intermittent claudication, thromboembolic events, thrombophlebitis, swelling and phlebitis at xanthoma site, pulmonary embolism. Skeletal muscle: Asthenia, arthralgia, myalgia, weakness, muscle cramps, aches. GU: Impotence, dysuria, hematuria, decreased urine output, decreased libido, proteinuria. Hematologic: Anemia, leukopenia, eosinophilia. Dermatologic: Allergic reactions, including urticaria, skin rash, dry skin, pruritus, dry brittle hair, alopecia. Other: Dyspnea, polyphagia, flu-like symptoms, noncardiovascular death.

Laboratory Test Alterations: AST, ALT, thymol turbidity, CPK, BSP retention. Proteinuria.

Drug Interactions: Anticoagulants / Anticoagulant effect by plasma protein binding Antidiabetics (sulfonylureas) / Antidiabetic effect Furosemide / Exaggerated diuretic response Insulin / Insulin effect Probenecid / Therapeutic and toxic effects of clofibrate R/T liver breakdown and kidney excretion Ursodiol / Risk of gallstone formation

How Supplied: Capsule: 500 mg

?Capsules Antihyperlipidemic.
Adults: 500 mg q.i.d. Therapeutic response may take several weeks to become apparent. Drug must be administered on a continuous basis because lowered levels of cholesterol and other lipids will return to elevated state within several weeks after administration is stopped. Discontinue after 3 months if response is poor.

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