Fenofibrate
Fenofibrate (TRICOR)
Fenofibrate
( fee-noh- FY-brayt)
Pregnancy Category: C TRICOR (Rx)

Classification: Antihyperlipidemic drug

Action/Kinetics: Is converted to the active fenofibric acid, which lowers plasma triglycerides. Probable mechanism is to inhibit triglyceride synthesis, resulting in a reduction of VLDL released into the circulation, and by stimulating catabolism of triglyceride-rich lipoprotein. Also increases urinary excretion of uric acid. Well absorbed; absorption is increased when given with food. Peak plasma levels: 6-8 hr; steady-state plasma levels: within 5 days. Highly bound to plasma proteins. t 1/2: 20 hr with once daily dosing. Fenofibric acid and an inactive metabolite are excreted through the urine.

Uses: Adjunct to diet to treat Types IV and V hyperlipidemia in adults who are at risk of pancreatitis and who do not respond to diet alone.

Contraindications: Hepatic or severe renal dysfunction (including primary biliary cirrhosis), those with unexplained, persistent abnormal liver function, and preexisting gallbladder disease. Lactation.

Special Concerns: Due to similarity to clofibrate and gemfibrozil, side effects, including death, are possible. Safety and efficacy have not been determined in children.

Side Effects: GI: Pancreatitis, cholelithiasis, dyspepsia, N&V, diarrhea, abdominal pain, constipation, flatulence, eructation, hepatitis, cholecystitis, hepatomegaly. CNS: Decreased libido, dizziness, increased appetite, insomnia, paresthesia. Respiratory: Rhinitis, cough, sinusitis, allergic pulmonary alveolitis. GU: Polyuria, vaginitis. Musculoskeletal: Myopathy, myositis, arthralgia, myalgia, myasthenia, rhabdomyolysis. Hypersensitivity: Severe skin rashes, urticaria. Ophthalmic: Eye irritation, blurred vision, conjunctivitis, eye floaters. Miscellaneous: Infections, pain, headache, asthenia, fatigue, flu syndrome, arrhythmia, photosensitivity, eczema.

Laboratory Test Alterations: AST, ALT, creatinine, blood urea. Hemoglobin, uric acid.

Drug Interactions: Anticoagulants / Prolongation of PT Bile acid sequestrants / Absorption of fenofibrate due to binding Cyclosporine / Risk of nephrotoxicity HMG-CoA reductase inhibitors / Possibility of rhabdomyolysis, myopathy, and acute renal failure

How Supplied: Capsules: 67 mg

Dosage
?Capsules Hypertriglyceridemia.
Initial: 67 mg/day given with meals to optimize bioavailability. Then, individualize based on client response. Increase, if necessary, at 4- 8-week intervals. Maximuim daily dose: 201 mg/day (i.e., 3 capsules). If C _CR is less than 50 mL/min, start with 67 mg/day; increase dose only after evaluation of effects on renal function and triglyceride levels. In the elderly, limit the initial dose to 67 mg/day.