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Fibrate

Fenofibrate

Brand names: Lipantil, Supralip, Fenogal

Adult dose

Dose: 160mg OD with food (formulations vary 67–267mg)
Route: PO
Frequency: OD

Dose adjustments

Renal

Reduce in CKD; avoid if eGFR <30

Clinical pearls

  • Severe hypertriglyceridaemia
  • Mild creatinine rise typical and reversible — usually NOT a reason to stop

Contraindications

  • Severe renal/hepatic impairment
  • Gallbladder disease
  • Pancreatitis (unless 2° to severe hyperTG)
  • Pregnancy/breastfeeding

Side effects

  • Myopathy
  • GI upset
  • Headache
  • Cholelithiasis
  • Mild rise in serum creatinine

Interactions

  • Statins (myopathy — avoid combination if possible; if needed use fenofibrate, not gemfibrozil)
  • Warfarin (raised INR)
  • Ciclosporin (renal toxicity)

Monitoring

  • Lipids
  • LFTs
  • U&E
  • CK if symptoms

Reference: BNF; NICE CG181; https://bnf.nice.org.uk/drugs/fenofibrate/. Verify against your local formulary and the latest BNF before prescribing.

Related

Curated clinical cross-links plus same-class fallbacks.

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