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Fibrate

Fenofibrate

Brand names: Lipantil, Supralip, Fenogal

Fenofibrate is a fibrate (PPAR-alpha agonist) used mainly for hypertriglyceridaemia and mixed dyslipidaemia, typically when triglycerides remain high or as an adjunct to diet and other measures. Statins remain first-line for cardiovascular prevention.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

US labelling (FDA)

Reference — US labelling, may differ from UK

Primary hypercholesterolemia or mixed dyslipidemia: Initial dose of 160 mg once daily ( 2.2 ). Severe hypertriglyceridemia: Initial dose of 54 to 160 mg once daily. Maximum dose is 160 mg ( 2.3 ). Renally impaired patients: Initial dose of 54 mg once daily ( 2.4 ). Geriatric patients: Select the dose on the basis of renal function ( 2.5 ). Should be given with meals ( 2.1 ). 2.1 General Considerations Patients should be placed on an appropriate lipid-lowering diet before receiving fenofibrate tablet USP, and should continue this diet during treatment with fenofibrate tablet USP. Fenofibrate tablets USP should be given with meals, thereby optimizing the bioavailability of the medication. The …

Source: US FDA prescribing information (openFDA / DailyMed), label dated 2024-04-29. Accessed 2026-06-12. US dosing and indications can differ from UK practice — use UK sources for prescribing decisions.

Clinical monograph

How it works

It activates peroxisome proliferator-activated receptor alpha (PPAR-alpha), enhancing lipoprotein lipase activity and fatty-acid oxidation. This lowers serum triglycerides and VLDL and tends to raise HDL-cholesterol.

Prescribing in practice

  • Muscle toxicity (myopathy, and rarely rhabdomyolysis) can occur and the risk is increased when combined with a statin — investigate unexplained muscle pain or weakness and check creatine kinase, with extra caution in renal impairment.
  • Serum creatinine can rise (usually reversible) and the risk of gallstones is increased; avoid in significant hepatic or renal impairment and in gallbladder disease.
  • Monitor liver function, and avoid in pregnancy and breastfeeding; review interacting drugs including anticoagulants (potentiated) and statins.

Monitoring

Check baseline lipids, liver and renal function, and monitor liver function periodically during treatment. Reassess the lipid response, monitor renal function, and measure creatine kinase if muscle symptoms develop; review the need for continued treatment if there is an inadequate response.

Counselling the patient

  • Report promptly any unexplained muscle pain, tenderness or weakness.
  • Seek advice if you develop upper abdominal pain, jaundice or pale stools, which may indicate gallstones or liver problems.
  • Continue dietary and lifestyle measures, and tell us if you become pregnant or are breastfeeding.

Evidence & guidelines

Considered for hypertriglyceridaemia where statins are insufficient or not tolerated (NICE CG181; NICE NG238).

Reference: NICE CG181; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

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