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PPAR-α/δ agonist

Elafibranor

Brand names: Iqirvo

Elafibranor is an oral agent used in the treatment of primary biliary cholangitis, typically in combination with ursodeoxycholic acid or alone where that is not tolerated.

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.

Clinical monograph

How it works

It is a peroxisome proliferator-activated receptor (PPAR) agonist acting on PPAR-alpha and PPAR-delta, modulating bile acid metabolism and inflammation to improve cholestatic markers.

Prescribing in practice

  • Liver function and cholestatic markers should be monitored, and the drug used under specialist hepatology supervision, with attention to muscle-related and other adverse effects.
  • It is taken orally, usually as an add-on to ursodeoxycholic acid in patients with an inadequate response, or as monotherapy where ursodeoxycholic acid is not tolerated.
  • Muscle-related symptoms including myalgia have been reported, so advise patients to report significant or unexplained muscle pain or weakness.

Monitoring

Monitor liver biochemistry and cholestatic markers to assess response, and review for muscle-related and other adverse effects.

Counselling the patient

  • Take it as directed and continue any other prescribed liver medicines unless told otherwise.
  • Report unexplained muscle pain, tenderness or weakness.
  • Attend for blood tests as arranged to check your liver.

Evidence & guidelines

Approval is supported by a randomised controlled trial showing improvement in cholestatic markers in primary biliary cholangitis.

Reference: EASL PBC clinical practice guidelines; NICE TA evaluation; SmPC; 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.

Pathways