Fibrate·Cardiovascular - Lipid Lowering

Fenofibrate

Severe hypertriglyceridemia (risk of pancreatitis), mixed dyslipidemia

Authority requiredPBSFIBRATELipidil48 mg tablet+2

No source link confirmed for this record yet. Its own source notes are under Additional.

At a glance

Max Dose

145 mg/day

Half-life

20 h

Caution: Myopathy

HIGH w/ STATIN

Caution: Renal Adj.

DOSE RED.

Cautions

Avoid / Cautions

Severe renal impairment, active liver disease, gallbladder disease. Pregnancy Category B3.

Where it stands

Rapid Summary

Overview

PPAR-alpha agonist used primarily to lower extremely high triglycerides to prevent acute pancreatitis.

Clinical Focus

Highly toxic to muscles if combined with statins. If a fibrate must be used with a statin, Fenofibrate is safer than Gemfibrozil.

Bottom Line

Fenofibrate is the fibrate of choice for hypertriglyceridaemia and diabetic dyslipidaemia, but increases creatinine (non-pathological) and carries myopathy risk when combined with statins.

Formulation & Access

Brand Names

Lipidil

Oral Routes

Take with food

Tablets (48 mg, 145 mg). Take with food to improve absorption (unless nanoparticle formulation).

Prescribing & PBS

Authority Required (PBS).

Indications & Use

Primary

PBSTGA

Severe hypertriglyceridemia (risk of pancreatitis), mixed dyslipidemia.

Clinical Place

Niche role. Used almost exclusively when Triglycerides are > 10 mmol/L to prevent pancreatitis, or in diabetic retinopathy.

Quick reference

Class & Role

Fibrate — PPAR-alpha agonist used primarily to lower extremely high triglycerides to prevent acute pancreatitis.

Route / Formulation

Tablets (48 mg, 145 mg). Take with food to improve absorption (unless nanoparticle formulation). (Lipidil)

Usual Dose & Max

PO 145 mg OD (Lipidil) OR 160 mg OD (Lipidil EZ). Max 145 mg/day (nanoparticle formulation) or 160 mg/day (standard).

Key Indication Doses

Severe Hypertriglyceridemia: PO 145 mg OD (Lipidil) OR 160 mg OD (Lipidil EZ). Renal Impairment: Reduce dose to 48 mg/day if eGFR 30-59. Avoid entirely if eGFR < 30.

Best Uses

Fenofibrate is the fibrate of choice for hypertriglyceridaemia and diabetic dyslipidaemia, but increases creatinine (non-pathological) and carries myopathy risk when combined with statins.

Key Risks

Musculoskeletal: Myopathy, Rhabdomyolysis (exponentially increased if combined with a statin). Gastrointestinal: Cholelithiasis (gallstones), GI upset. Renal: Can cause a reversible bump in serum creatinine.

Key Interactions

Statins. The combo risks massive muscle breakdown. (Note: Gemfibrozil + Statin is an absolute contraindication. Fenofibrate + Statin is used with extreme caution). Enhances the effect of Warfarin. Monitor INR closely.

Monitoring

Lipids (focusing on triglycerides), LFTs, U&E (creatinine), and baseline CK. Warn patients to report unexplained muscle pain immediately.

Clinical Pearl

Statins are for heart attacks; Fibrates are for the pancreas. Fibrates only have a strong clinical role when TGs exceed 10 mmol/L, as this is the threshold for acute pancreatitis.

Access

Authority requiredLipidil48 mg tablet

Brand: Lipidil
PBS status: Authority required
Formulation: Tablets (48 mg, 145 mg). Take with food to improve absorption (unless nanoparticle formulation).

From this page

No calculator, monitoring schedule or factsheet is linked to this medicine page yet.

Fibrate·Cardiovascular - Lipid Lowering

Fenofibrate

Severe hypertriglyceridemia (risk of pancreatitis), mixed dyslipidemia

Authority requiredPBSFIBRATELipidil48 mg tablet+2

No source link confirmed for this record yet. Its own source notes are under Additional.

At a glance

Max Dose

145 mg/day

Half-life

20 h

Caution: Myopathy

HIGH w/ STATIN

Caution: Renal Adj.

DOSE RED.

Cautions

Avoid / Cautions

Severe renal impairment, active liver disease, gallbladder disease. Pregnancy Category B3.

Where it stands

Rapid Summary

Overview

PPAR-alpha agonist used primarily to lower extremely high triglycerides to prevent acute pancreatitis.

Clinical Focus

Highly toxic to muscles if combined with statins. If a fibrate must be used with a statin, Fenofibrate is safer than Gemfibrozil.

Bottom Line

Fenofibrate is the fibrate of choice for hypertriglyceridaemia and diabetic dyslipidaemia, but increases creatinine (non-pathological) and carries myopathy risk when combined with statins.

Formulation & Access

Brand Names

Lipidil

Oral Routes

Take with food

Tablets (48 mg, 145 mg). Take with food to improve absorption (unless nanoparticle formulation).

Prescribing & PBS

Authority Required (PBS).

Indications & Use

Primary

PBSTGA

Severe hypertriglyceridemia (risk of pancreatitis), mixed dyslipidemia.

Clinical Place

Niche role. Used almost exclusively when Triglycerides are > 10 mmol/L to prevent pancreatitis, or in diabetic retinopathy.

Quick reference

Class & Role

Fibrate — PPAR-alpha agonist used primarily to lower extremely high triglycerides to prevent acute pancreatitis.

Route / Formulation

Tablets (48 mg, 145 mg). Take with food to improve absorption (unless nanoparticle formulation). (Lipidil)

Usual Dose & Max

PO 145 mg OD (Lipidil) OR 160 mg OD (Lipidil EZ). Max 145 mg/day (nanoparticle formulation) or 160 mg/day (standard).

Key Indication Doses

Severe Hypertriglyceridemia: PO 145 mg OD (Lipidil) OR 160 mg OD (Lipidil EZ). Renal Impairment: Reduce dose to 48 mg/day if eGFR 30-59. Avoid entirely if eGFR < 30.

Best Uses

Fenofibrate is the fibrate of choice for hypertriglyceridaemia and diabetic dyslipidaemia, but increases creatinine (non-pathological) and carries myopathy risk when combined with statins.

Key Risks

Key Interactions

Monitoring

Lipids (focusing on triglycerides), LFTs, U&E (creatinine), and baseline CK. Warn patients to report unexplained muscle pain immediately.

Clinical Pearl

Statins are for heart attacks; Fibrates are for the pancreas. Fibrates only have a strong clinical role when TGs exceed 10 mmol/L, as this is the threshold for acute pancreatitis.

Access

Authority requiredLipidil48 mg tablet

Brand: Lipidil
PBS status: Authority required
Formulation: Tablets (48 mg, 145 mg). Take with food to improve absorption (unless nanoparticle formulation).

From this page

No calculator, monitoring schedule or factsheet is linked to this medicine page yet.