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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. t1/2: 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 CCR 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. |
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