Fenofibrate
Fenofibrate helps reduce cholesterol and triglycerides (fatty acids) in the blood. High levels of these types of fat in the blood are associated with an increased risk of atherosclerosis (clogged arteries). Fenofibrate is used to treat high cholesterol and high triglyceride levels.
Mechanism of effect
Fenofibrate exerts its therapeutic effects through activation of peroxisome proliferator activated receptor a (PPARa). This increases lipolysis and elimination of triglyceride-rich particles from plasma by activating lipoprotein lipase and reducing production of apoprotein C-III. The resulting fall in triglycerides produces an alteration in the size and composition of LDL from small, dense particles, to large buoyant particles. These larger particles have a greater affinity for cholesterol receptors and are catabolized rapidly.
Pharmacodynamic
Fenofibrate is a lipid regulating agent indicated as adjunctive therapy to diet to reduce elevated LDL-C, Total-C,Triglycerides and Apo B, and to increase HDL-C in adult patients with primary hypercholesterolemia or mixed dyslipidemia (Fredrickson Types IIa and IIb).
Pharmacokinetics
fenofibrate is well absorbed from the gastrointestinal tract. Peak plasma levels of fenofibric acid occur within approximately 5 hours after oral administration. Following oral administration, fenofibrate is rapidly hydrolyzed by esterases to the active metabolite, fenofibric acid; After absorption, fenofibrate is mainly excreted in the urine in the form of metabolites approximately 60% of the dose appeared in the urine and 25% was excreted in feces. Fenofibric acid is eliminated with a half-life of approximately 20 hours allowing once daily dosin
Dosage
Usual Adult Dose for Hyperlipidemia Capsules: 150 mg orally once a day Micronized Capsules: 90 to 200 mg orally once a day Tablets: 120 to 160 mg orally once a day Usual Adult Dose for Hyperlipoproteinemia Type IIa (Elevated LDL) Capsules: 150 mg orally once a day Micronized Capsules: 90 to 200 mg orally once a day Tablets: 120 to 160 mg orally once a day Usual Adult Dose for Hyperlipoproteinemia Type IIb (Elevated LDL + VLDL) Capsules: 150 mg orally once a day Micronized Capsules: 90 to 200 mg orally once a day Tablets: 120 to 160 mg orally once a day Usual Adult Dose for Dyslipidemia Capsules: 150 mg orally once a day Micronized Capsules: 90 to 200 mg orally once a day Tablets: 120 to 160 mg orally once a day
Alerts
Fibrates increase the risk for myopathy and have been associated with rhabdomyolysis. The risk for serious muscle toxicity appears to be increased in elderly patients and in patients with diabetes, renal insufficiency, or hypothyroidism.
Points of recommendation
1- to continue to follow an appropriate lipid-modifying diet while taking Fenofibrate Capsules 2- to take Fenofibrate Capsules once daily at the prescribed dose, swallowing each capsule whole 3-to inform their physician of any muscle pain, tenderness, or weakness; onset of abdominal pain; or any other new symptoms. May be taken with food to increase absorption. 4-Take at least 1 hour before or 4 to 6 hours after a bile acid binding resin.
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