What is fenofibrate?

Fenofibrate is a cholesterol and triglyceride-lowering medication used primarily to prevent pancreatitis. People with high levels of fat in the blood are at risk for inflammation of the pancreas. Doctors also prescribe fenofibrate when a patient is unable to take statin medications, the first course of treatment for high cholesterol due to either side effects or ineffectiveness.

Fenofibrate belongs to a class of medications called fibrates (fibric acid derivatives). It works by speeding up the body’s natural processes to remove cholesterol. Though fibrates are less effective at lowering LDL cholesterol levels, they can better reduce triglycerides than most statins.

How to take fenofibrate

Fenofibrate is an oral medication available in tablet and capsule forms, taken once per day. Follow all instructions on the label carefully, as dosage instructions vary from patient to patient. The micronized form used in the United States absorbs more rapidly than the standard formulation.  Some brand versions of fenofibrate (Fenoglide, Lipofen, Lofibra, and Tricor) absorb more quickly when taken with a meal.

When combining fenofibrate and a statin as a therapy for certain conditions, take fenofibrate in the morning and the statin in the evening, so each medication’s peak effectiveness occurs at different times.

If you miss a dose, take it as soon as possible, unless it is almost time for the next dose. In such a case, take only that dose. Be careful not to take extra doses.

In addition to prescribing this medicine, your doctor may recommend a diet low in fat, sugar, and cholesterol. Following these recommendations are essential for fenofibrate to work well. Continue to see your doctor regularly to ensure the treatment is effective or if dosage adjustments are needed.

Fenofibrate drug interactions

People taking fenofibrate should provide their doctor with a list of all currently prescribed medications. While fenofibrate can be taken in combination with some drugs, it negatively interacts with others. The below medication types are especially important to mention, however check with your pharmacist about any potential drug interactions.

  • Other cholesterol medications like bile acid sequestrants or statins
  • Immunosuppressants like ciclosporin or tacrolimus present an increased risk of kidney dysfunction when used with fenofibrate
  • Blood thinners like warfarin interact with fenofibrate and increase the risk of bleeding

 Fenofibrate side effects

Side effects of fenofibrate range from mild to severe. Some side effects do not require medical attention and may disappear over time. However, always check with your doctor if any side effects are concerning. Mild side effects include:

  • Runny nose, sneezing, stuffy nose
  • Back pain
  • Diarrhea, nausea, vomiting, constipation, gas
  • Eye irritation
  • Increased sun sensitivity
  • Dizziness, headache

Skin reactions can occur with this medicine, sometimes even months after beginning the treatment. Watch for blistering, peeling, itching, rash, red lesions, sores, ulcers, or white spots on the lips or in the mouth. Consult your doctor if these symptoms occur.

Fenofibrate may also cause muscle injuries like myopathy or rhabdomyolysis. Signs of muscle injury include muscle pain, back pain, spasms or cramps, stiffness, or unusual weakness. If left untreated these injuries can damage the kidneys.

Liver problems are also a serious side effect. Watch for stomach pain or tenderness, pale stool, loss of appetite, nausea, vomiting, or jaundice (yellow eyes or skin).

Pancreatitis and gallstones are also a risk when using this medicine. Sudden and severe stomach pain, constipation, nausea, vomiting, chills, and fever can be signs of pancreatitis or gallstones.

In addition to the above side effects, fenofibrate can cause severe allergic reactions in some people, which can be life-threatening and require immediate medical attention. Tell your doctor right away if you have a rash, itching, hoarseness, trouble breathing or swallowing, or swelling of the hands, face, or tongue.

Medical history risks

People with the following pre-existing conditions should not take fenofibrate or risk serious side effects:

  • Gallbladder disease
  • Heart disease
  • Kidney disease
  • Liver disease
  • Blood clotting issues (e.g., deep vein thrombosis, pulmonary embolism)
  • History of muscle pain or tenderness, weakness
  • Diabetes
  • Hypothyroidism

Key takeaways

While statins are the first course of treatment when lowering cholesterol, fenofibrate can be used when statins are ineffective or cause unwanted side effects. Fenofibrate is also the primary treatment for lowering triglycerides to prevent pancreatitis. However, this medication comes with its own list of potential side effects, drug interactions, and potential medical history complications which should be carefully observed.