5 Fenofibrate side effects and how to take fenofibrate

Fenofibrate Side Effects:

Fenofibrate side effects 1:Muscle Pain:

Similar to statins, fenofibrate also poses a risk of muscle pain during its use. A very small number of patients may develop rhabdomyolysis. Therefore, it is recommended to regularly monitor creatine phosphokinase (CPK) levels during treatment. If a significant increase is observed, discontinuation of the medication should be considered promptly.

Fenofibrate side effects 2:Gastrointestinal Side Effects:

Issues such as abdominal discomfort, diarrhea, constipation, and indigestion may occur, with an incidence rate of around 5%.

Fenofibrate side effects 3:Neurological Adverse Reactions:

Symptoms such as fatigue, headache, loss of libido, and insomnia may occur; with an incidence rate of about 3%.

Fenofibrate side effects 4:moderate changes in blood

In the early stages of medication use, mild to moderate changes in blood indices may occur, including changes in hemoglobin, hematocrit, and a decrease in white blood cells. Elevated blood aminotransferase levels are occasionally observed.

Fenofibrate side effects 5:Skin Adverse Reactions:

Allergic reactions such as rash, itching, and hives are occasionally seen. Even months after discontinuation, photosensitive reactions like erythema, papules, and eczema may occur under sun exposure.

5 Fenofibrate side effects and how to take fenofibrate
5 Fenofibrate side effects and how to take fenofibrate

The likelihood of experiencing drug side effects varies among individuals. Therefore, while taking fenofibrate, there is no need to be overly concerned about side effects to the point of avoiding medication. However, being aware of possible adverse reactions and seeking timely and accurate medical advice if they occur is essential.

Is Fenofibrate Safe During Pregnancy?

According to literature reports, several pregnant women, between 8-32 weeks of gestation, suffering from pancreatitis due to high triglyceride levels and unable to control it through diet and conventional treatment alone, were treated with fenofibrate. The newborns were not teratogenic, and follow-ups after 1 year showed they were healthy.

Fenofibrate should only be used by pregnant women if dietary control is insufficient to prevent HLAP. Pharmacokinetic characteristics indicate that the drug is rapidly metabolized in the liver into the active metabolite fenofibric acid, with a molecular weight of 319u and a long half-life (20h). It may cross the placental barrier, but its high protein binding rate (99%) may limit the amount of drug entering the fetus.

No teratogenic effects were observed in animal experiments, except for a risk of miscarriage, growth restriction, and skeletal abnormalities at doses far higher than those used in humans (7-9 times), especially during the first 3 months of pregnancy. Reports of fenofibrate use during pregnancy for HLAP have not found teratogenic or embryotoxic effects and have shown good efficacy. Clinical studies have found that fenofibrate, combined with low molecular weight heparin, insulin, and other drugs for HLAP during pregnancy, is effective and safe, with no new adverse reactions reported, indicating the safety and efficacy of combined medication use.

Fenofibrate Contraindications and Precautions:

  1. Fenofibrate increases the risk of gallstones, thus it is contraindicated in patients with a history of gallbladder disease or those who have gallstones.
  2. Patients with severe liver or kidney dysfunction, biliary cirrhosis, or persistent liver function abnormalities should not use this medication.
  3. Regular monitoring during medication use should include:
    • 1) Complete blood count and platelet count (to prevent hematological side effects);
    • 2) Liver function tests (to prevent liver damage);
    • 3) Blood cholesterol, triglycerides, and low-density lipoprotein levels (to confirm medication efficacy);
    • 4) Creatine phosphokinase (CPK) levels (to prevent muscle pain and kidney damage).
  4. Strict dietary control is essential during medication use. The best lipid-lowering effects are achieved by combining diet management with medication.
  5. Primary diseases, such as hypothyroidism and diabetes, can also cause lipid abnormalities. Control of related diseases is necessary during medication use.
  6. Be cautious of other medications that may increase lipid levels, such as estrogens, beta-blockers, and thiazide diuretics. Try to avoid these if possible.
  7. For mixed lipid abnormalities with severe triglyceride increases, statins and fibrates should be used together. This combination increases the risk of muscle pain, so caution is advised, and CPK levels should be monitored regularly.
  8. When taken with bile acid-binding resins such as colestyramine, fenofibrate should be taken either 1 hour before or 4-6 hours after these medications, as bile acid-binding drugs may also bind with other medications.
  9. Fenofibrate is primarily excreted by the kidneys, so its use with medications that may impair kidney function (e.g., sulfonylureas, cyclosporine) could increase the risk of kidney damage.
  10. When used with warfarin, fenofibrate can displace warfarin from its protein binding sites, enhancing warfarin’s anticoagulant effect and further prolonging the INR, leading to bleeding symptoms. To avoid bleeding complications, the dose of oral warfarin should be reduced and INR monitored more frequently until stable.

Fenofibrate Dosage and Administration:

1.Take with meals.

2.Drink a sip of water before taking the medication to moisten the throat and avoid the medication sticking to the mouth or esophagus. Take the medication in a sitting or standing position with about 200ml of warm water, without chewing or crushing the tablet.

3.Do not discontinue medication on your own; dosage should be gradually reduced under a doctor’s guidance.

Fenofibrate Dosage:

1.The common adult dose is 0.1g three times daily. The maintenance dose is 0.1g once or twice daily.

2.Dosage should be reduced for patients with renal impairment and the elderly. If ineffective after 2 months of treatment, discontinue the medication.

Fenofibrate manufacturer:

The manufacturers of Fenofibrate include RECIPHARM FONTAINE, Lupin, Cipla, Mylan, Abbvie.

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