In addition, treatment with fenofibrate results in increases in high density lipoprotein hdl and apoproteins apo ai and apo aii. Welcome to the fifth edition of the renal drug handbook. Fenofibrate may interact with blood thinners, cyclosporine, or other cholesterollowering medicines. Increases in dosage should occur only after evaluating the effects on renal function and lipid levels at this dose, with a maximum recommended dose of 145 mg24 hours. Renal drug handbook 3rd edition general intensive care unit. Fenofibrate is known to increase serum creatinine, but this effect is fully reversible, even after longterm treatment. Fenofibrate can increase serum creatinine levels in renal. It helps reduce levels of ldlc, total cholesterol, triglycerides, and apolipoprotein b, and increase hdl c. Jan 18, 2012 new york reuters health fenofibrate is safe to use in patients with type 2 diabetes and moderate renal impairment, researchers conclude in a report online december 30 in diabetes care. The information on dosage adjustments in renal impairment given in this book is based on. Each tablet contains 54 mg or 160 mg of fenofibrate. Fenofibrate, like clofibrate and gemfibrozil, may increase cholesterol excretion into the bile, leading to cholelithiasis.
The nkf recommends that patients with gfr 60 to 90 mlmin1. Pediatric drugs analgesics antihypertensive and cardiovascular agents antimicrobial agents miscellaneous agents sedatives, hypnotics, and other drugs used in psychiatry. Consider renal function monitoring in elderly patients. Fenofibric acid exposure is not influenced by age, but due to substantial renal excretion, it is affected by. If cholelithiasis is suspected in a patient receiving ezetimibe and fenofibrate, gallbladder studies are indicated and alternative lipidlowering therapy should be considered. Managing dyslipidemia in chronic kidney disease sciencedirect. Monitor liver tests, including alt, periodically during therapy. Furthermore, guidelines regarding fenofibrate dosing in renal impairment vary internationally. Fenofibrate increases cholesterol excretion into bile, leading to risk of cholelithiasis. Fenofibrate treatment resulted in increased serum creatinine levels and. The chemical name for fenofibrate is 244chlorobenzoyl phenoxy2methylpropanoic acid, 1methylethyl ester with the following structural.
It acts by the activation of peroxisome proliferator activated receptor a. Click here for a specialized list of other renal medication dosing not listed in the alphabetical main section simple renal dosing guidelines. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. Rhabdomyolysisinduced acute renal failure following.
Specific precautions and warnings with fenofibrate some precautions and warnings to be aware while taking fenofibrate include. Fenofibrate 299 fenoprofen 300 fentanyl 302 ferrous gluconate 303 ferrous sulphate 304. Although the exact mechanism of action has not been fully characterized, clofibrate may enhance the conversion of verylowdensity lipoprotein vldl to lowdensity lipoprotein ldl, decreasing the production of hepatic vldl, inhibiting cholesterol production, and increasing fecal excretion of. Lowering triglycerides in people with very high triglyceride blood levels may decrease the risk of. Fenofibrate is not recommended for use during pregnancy. Mar 18, 2019 detailed fenofibrate dosage information for adults and the elderly. If cholelithiasis is suspected, gallbladder studies are. Mainly renal 6088% in urine as the active metabolite and glucuronidated forms, 525% in feces as unchanged fenofibrate. It may be used alone or with other cholesterollowering medications. Effects of fenofibrate on renal function in patients with. Consider dosage reduction if serum lipid concentrations fall significantly below target goals. Acute renal failure secondary to fenofibrate monotherapyinduced rhabdomyolysis is a rare and newly encountered clinical condition, and there are only sixteen cases associated with fenofibrate therapy nine with monotherapy and seven with fenofibratestatin combination therapy which have been published in the englishlanguage literature. Renal monitoring should also be considered for patients taking antara at risk for renal insufficiency such as the elderly and patients with diabetes. Common side effects include liver problems, breathing problems.
Clofibrate definition nci an aryloxyisobutyric acid derivate with antihyperlipidemic activity. Tricor fenofibrate tablets, is a lipid regulating agent available as tablets for oral administration. Lowering triglycerides in people with very high triglyceride blood levels may decrease the risk of pancreas disease pancreatitis. The patients with endstage renal disease treated with hemodialysis may be particularly susceptible to toxic effects of fibrates since in the absence of the removal of their metabolites with urine only about 10% of a single fenofibrate dose was cleared from the blood by hemodialysis resulting in a substantially prolonged plasma halflife of its. Tricor, lofibra tablets fenofibrate dosing, indications. Renal and hepatic dysfunction, and gall bladder disease. Fenofibrate tricor side effects, dosage, interactions. Treatment of chronic hemodialysis patients with lowdose. Fenofibrate tricor side effects, dosage, interactions drugs. Fenofibrate, sold under the brand name tricor among others, is a medication of the fibrate class used to treat abnormal blood lipid levels. Given potential renal benefit, but the possible safety. Analgesics antihypertensive and cardiovascular agents antimicrobial agents miscellaneous agents sedatives, hypnotics, and other drugs used in psychiatry.
A186002,l8588,l8591 fenofibrate requires once daily dosing and has a half life of 1927 hours so its duration of action is long. Fenofibrate belongs to a group of drugs called fibrates. Initially 200 mg daily, then increased if necessary to 267 mg daily, maximum 200 mg daily with concomitant statin, 267 mg capsules not appropriate for initial dose titration. Fenofibrate is the generic form of the brand name drug tricor, used to treat high levels of cholesterol and triglyceride in your blood fenofibrate belongs to a class of medications known as. Acute renal failure secondary to fenofibrate monotherapyinduced rhabdomyolysis is a rare and newly encountered clinical condition, and there are only sixteen cases associated with fenofibrate therapy nine with monotherapy and seven with fenofibrate statin combination therapy which have been published in the englishlanguage literature. If you are over the age of 65 or have kidney problems, your healthcare provider may choose to start you at a lower dose than normal. Fenofibrates propensity to elevate plasma creatinine is one of the major hindrances to more widespread use, dr. We prospectively examined the effect of 2 weeks fenofibrate treatment 200 mg daily on renal function in thirteen hyperlipidemic patients with normal renal function or mild to moderate renal. Fenofibrate is used with dietary modifications for the treatment of lipid disorders.
Fenofibrateassociated changes in renal function and. The oral tablet is available as the brandname drugs fenoglide, tricor, and triglide. Treatment with tricor should be initiated at a dose of 48 mgday in patients having mild to moderately impaired renal function, and increased only after evaluation of the effects on renal function and lipid levels at this dose. Fenofibrate mechanism, indication, contraindications. This emedtv page lists other factors that determine a fenofibrate dose, such as your age, other medical conditions you have, and medicines you are taking. Each tablet contains 50 mg or 160 mg of fenofibrate. Fenofibrate is a fibrate that activates peroxisome proliferator activated receptor alpha ppar. Benefits and safety of longterm fenofibrate therapy in people. Adult drugs analgesics antihypertensive and cardiovascular agents antimicrobial agents miscellaneous agents sedatives, hypnotics, and other drugs used in. Recent studies have shown that fenofibrate may cause a moderate. Effect of fenofibrate medication on renal function ncbi. Fenofibrate reduced urine albumin concentrations and hence albumincreatinine ratio by 24% vs 11% p fenofibrate micronized capsules. Renal monitoring should also be considered for patients taking fenofibrate tablets at risk for renal insufficiency such as the elderly and patients with diabetes.
The renal drug handbook the st georges hospital, adult critical. Oral dosage tricor tablets 48 or 145 mg fenofibrate initially, 48145 mg po once daily, administered without regard to meals. In a pharmacokinetic study, concomitant fenofibrate or gemfibrozil administration increased total ezetimibe concentrations by approximately 1. It works by increasing the natural substance that breaks down fats in the blood. Kidney disease is a known side effect of fenofibrate.
Fenofibrate dosing varies, depending on the brand of medicine and the condition being treated. The authors make no claims of the accuracy of the information contained herein. Fenofibrate reduced urine albumin concentrations and hence albumincreatinine ratio by 24% vs 11% p book is available from the british library. New york reuters health fenofibrate is safe to use in patients with type 2 diabetes and moderate renal impairment, researchers conclude in a report online december 30 in diabetes care.
Detailed fenofibrate dosage information for adults and the elderly. It helps reduce levels of ldlc, total cholesterol, triglycerides, and apolipoprotein b, and increase hdlc. Its use is recommended together with dietary changes. Treatment with fenofibrate tablets for oral use should be initiated at a dose of 48 mg per day in patients having mild to moderately impaired renal function, and increased only after evaluation of the effects on renal function and lipid levels at this dose. Evaluate lipid serum concentrations at 48 week intervals. Dec 30, 2019 renal monitoring should also be considered for patients taking fenofibrate tablets for oral use at risk for renal insufficiency such as the elderly and patients with diabetes. Fenofibrate information, side effects, warnings and recalls. Fenofibrate is a prescription medication used to lower cholesterol and triglycerides a type of fat and to increase hdl good cholesterol in the blood. Usual adult dose of fenofibrate for hyperlipoproteinemia type iia elevated ldl. Fenofibrate is used along with a proper diet to help lower bad cholesterol and fats such as ldl, triglycerides and raise good cholesterol in the blood. Fenofibrate can increase serum creatinine levels in renal insufficiency sir, fenofibrate is widely used to treat hypertriglyceridemia. Data sources include ibm watson micromedex updated 4 may 2020, cerner multum updated 4 may 2020, wolters kluwer updated.
Fenofibrate safe in type 2 diabetes and moderate renal. It is less preferred to statin medications as it does not appear to reduce the risk of heart disease or death. It acts by increasing the expression of the lpl gene, while decreasing expression of apoc iii a powerful inhibitor of lpl activity. May 07, 2019 renal monitoring should also be considered for patients taking fenofibrate tablets at risk for renal insufficiency such as the elderly and patients with diabetes. By continuing to browse this site you are agreeing to our use of cookies. Fenofibrate has been noted to cause an elevation in serum creatinine in some individuals. No adverse effect of fenofibrate on renal function was reported. Lopid gemfibrozil dose, indications, adverse effects. Fenofibrate belongs to a group of drugs known as fibrates. Pdf effects of fenofibrate on renal function in patients. Includes dosages for hyperlipidemia, hypertriglyceridemia, hyperlipoproteinemia type iia elevated ldl and more. Usual geriatric dose of fenofibrate for hyperlipoproteinemia. It is prescribed to patients with primary hypercholesterolemia or mixed dyslipidemia, and hypertriglyceridemia. Participants in the action to control cardiovascular risk in diabetes lipid study were studied to better characterise who is at risk of an increase in creatinine level and to determine whether those with creatinine elevation have a differential risk of adverse renal or cardiovascular.
Tricor fenofibrate dose, indications, adverse effects. Fenofibrate has been shown to decrease albuminuria in a mousemodeloftype2diabetes10 and in humans 1, 2, 11. Patients with severe renal impairment, including those receiving dialysis 2. Fenofibrate safe in type 2 diabetes and moderate renal impairment. Rudee ting from university of sydney and royal prince alfred hospital in new. The mechanism underlying this is poorly understood, but fenofibrate is not.
1001 652 375 1060 743 61 1483 394 1248 830 1430 192 721 1074 169 948 318 174 219 1528 676 844 329 1379 1437 391 882 552 1317 444 910 174 782 1214 1487 661 1419 840 994 1201