Fenofibrate

Fibrate·Cardiovascular - Lipid Lowering

Severe hypertriglyceridemia (risk of pancreatitis), mixed dyslipidemia

Authority requiredPBSFIBRATELipidil48 mg tablet+2

Max Dose

145 mg/day

Half-life

20 h

Myopathy

HIGH w/ STATIN

Renal Adj.

DOSE RED.

Rapid Summary

Overview

PPAR-alpha agonist used primarily to lower extremely high triglycerides to prevent acute pancreatitis.

Maximum Dose

Max 145 mg/day (nanoparticle formulation) or 160 mg/day (standard).

Clinical Focus

Highly toxic to muscles if combined with statins. If a fibrate must be used with a statin, Fenofibrate is safer than Gemfibrozil.

Bottom Line

Fenofibrate is the fibrate of choice for hypertriglyceridaemia and diabetic dyslipidaemia, but increases creatinine (non-pathological) and carries myopathy risk when combined with statins.

Formulation & Access

Brand Names

Lipidil

Oral Routes

Take with food

Tablets (48 mg, 145 mg). Take with food to improve absorption (unless nanoparticle formulation).

Prescribing & PBS

Authority Required (PBS).

Indications & Use

Primary

PBSTGA

Severe hypertriglyceridemia (risk of pancreatitis), mixed dyslipidemia.

Clinical Place

Niche role. Used almost exclusively when Triglycerides are > 10 mmol/L to prevent pancreatitis, or in diabetic retinopathy.

Quick reference

Class & Role

Fibrate — PPAR-alpha agonist used primarily to lower extremely high triglycerides to prevent acute pancreatitis.

Route / Formulation

Tablets (48 mg, 145 mg). Take with food to improve absorption (unless nanoparticle formulation). (Lipidil)

Usual Dose & Max

PO 145 mg OD (Lipidil) OR 160 mg OD (Lipidil EZ). Max 145 mg/day (nanoparticle formulation) or 160 mg/day (standard).

Key Indication Doses

Severe Hypertriglyceridemia: PO 145 mg OD (Lipidil) OR 160 mg OD (Lipidil EZ). Renal Impairment: Reduce dose to 48 mg/day if eGFR 30-59. Avoid entirely if eGFR < 30.

Best Uses

Fenofibrate is the fibrate of choice for hypertriglyceridaemia and diabetic dyslipidaemia, but increases creatinine (non-pathological) and carries myopathy risk when combined with statins.

Avoid / Cautions

Severe renal impairment, active liver disease, gallbladder disease. Pregnancy Category B3.

Key Risks

Musculoskeletal: Myopathy, Rhabdomyolysis (exponentially increased if combined with a statin). Gastrointestinal: Cholelithiasis (gallstones), GI upset. Renal: Can cause a reversible bump in serum creatinine.

Key Interactions

Statins. The combo risks massive muscle breakdown. (Note: Gemfibrozil + Statin is an absolute contraindication. Fenofibrate + Statin is used with extreme caution). Enhances the effect of Warfarin. Monitor INR closely.

Monitoring

Lipids (focusing on triglycerides), LFTs, U&E (creatinine), and baseline CK. Warn patients to report unexplained muscle pain immediately.

Clinical Pearl

Statins are for heart attacks; Fibrates are for the pancreas. Fibrates only have a strong clinical role when TGs exceed 10 mmol/L, as this is the threshold for acute pancreatitis.

Access

Authority requiredLipidil48 mg tablet

Brand: Lipidil
PBS status: Authority required
Formulation: Tablets (48 mg, 145 mg)

Fenofibrate

Fibrate·Cardiovascular - Lipid Lowering

Severe hypertriglyceridemia (risk of pancreatitis), mixed dyslipidemia

Authority requiredPBSFIBRATELipidil48 mg tablet+2

Max Dose

145 mg/day

Half-life

20 h

Myopathy

HIGH w/ STATIN

Renal Adj.

DOSE RED.

Rapid Summary

Overview

PPAR-alpha agonist used primarily to lower extremely high triglycerides to prevent acute pancreatitis.

Maximum Dose

Max 145 mg/day (nanoparticle formulation) or 160 mg/day (standard).

Clinical Focus

Highly toxic to muscles if combined with statins. If a fibrate must be used with a statin, Fenofibrate is safer than Gemfibrozil.

Bottom Line

Fenofibrate is the fibrate of choice for hypertriglyceridaemia and diabetic dyslipidaemia, but increases creatinine (non-pathological) and carries myopathy risk when combined with statins.

Formulation & Access

Brand Names

Lipidil

Oral Routes

Take with food

Tablets (48 mg, 145 mg). Take with food to improve absorption (unless nanoparticle formulation).

Prescribing & PBS

Authority Required (PBS).

Indications & Use

Primary

PBSTGA

Severe hypertriglyceridemia (risk of pancreatitis), mixed dyslipidemia.

Clinical Place

Niche role. Used almost exclusively when Triglycerides are > 10 mmol/L to prevent pancreatitis, or in diabetic retinopathy.

Quick reference

Class & Role

Fibrate — PPAR-alpha agonist used primarily to lower extremely high triglycerides to prevent acute pancreatitis.

Route / Formulation

Tablets (48 mg, 145 mg). Take with food to improve absorption (unless nanoparticle formulation). (Lipidil)

Usual Dose & Max

PO 145 mg OD (Lipidil) OR 160 mg OD (Lipidil EZ). Max 145 mg/day (nanoparticle formulation) or 160 mg/day (standard).

Key Indication Doses

Severe Hypertriglyceridemia: PO 145 mg OD (Lipidil) OR 160 mg OD (Lipidil EZ). Renal Impairment: Reduce dose to 48 mg/day if eGFR 30-59. Avoid entirely if eGFR < 30.

Best Uses

Fenofibrate is the fibrate of choice for hypertriglyceridaemia and diabetic dyslipidaemia, but increases creatinine (non-pathological) and carries myopathy risk when combined with statins.

Avoid / Cautions

Severe renal impairment, active liver disease, gallbladder disease. Pregnancy Category B3.

Key Risks

Key Interactions

Monitoring

Lipids (focusing on triglycerides), LFTs, U&E (creatinine), and baseline CK. Warn patients to report unexplained muscle pain immediately.

Clinical Pearl

Statins are for heart attacks; Fibrates are for the pancreas. Fibrates only have a strong clinical role when TGs exceed 10 mmol/L, as this is the threshold for acute pancreatitis.

Access

Authority requiredLipidil48 mg tablet

Brand: Lipidil
PBS status: Authority required
Formulation: Tablets (48 mg, 145 mg)