fenofibrate micronized (Rx)

Brand and Other Names:Antara, Lofibra capsules

Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

capsule (Antara)

  • 30mg
  • 90mg

capsule (fenofibrate, micronized)

  • 43mg
  • 130mg

capsule (Lofibra)

  • 67mg
  • 134mg
  • 200mg

Hypertriglyceridemia

Indicated as adjunct to diet for severe hypertriglyceridemia (>500 mg/dL)

Individualize dose according to patient response

Antara: 30-90 mg PO qDay

Fenofibrate (micronized): 43-130 mg PO qDay; not to exceed 130 mg/day

Lofibra capsules: 67-200 mg PO qDay

Primary Hypercholesterolemia or Mixed Lipidemia

Indicated as adjunct to diet to reduce elevated LDL-C, Total-C, TG, and Apo B, and to increase HDL-C in patients with primary hypercholesterolemia or mixed dyslipidemia

Antara: 90 mg PO qDay initially; discontinue if inadequate response after 2 months of treatment; may decrease dose if patient responds

Fenofibrate (micronized): 130 mg PO qDay; not to exceed 130 mg/day

Lofibra capsules: 200 mg PO qDay

Dosage Modifications

Renal impairment

  • Mild-to-moderate (CrCl 30-80 mL/min): Initiate at lowest available dose and increase only after evaluating effects on renal function and lipid levels
  • Severe (CrCl <30 mL/min): Contraindicated

Dosing Considerations

Hypertriglyceridemia: Improving glycemic control in diabetic patients with fasting chylomicronemia will usually obviate the need for pharmacological intervention

Fenofibrate was not shown to reduce coronary heart disease morbidity and mortality in patients with type 2 diabetes mellitus

Administration

Antara: May take with or without meals

Lofibra capsules: Take with meals to optimize bioavailability

Safety and efficacy not established

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Interactions

Interaction Checker

and fenofibrate micronized

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              Serious - Use Alternative (13)

              • apalutamide

                apalutamide will decrease the level or effect of fenofibrate micronized by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Coadministration of apalutamide, a strong CYP3A4 inducer, with drugs that are CYP3A4 substrates can result in lower exposure to these medications. Avoid or substitute another drug for these medications when possible. Evaluate for loss of therapeutic effect if medication must be coadministered. Adjust dose according to prescribing information if needed.

              • atorvastatin

                fenofibrate micronized, atorvastatin. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Fenofibrate may further increase risk for rhabdomyolysis when added to optimal statin regimen to further decrease TG and increase HDLs.

              • colchicine

                colchicine, fenofibrate micronized. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Increased risk of rhabdomyolysis (incl a fatality).

              • fexinidazole

                fexinidazole will increase the level or effect of fenofibrate micronized by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Fexinidazole inhibits CYP3A4. Coadministration may increase risk for adverse effects of CYP3A4 substrates.

              • fluvastatin

                fenofibrate micronized, fluvastatin. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Fenofibrate may further increase risk for rhabdomyolysis when added to optimal statin regimen to further decrease TG and increase HDLs.

              • idelalisib

                idelalisib will increase the level or effect of fenofibrate micronized by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Idelalisib is a strong CYP3A inhibitor; avoid coadministration with sensitive CYP3A substrates

              • lovastatin

                fenofibrate micronized, lovastatin. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Fenofibrate may further increase risk for rhabdomyolysis when added to optimal statin regimen to further decrease TG and increase HDLs. Do not exceed 20 mg/day of lovastatin.

              • pitavastatin

                fenofibrate micronized, pitavastatin. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Fenofibrate may further increase risk for rhabdomyolysis when added to optimal statin regimen to further decrease TG and increase HDLs.

              • pravastatin

                fenofibrate micronized, pravastatin. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Fenofibrate may further increase risk for rhabdomyolysis when added to optimal statin regimen to further decrease TG and increase HDLs.

              • rosuvastatin

                fenofibrate micronized, rosuvastatin. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Fenofibrate may further increase risk for rhabdomyolysis when added to optimal statin regimen to further decrease TG and increase HDLs.

              • simvastatin

                fenofibrate micronized, simvastatin. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Fenofibrate may further increase risk for rhabdomyolysis when added to optimal statin regimen to further decrease TG and increase HDLs.

              • tucatinib

                tucatinib will increase the level or effect of fenofibrate micronized by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid concomitant use of tucatinib with CYP3A substrates, where minimal concentration changes may lead to serious or life-threatening toxicities. If unavoidable, reduce CYP3A substrate dose according to product labeling.

              • voxelotor

                voxelotor will increase the level or effect of fenofibrate micronized by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Voxelotor increases systemic exposure of sensitive CYP3A4 substrates. Avoid coadministration with sensitive CYP3A4 substrates with a narrow therapeutic index. Consider dose reduction of the sensitive CYP3A4 substrate(s) if unable to avoid.

              Monitor Closely (38)

              • belzutifan

                belzutifan will decrease the level or effect of fenofibrate micronized by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. If unable to avoid coadministration of belzutifan with sensitive CYP3A4 substrates, consider increasing the sensitive CYP3A4 substrate dose in accordance with its prescribing information.

              • cenobamate

                cenobamate will decrease the level or effect of fenofibrate micronized by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Increase dose of CYP3A4 substrate, as needed, when coadministered with cenobamate.

              • chlorpropamide

                fenofibrate micronized increases effects of chlorpropamide by plasma protein binding competition. Use Caution/Monitor. Hypoglycemia; increased risk in hypoalbuminemia.

              • cholestyramine

                cholestyramine decreases levels of fenofibrate micronized by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

              • cholic acid

                fenofibrate micronized increases toxicity of cholic acid by decreasing elimination. Modify Therapy/Monitor Closely. Avoid concomitant use of inhibitors of the bile salt efflux pump (BSEP). May exacerbate accumulation of conjugated bile salts in the liver and result in clinical symptoms. If concomitant use is necessary, monitor serum transaminases and bilirubin.

              • cyclosporine

                fenofibrate micronized increases levels of cyclosporine by unspecified interaction mechanism. Use Caution/Monitor.

              • dabrafenib

                dabrafenib will decrease the level or effect of fenofibrate micronized by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely.

              • elagolix

                elagolix decreases levels of fenofibrate micronized by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Elagolix is a weak-to-moderate CYP3A4 inducer. Monitor CYP3A substrates if coadministered. Consider increasing CYP3A substrate dose if needed.

              • elvitegravir/cobicistat/emtricitabine/tenofovir DF

                elvitegravir/cobicistat/emtricitabine/tenofovir DF increases levels of fenofibrate micronized by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Cobicistat is a CYP3A4 inhibitor; contraindicated with CYP3A4 substrates for which elevated plasma concentrations are associated with serious and/or life-threatening events.

              • fedratinib

                fedratinib will increase the level or effect of fenofibrate micronized by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Adjust dose of drugs that are CYP3A4 substrates as necessary.

              • fosphenytoin

                fosphenytoin will decrease the level or effect of fenofibrate micronized by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              • furosemide

                fenofibrate micronized, furosemide. Either increases levels of the other by plasma protein binding competition. Use Caution/Monitor. Increased risk in hypoalbuminemia.

              • glimepiride

                fenofibrate micronized increases effects of glimepiride by plasma protein binding competition. Use Caution/Monitor. Hypoglycemia; increased risk in hypoalbuminemia.

              • glipizide

                fenofibrate micronized increases effects of glipizide by plasma protein binding competition. Use Caution/Monitor. Hypoglycemia; increased risk in hypoalbuminemia.

              • glyburide

                fenofibrate micronized increases effects of glyburide by plasma protein binding competition. Use Caution/Monitor. Hypoglycemia; increased risk in hypoalbuminemia.

              • iloperidone

                iloperidone increases levels of fenofibrate micronized by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Iloperidone is a time-dependent CYP3A inhibitor and may lead to increased plasma levels of drugs predominantly eliminated by CYP3A4.

              • insulin aspart

                fenofibrate micronized increases effects of insulin aspart by unspecified interaction mechanism. Use Caution/Monitor. Hypoglycemia; increased risk in hypoalbuminemia.

              • insulin degludec

                fenofibrate micronized, insulin degludec. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Both drugs decrease blood glucose.

              • insulin degludec/insulin aspart

                fenofibrate micronized, insulin degludec/insulin aspart. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Both drugs decrease blood glucose.

              • insulin detemir

                fenofibrate micronized increases effects of insulin detemir by unspecified interaction mechanism. Use Caution/Monitor. Hypoglycemia; increased risk in hypoalbuminemia.

              • insulin glargine

                fenofibrate micronized increases effects of insulin glargine by unspecified interaction mechanism. Use Caution/Monitor. Hypoglycemia; increased risk in hypoalbuminemia.

              • insulin glulisine

                fenofibrate micronized increases effects of insulin glulisine by unspecified interaction mechanism. Use Caution/Monitor. Hypoglycemia; increased risk in hypoalbuminemia.

              • insulin inhaled

                fenofibrate micronized, insulin inhaled. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Both drugs decrease blood glucose.

              • insulin lispro

                fenofibrate micronized increases effects of insulin lispro by unspecified interaction mechanism. Use Caution/Monitor. Hypoglycemia; increased risk in hypoalbuminemia.

              • insulin NPH

                fenofibrate micronized increases effects of insulin NPH by unspecified interaction mechanism. Use Caution/Monitor. Hypoglycemia; increased risk in hypoalbuminemia.

              • insulin regular human

                fenofibrate micronized increases effects of insulin regular human by unspecified interaction mechanism. Use Caution/Monitor. Hypoglycemia; increased risk in hypoalbuminemia.

              • istradefylline

                istradefylline will increase the level or effect of fenofibrate micronized by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Istradefylline 40 mg/day increased peak levels and AUC of CYP3A4 substrates in clinical trials. This effect was not observed with istradefylline 20 mg/day. Consider dose reduction of sensitive CYP3A4 substrates.

              • lenacapavir

                lenacapavir will increase the level or effect of fenofibrate micronized by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Lencapavir (a moderate CYP3A4 inhibitor) may increase CYP3A4 substrates initiated within 9 months after last SC dose of lenacapavir, which may increase potential risk of adverse reactions of CYP3A4 substrates.

              • mavacamten

                fenofibrate micronized will increase the level or effect of mavacamten by affecting hepatic enzyme CYP2C19 metabolism. Modify Therapy/Monitor Closely. Inititiation of weak CYP2C19 inhibitors may require decreased mavacamten dose.

              • mitotane

                mitotane decreases levels of fenofibrate micronized by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Mitotane is a strong inducer of cytochrome P-4503A4; monitor when coadministered with CYP3A4 substrates for possible dosage adjustments.

              • rucaparib

                rucaparib will increase the level or effect of fenofibrate micronized by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Adjust dosage of CYP3A4 substrates, if clinically indicated.

              • stiripentol

                stiripentol, fenofibrate micronized. affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Stiripentol is a CYP3A4 inhibitor and inducer. Monitor CYP3A4 substrates coadministered with stiripentol for increased or decreased effects. CYP3A4 substrates may require dosage adjustment.

              • tazemetostat

                tazemetostat will decrease the level or effect of fenofibrate micronized by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              • tecovirimat

                tecovirimat will decrease the level or effect of fenofibrate micronized by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Tecovirimat is a weak CYP3A4 inducer. Monitor sensitive CYP3A4 substrates for effectiveness if coadministered.

              • tenofovir DF

                fenofibrate micronized increases levels of tenofovir DF by decreasing renal clearance. Use Caution/Monitor. Increased risk of myopathy.

              • tolazamide

                fenofibrate micronized increases effects of tolazamide by plasma protein binding competition. Use Caution/Monitor. Hypoglycemia; increased risk in hypoalbuminemia.

              • tolbutamide

                fenofibrate micronized increases effects of tolbutamide by plasma protein binding competition. Use Caution/Monitor. Hypoglycemia; increased risk in hypoalbuminemia.

              • warfarin

                fenofibrate micronized will increase the level or effect of warfarin by affecting hepatic enzyme CYP2C9/10 metabolism. Modify Therapy/Monitor Closely. Mechanism of interaction may be caused by CYP2C9 inhibition and protein-binding displacement.

              Minor (10)

              • acetazolamide

                acetazolamide will increase the level or effect of fenofibrate micronized by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • anastrozole

                anastrozole will increase the level or effect of fenofibrate micronized by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • colestipol

                colestipol decreases levels of fenofibrate micronized by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • cyclophosphamide

                cyclophosphamide will increase the level or effect of fenofibrate micronized by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • ezetimibe

                fenofibrate micronized increases levels of ezetimibe by unspecified interaction mechanism. Minor/Significance Unknown.

              • larotrectinib

                larotrectinib will increase the level or effect of fenofibrate micronized by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • levoketoconazole

                levoketoconazole will increase the level or effect of fenofibrate micronized by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • octacosanol

                octacosanol increases effects of fenofibrate micronized by pharmacodynamic synergism. Minor/Significance Unknown.

              • orlistat

                orlistat increases effects of fenofibrate micronized by pharmacodynamic synergism. Minor/Significance Unknown.

              • ribociclib

                ribociclib will increase the level or effect of fenofibrate micronized by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

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              Adverse Effects

              1-10%

              Abdominal pain (4.6%)

              Back pain (3.4%)

              Increased AST (3.4%)

              Headache (3.2%)

              Increased ALT (3%)

              Increased CPK (3%)

              Nausea (2.3%)

              Constipation (2.1%)

              Postmarketing Reports

              Myalgia, rhabdomyolysis, muscle spasms, arthralgia

              Pancreatitis

              Renal failure

              Hepatitis, cirrhosis

              Anemia

              Severely depressed HDL levels

              Photosensitivity reactions (may occur days to months after initiating therapy)

              Interstitial lung disease

              Increase total bilirubin

              Asthenia

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              Warnings

              Contraindications

              Hypersensitivity

              Severe renal impairment (including dialysis)

              Active liver disease, including primary biliary cirrhosis and unexplained persistent liver function abnormalities

              Pre-existing gallbladder disease

              Breastfeeding women

              Cautions

              Effect on coronary heart disease morbidity and mortality not established

              Increases risk of myositis or myopathy, and has been associated with rhabdomyolysis; risk may increase when coadministered with statins

              Higher doses or coadministration with statins associated with increased serum transaminases

              May increase serum creatinine; monitor renal function periodically in patients with renal impairment

              May increase cholesterol excretion in bile, potentially leading to cholelithiasis

              Coadministration with warfarin may increase anticoagulant effects resulting in PT/INR prolongation

              Pancreatitis reported; may be a failure of efficacy with severe hypertriglyceridemia, a direct drug effect, or secondary effect via biliary stone or sludge formation

              May decrease hemoglobin, hematocrit, and leukocytes; thrombocytopenia and agranulocytosis reported; monitoring of blood counts recommended during first year of therapy

              Anaphylaxis and angioedema reported; if patient develops signs or symptoms of acute hypersensitivity reaction, advise them to seek immediate medical attention and discontinue therapy Severe cutaneous adverse drug reactions (SCAR), including Stevens-Johnson syndrome, toxic epidermal necrolysis, and drug reaction with eosinophilia and systemic symptoms (DRESS), reported postmarketing, occurring days to weeks after initiation of therapy; cases of DRESS associated with cutaneous reactions (such as rash exfoliative dermatitis) and a combination of eosinophilia, fever, systemic organ involvement (renal, hepatic, or respiratory); discontinue therapy and treat patients appropriately if SCAR is suspected

              PE and DVT reported; use caution in patients with risk factors for VTE

              Paradoxical decreases in HDL cholesterol reported; monitor HDL-C within few months of initiating therapy; discontinue of HDL-C becomes severely depressed; do not restart therapy

              Hepatotoxicity

              • Serious drug-induced liver injury (DILI), including liver transplantation and death, reported; DILI reported within first few weeks of treatment or after several months of therapy and in some cases has reversed with discontinuation of treatment
              • Patients with DILI have experienced signs and symptoms including dark urine, abnormal stool, jaundice, malaise, abdominal pain, myalgia, weight loss, pruritus, and nausea
              • Many patients had concurrent elevations of total bilirubin, serum alanine transaminase (ALT), and aspartate transaminase (AST)
              • DILI has been characterized as hepatocellular, chronic active, and cholestatic hepatitis, and cirrhosis has occurred in association with chronic active hepatitis
              • In clinical trials, fenofibrate at doses equivalent to 90 mg daily associated with increases in serum AST or ALT; the incidence of increases in transaminases may be dose-related
              • Monitor patient’s liver function, including serum ALT, AST, and total bilirubin, at baseline and periodically for duration of therapy
              • Discontinue therapy if signs or symptoms of liver injury develop or if elevated enzyme levels persist (ALT or AST > 3 times the upper limit of normal, or if accompanied by elevation of bilirubin); do not restart therapy in these patients if there is no alternative explanation for the liver injury
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              Pregnancy & Lactation

              Pregnancy Category: C

              Lactation: Contraindicated

              Pregnancy Categories

              A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

              B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

              C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

              D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

              X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

              NA: Information not available.

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              Pharmacology

              Mechanism of Action

              Fenofibrate is a prodrug that is metabolized to the active moiety, fenofibric acid

              Activates peroxisome proliferator activated receptor-alpha (PPAR-alpha); increases lipolysis and elimination of triglyceride-rich particles from plasma by activating lipoprotein lipase and reduces Apo CIII production (lipoprotein lipase inhibitor)

              Reduces TC, LDL-C, Apo B, TG, and VLDL; increases HDL-C, Apo AI, and Apo AII

              Absorption

              Peak Plasma Time: 4-8 hr (fenofibric acid)

              Distribution

              Time to steady-state: within 7 days (Antara); within 5 days (Lofibra capsules)

              Protein Bound: 99%

              Metabolism

              Fenofibrate converted by ester hydrolysis to fenofibric acid (active moiety)

              Fenofibric acid is primarily conjugated with glucuronic acid; a small amount is reduced at the carbonyl moiety to a benzhydrol metabolite which is, in turn, conjugated with glucuronic acid

              Elimination

              Half-life: 20-23 hr

              Excretion: 66% in urine, primarily as fenofibric acid and fenofibric acid glucuronide; 25% feces

              Pharmacogenomics

              Genotyping patients with atherogenic dyslipidemia might establish who will benefit most from therapy with fenofibric to increase HDL-C

              Three single-nucleotide polymorphisms (SNPs) in the APOA5 region have been associated with increases in HDL-C

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              Images

              BRAND FORM. UNIT PRICE PILL IMAGE
              Tricor oral
              -
              145 mg tablet
              Tricor oral
              -
              48 mg tablet
              Antara oral
              -
              90 mg capsule
              fenofibrate micronized oral
              -
              130 mg capsule
              fenofibrate micronized oral
              -
              67 mg capsule
              fenofibrate micronized oral
              -
              67 mg capsule
              fenofibrate micronized oral
              -
              200 mg capsule
              fenofibrate micronized oral
              -
              43 mg capsule
              fenofibrate micronized oral
              -
              130 mg capsule
              fenofibrate micronized oral
              -
              90 mg capsule
              fenofibrate micronized oral
              -
              134 mg capsule
              fenofibrate micronized oral
              -
              134 mg capsule
              fenofibrate micronized oral
              -
              134 mg capsule
              fenofibrate micronized oral
              -
              200 mg capsule
              fenofibrate micronized oral
              -
              130 mg capsule
              fenofibrate micronized oral
              -
              43 mg capsule
              fenofibrate micronized oral
              -
              134 mg capsule
              fenofibrate micronized oral
              -
              43 mg capsule
              fenofibrate micronized oral
              -
              67 mg capsule
              fenofibrate micronized oral
              -
              134 mg capsule
              fenofibrate micronized oral
              -
              200 mg capsule
              fenofibrate micronized oral
              -
              200 mg capsule
              fenofibrate micronized oral
              -
              67 mg capsule
              fenofibrate micronized oral
              -
              200 mg capsule
              fenofibrate micronized oral
              -
              134 mg capsule
              fenofibrate micronized oral
              -
              200 mg capsule
              fenofibrate micronized oral
              -
              67 mg capsule
              fenofibrate micronized oral
              -
              67 mg capsule
              fenofibrate micronized oral
              -
              134 mg capsule
              fenofibrate micronized oral
              -
              200 mg capsule
              fenofibrate micronized oral
              -
              134 mg capsule
              fenofibrate micronized oral
              -
              67 mg capsule
              fenofibrate micronized oral
              -
              200 mg capsule
              fenofibrate micronized oral
              -
              67 mg capsule
              fenofibrate micronized oral
              -
              200 mg capsule
              fenofibrate micronized oral
              -
              130 mg capsule
              fenofibrate micronized oral
              -
              134 mg capsule
              fenofibrate micronized oral
              -
              67 mg capsule

              Copyright © 2010 First DataBank, Inc.

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              Patient Handout

              Patient Education
              fenofibrate micronized oral

              FENOFIBRATE - ORAL

              (fen-oh-FYE-brate)

              COMMON BRAND NAME(S): Tricor, Triglide

              USES: Fenofibrate is used along with a proper diet to help lower "bad" cholesterol and fats (such as LDL, triglycerides) and raise "good" cholesterol (HDL) in the blood. It works by increasing the natural substance (enzyme) that breaks down fats in the blood. Fenofibrate belongs to a group of drugs known as "fibrates." Lowering triglycerides in people with very high triglyceride blood levels may decrease the risk of pancreas disease (pancreatitis). However, fenofibrate might not lower your risk of a heart attack or stroke. Talk to your doctor about the risks and benefits of fenofibrate.In addition to eating a proper diet (such as a low-cholesterol/low-fat diet), other lifestyle changes that may help this medication work better include exercising, losing weight if overweight, and stopping smoking. Consult your doctor for more details.

              HOW TO USE: Take this medication by mouth as directed by your doctor, usually once daily. Fenofibrate comes in different types of capsules and tablets which provide different amounts of the medication. Do not switch between different forms or brands of this medication unless directed by your doctor. Some forms of this drug should be taken with food but others may be taken with or without food. Ask your pharmacist about your brand of fenofibrate. It is important to take this medication correctly so that the drug has the greatest benefit.The dosage is based on your medical condition and response to treatment.If you are also taking certain other drugs to lower your cholesterol (bile acid-binding resins such as cholestyramine or colestipol), take fenofibrate at least 1 hour before or at least 4 to 6 hours after taking these medications. These medications can bind to fenofibrate, preventing your body from fully absorbing the drug.Take this medication regularly to get the most benefit from it. To help you remember, take it at the same time each day. Do not increase your dose or use this drug more often or for longer than prescribed. Your cholesterol/triglycerides level will not lower faster, and your risk of side effects will increase. Keep taking this medication even if you feel well. Most people with high cholesterol/triglycerides do not feel sick.It is very important to continue to follow your doctor's advice about diet and exercise. It may take up to 2 months before you get the full benefit of this medication.

              SIDE EFFECTS: Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.This medication may rarely cause gallstones and liver problems. If you notice any of the following unlikely but serious side effects, tell your doctor right away: nausea/vomiting that doesn't stop, loss of appetite, stomach/abdominal pain, yellowing eyes/skin, dark urine.This drug may rarely cause muscle problems (which can rarely lead to a very serious condition called rhabdomyolysis). Tell your doctor right away if you develop any of these symptoms: muscle pain/tenderness/weakness (especially with fever or unusual tiredness), signs of kidney problems (such as change in the amount of urine).Rarely, this medication has caused severe lowering of HDL ("good" cholesterol) levels. This is the opposite of what should happen to your HDL levels (paradoxical reaction). Your HDL cholesterol levels should be checked regularly. Keep all of your lab appointments.Tell your doctor right away if you have any serious side effects, including: easy bleeding/bruising, unusual tiredness.Get medical help right away if you have any very serious side effects, including: chest pain, sudden pain/redness/swelling usually in the leg, signs of infection (such as sore throat that doesn't go away, fever, swollen lymph nodes, chills, cough).A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

              PRECAUTIONS: Before taking fenofibrate, tell your doctor or pharmacist if you are allergic to it; or to other "fibrates" (such as fenofibric acid); or if you have any other allergies. This product may contain inactive ingredients (such as soy), which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: kidney disease, gallbladder disease, liver disease (such as biliary cholangitis, hepatitis), alcohol use.Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.It is unknown if this medication passes into breast milk. Because of the possible risk to the infant, breast-feeding is not recommended while using this drug and for 5 days after stopping the drug. Consult your doctor before breast-feeding.

              DRUG INTERACTIONS: See also How to Use section.Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.Some products that may interact with this drug include: "blood thinners" (such as warfarin).Fenofibrate is very similar to fenofibric acid. Do not use medications containing fenofibric acid while using fenofibrate.

              OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center.

              NOTES: Do not share this medication with others.Lab and/or medical tests (such as cholesterol/triglyceride levels, kidney/liver function, complete blood count) should be done while you are taking this medication. Keep all medical and lab appointments. Consult your doctor for more details. (See also Side Effects section.)

              MISSED DOSE: If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.

              STORAGE: Store at room temperature away from light and moisture. Different brands of this medication have different storage needs. Check the product package for instructions on how to store your brand, or ask your pharmacist. Do not store in the bathroom. Keep all medications away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

              Information last revised August 2023. Copyright(c) 2023 First Databank, Inc.

              IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.

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              Formulary

              FormularyPatient Discounts

              Adding plans allows you to compare formulary status to other drugs in the same class.

              To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

              Adding plans allows you to:

              • View the formulary and any restrictions for each plan.
              • Manage and view all your plans together – even plans in different states.
              • Compare formulary status to other drugs in the same class.
              • Access your plan list on any device – mobile or desktop.

              The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

              Tier Description
              1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
              2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
              3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
              4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
              5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
              6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
              NC NOT COVERED – Drugs that are not covered by the plan.
              Code Definition
              PA Prior Authorization
              Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
              QL Quantity Limits
              Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
              ST Step Therapy
              Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
              OR Other Restrictions
              Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
              Additional Offers
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              Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.