Fenofibrate
TRICOR
Pronunciation: fen-oe-FYE-brayt
“Feno’s fibrous Tricorne”
What it isPPAR-alpha agonist that lowers triglycerides; severe hypertriglyceridemia and primary hyperlipidemia.
Why this oneUnlike gemfibrozil, it can be paired more safely with a statin when triglycerides remain severe.
What limits itIt can raise creatinine without true GFR loss; monitor renal function. Gallstones and statin-associated myopathy can end treatment.
FDA-approved for
- hyperlipidemia (~1993)
FDA label
Read the full label on DailyMed ↗
| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| Primary hypercholesterolemia / mixed dyslipidemia | adult | 160 mg QD | 160 mg QD | 160 mg QD |
| Severe hypertriglyceridemia | adult | 54–160 mg QD | 160 mg QD | |
| Mild–moderate renal impairment | adult | 54 mg QD |
Titration For severe hypertriglyceridemia, adjust at 4–8 week intervals.
Renal Mild–moderate impairment: initiate 54 mg QD; severe impairment/dialysis: contraindicated (avoid).
Hepatic Contraindicated in active liver disease.
Instructions
- Take with meals to optimize bioavailability.
- Withdraw if inadequate response after 2 months at the maximum 160 mg dose.
Available strengths
- tab 48, 145 mg
Contraindications
- Severe renal impairment, including dialysis
- Active liver disease (incl. primary biliary cirrhosis, persistent unexplained LFT abnormalities)
- Preexisting gallbladder disease
- Nursing mothers
Cautions
- Hepatotoxicity (monitor LFTs)
- Myopathy/rhabdomyolysis (increased with statins, elderly, renal failure, hypothyroidism, diabetes)
- Reversible increase in serum creatinine
- Cholelithiasis
- Potentiates coumarin anticoagulants
- Acute and delayed hypersensitivity reactions (anaphylaxis, angioedema, severe cutaneous reactions)
- Pancreatitis
- Venothromboembolic disease
Adverse reactions
- Abnormal liver tests
- Increased AST/ALT
- Increased CPK
- Rhinitis
Pregnancy Limited data insufficient; use only if benefit justifies risk.
Lactation Contraindicated in nursing mothers.
Cost
Generic entry2002
NO BOXED WARNINGS
Principal riskMyopathy with a statin; raises creatinine without lowering GFR
Classes and tags
Clinical profile
Legacy pregnancy categoryC
Defining liabilityMyopathy/rhabdomyolysis and hepatotoxicity; interaction burden varies by agent.
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