Fenofibrate: Brands, Price & Uses in Bangladesh

Fenofibrate is a fibric acid derivative (fibrate) used as an adjunct to diet for the management of lipid disorders. Its evidence-based uses include:

Established / FDA-approved uses

• Primary hypercholesterolemia and mixed dyslipidemia (Fredrickson Types IIa and IIb) — used together with diet to reduce elevated LDL cholesterol, total cholesterol, triglycerides, and apolipoprotein B, and to increase HDL cholesterol in adult patients who have not responded adequately to diet alone.
• Severe hypertriglyceridemia (Fredrickson Types IV and V) — used as an adjunct to diet in adult patients with very high triglyceride levels who are at risk of pancreatitis and have not responded adequately to dietary measures.

Guideline-supported / adjunct use

• May be used in combination with a statin in selected high-risk patients with mixed dyslipidemia when triglycerides remain elevated despite statin therapy, but this combination requires careful monitoring for muscle toxicity (see Precautions).

Fenofibrate has not been shown to reduce coronary heart disease morbidity or mortality in controlled clinical trials, and it is not indicated to prevent cardiovascular events on its own.

Adults

Doses are not interchangeable across different Fenofibrate brands/formulations (micronized vs. non-micronized, tablet vs. capsule) because bioavailability differs; always follow the strength and schedule specified for the exact product dispensed, per physician instructions.

Administration

Fenofibrate should be taken with a meal, as food increases the extent of absorption of some formulations. Capsules/tablets should be swallowed whole and not crushed or chewed unless the product labeling states otherwise.

Renal impairment

In patients with mild-to-moderate renal impairment (eGFR 30–59 mL/min/1.73 m²), treatment should be initiated at the lowest available dose and increased only after assessing effects on renal function and lipid levels. Fenofibrate should be avoided in severe renal impairment (eGFR <30 mL/min/1.73 m²), including patients on dialysis (see Contraindications).

Hepatic impairment

Use has not been systematically studied in hepatic impairment; avoid use in patients with active liver disease (see Contraindications) and monitor liver function during therapy.

Duration and monitoring

Lipid levels should be monitored periodically; if an adequate triglyceride/cholesterol response is not obtained after about 2 months on the maximum dose, Fenofibrate should be discontinued and alternative therapy considered.

Like most medicines, Fenofibrate can cause side effects in some patients, though not everyone experiences them.

Common

• Headache
• Nausea, abdominal pain, diarrhoea, or other mild gastrointestinal upset
• Back pain
• Mild elevations in liver enzymes
• Respiratory symptoms (e.g., upper respiratory infection-like symptoms in trials)

Less common but clinically important

• Myopathy and, rarely, rhabdomyolysis (muscle pain, tenderness, or weakness with elevated creatine kinase) — see Precautions.
• Elevated serum creatinine (usually reversible after stopping the drug).
• Gallstones (cholelithiasis) — see Contraindications/Precautions.
• Pancreatitis (uncommon).
• Hepatotoxicity, including significant transaminase elevation.
• Hypersensitivity reactions, including skin rash.
• Decreased haemoglobin, haematocrit, or white blood cell count (usually mild and stabilizes with continued therapy).