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Currently approved fibrates in North America and Europe encompass gemfibrozil, fenofibrate, fenofibric acid, bezafibrate, etofibrate, and ciprofibrate, whereas clofibrate has been discontinued due to increased mortality (United Nations 2003; WHO 1978). Fibrates effectively modify atherogenic dyslipidemia, notably by reducing serum triglyceride levels, modestly elevating HDL-C levels, and slightly lowering LDL-cholesterol levels (Fazio 2004; Abourbih 2009; Jun 2010). This makes them particularly suitable for averting cardiovascular events in individuals with low HDL-C and high triglycerides (Khoury 2011).
NICE guidance on the use of Fibrates for CVD prevention
Fibrates for Preventing Cardiovascular Disease | Recommendation |
---|---|
Do not offer fibrates for preventing CVD to: | - People in primary prevention - People in secondary prevention - People with CKD - People with type 1 diabetes - People with type 2 diabetes |
If we review the BNF indication for Fenofibrate we note that it is recommended for use by specialists & requires more regular monitoring
Indications and Dose | Monitoring Requirements | Prescribing and Dispensing Information |
---|---|---|
Adjunct to diet in mixed hyperlipidaemia (if statin contraindicated or not tolerated) | Monitor hepatic transaminases every 3 months during the first 12 months of treatment. | Fibrates are mainly used in those with high triglycerides. |
Adjunct to diet in severe hypertriglyceridaemia | Monitor serum... |
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