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Clinical pharmacy 2024/2025 Level 3 Pharm D Pharmacology 1 (PO 502)

3- Fibrates

Mechanism of  Increase the expression of lipoprotein lipase (LPL) → ↓TG conc.

action  Fibrates also increase the level of HDL-C.

Ex: Fenofibrate and gemfibrozil

First line to be used for hypertriglyceridemia (↓TGs by 30-55%)

Can be used for elevated LDL-C in non-statin benefit groups

 DOC – Type III familial dysbetalipoproteinemia
– Severe hypertriglyceridemia – Chylomicronemia syndrome

Therapeutic  Familial hypercholesterolemia type IIa
Uses  Familial combined hypercholesterolemia type IIb
 High triglycerides and low HDL-C levels associated with the
metabolic syndrome or type 2 diabetes mellitus

 dyspepsia, cholelithiasis (due to increasing cholesterol in bile),

Adverse effects flatulence, myopathy, elevates transaminases (LFTs should be
monitored
 gallbladder diseases, severe hepatic and renal failure

 Bleeding risk from warfarin may be increased if combined with
Contraindication fibrates
 If to be used with statins, fenofibrate is preferred due to minimal

effect on statin clearance (fewer toxic effects)

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