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Understanding Cholesterol-Lowering Medications (cont.)

Fibrates

What are examples of fibrates available in the U.S.?

Examples of fibrates include:

gemfibrozil (Lopid), and
fenofibrate (Tricor).

How do fibrates work?

Fibrates are primarily effective in lowering triglycerides and, to a lesser extent, in increasing HDL cholesterol levels.

Who should not use fibrates?

Individuals who are allergic to fibrates, or who have liver disease (including biliary cirrhosis or gallbladder disease) or severe kidney disease, should not take these agents.

Use: Fibrates are typically ingested with the morning and/or evening meals.

Drug or food interactions: When combined with statins, an increased risk of myopathy or rhabdomyolysis may occur. Fibrates increase the effect of warfarin (Coumadin) and oral diabetic drugs [such as glyburide (Micronase, Diabeta, Glynase Prestab) or repaglinide (Prandin)]; therefore, closer monitoring of your bleeding time and blood sugar will be required. Patients taking cyclosporine may have decreased levels (your doctor will monitor you and determine if a dose adjustment is needed).

Side effects: Common side effects of fibrates include upset stomach, stomach pain, diarrhea, headache, tiredness, nausea, and vomiting. Muscle aches and pain also occur. Rarely, these muscle-related symptoms are associated with damage to muscles that releases chemicals into the blood that that can damage the kidney. Muscle damage is of greatest concern when gemfibrozil is combined with statins. The formation of gallstones and gallbladder surgery have been associated with the use of fibrates.