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CARDIOVASCULAR SYSTEM › LIPID MODIFYING AGENTS › LIPID MODIFYING AGENTS, PLAIN › Fibrates
clofibride
C10AB10
Adult Dosing
- Hyperlipidemia: 500 mg orally 2 to 3 times daily with meals
- Max daily dose: 1500 mg
Pediatric Dosing
- Safety and efficacy in pediatric patients not established
Indications
- Treatment of primary hypercholesterolemia and hypertriglyceridemia refractory to dietary intervention
Mechanism of Action
- Fibrate derivative that activates Peroxisome Proliferator-Activated Receptor alpha (PPAR-alpha)
- Upregulates lipoprotein lipase, increases VLDL clearance, reduces hepatic triglyceride production, and modestly increases HDL-C
Contraindications
- Known hypersensitivity to clofibride or other fibrates
- Pre-existing gallbladder disease
- Severe hepatic impairment
- Severe renal impairment (CrCl < 30 mL/min)
Adverse Reactions
- Gastrointestinal distress (dyspepsia, nausea, abdominal pain)
- Elevated transaminases and alkaline phosphatase
- Myalgia, myopathy, and rhabdomyolysis (especially when combined with statins)
- Increased risk of cholelithiasis
- Headache, fatigue, and impotence
Drug Interactions
- Coumarin anticoagulants: Potentiates anticoagulant effect; monitor INR and reduce anticoagulant dose accordingly
- HMG-CoA reductase inhibitors (statins): Significantly increases risk of myopathy and rhabdomyolysis
- Bile acid sequestrants: May bind clofibride in the GI tract; administer at least 1 hour before or 4 to 6 hours after sequestrants
- Sulfonylureas and insulin: May potentiate hypoglycemic effects
Curated Content: Needs Vetting Before Put to Clinical Use