Fibric acid derivatives for high cholesterol

Examples

Generic Name	Brand Name
fenofibrate	Lipidil, Lipidil EZ
gemfibrozil	Lopid

How It Works

These drugs lower triglycerides and raise HDL ("good") cholesterol. They may have little effect on LDL ("bad") cholesterol levels.

Why It Is Used

Gemfibrozil or fenofibrate is prescribed for people who have very high triglycerides or who have low HDL and high triglycerides.

Gemfibrozil may be used to reduce the risk of heart attack in people with coronary artery disease (CAD) who have low LDL, low HDL, and high triglycerides.

How Well It Works

• HDL may be increased by 20%.¹
• Triglycerides may be lowered by 40% to 50%.¹

Gemfibrozil may significantly reduce the risk of heart attack in people who have CAD and low HDL levels.² It may also be helpful in people who have several risk factors for metabolic syndrome or who have metabolic syndrome.

Test results show fenofibrate reduces the progression of CAD in people who have type 2 diabetes.³ The results of one study show that fenofibrate should not be used instead of statins by people with diabetes if they are able to take a statin without any problems.⁴

Side Effects

Gemfibrozil

• The most common side effects are upset stomach, nausea, or vomiting.
• Abdominal pain is the second most common side effect.
• There is a slightly increased risk of gallstones.
• Gemfibrozil can interact with drugs that prevent blood clotting (anticoagulants), causing bleeding.

Fenofibrate

• The most common side effects are rash and gastrointestinal problems such as stomach upset.
• There is a slightly increased risk of gallstones, inflamed liver (hepatitis), and muscle inflammation (myositis).

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

What To Think About

Fibric acid derivatives do not significantly lower LDL cholesterol in most people. They may cause LDL levels to rise a bit. Usually, fibric acid derivatives are not useful for people who are at risk for coronary artery disease because of high LDL cholesterol, but they are useful for those who have metabolic syndrome with high triglycerides, low HDL, and low LDL.⁵

Fibric acid derivatives should be used with caution by people who are taking statins. There is a greater risk of developing a life-threatening muscle problem called rhabdomyolysis, which can lead to kidney failure. In order to take this combination of medicines, you must have normal kidney and liver function. If you have any muscle problems or pain, report it immediately to your doctor.

Studies show that fenofibrate is safer than gemfibrozil when taken with a statin. Fenofibrate does not interfere with how liver metabolizes—or breaks down—the statin. Because of this, high and possibly harmful levels of statins do not develop.⁶

Gemfibrozil is usually taken twice per day, 30 minutes before the morning and evening meals.

Complete the new medication information form (PDF)(What is a PDF document?) to help you understand this medication.

Author:	Douglas Dana Ralph Poore	Last Updated: November 13, 2006
Medical Review:	Caroline S. Rhoads, MD - Internal Medicine Tom Bailey, MD - Family Medicine Neil J. Stone, MD, FACC, FACP - Internal Medicine, Cardiology
© 1995-2008 Healthwise, Incorporated. Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated.This information does not replace the advice of a doctor. Healthwise disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use. How this information was developed to help you make better health decisions.