Fenofibrate

Key facts

• Fenofibrate is a fibrate that mainly lowers high triglycerides and raises HDL ("good") cholesterol; it lowers LDL to a lesser extent.
• You take it once daily with food, which improves absorption. It can take several weeks to see the full effect on your blood fats.
• Combined with a statin, fenofibrate significantly raises the risk of rhabdomyolysis, a serious breakdown of muscle tissue. Report unexplained muscle pain, weakness or dark urine immediately.
• Seek urgent care for severe muscle pain with dark urine, or yellowing of the skin or eyes.

What fenofibrate treats

Fenofibrate treats severe high triglycerides, which raise the risk of pancreatitis, and mixed high cholesterol where both LDL and triglycerides are elevated. It's often added to lifestyle changes such as diet and exercise, and sometimes to a statin, when triglycerides remain high despite those measures.

How fenofibrate works

Fenofibrate activates a receptor in the liver called PPAR-alpha, which switches on genes that speed up the breakdown of fatty acids and reduce the liver's output of triglyceride-carrying particles. This lowers triglycerides in the blood, raises HDL, and shifts LDL particles to a less harmful size.

Before you take it

• Avoid fenofibrate if you have severe kidney or liver disease, gallbladder disease, or are breastfeeding.
• Tell your prescriber if you take a statin, warfarin or other blood thinners. Fenofibrate can raise the effect of blood thinners and, with a statin, raises the risk of muscle damage.
• Kidney function and liver enzymes are usually checked before starting and periodically afterward.
• Mention any personal or family history of gallstones, since fibrates can increase gallstone formation.

Side effects

Common effects include stomach upset, headache, and mild increases in liver enzymes found on routine blood tests.

Stop and seek urgent medical care for any of these:

• Severe muscle pain, weakness, or dark-colored urine.
• Yellowing of the skin or eyes, or persistent nausea.
• Sudden swelling of the face, lips or throat, or difficulty breathing.
• Sharp abdominal pain, which can signal gallstones or pancreatitis.

Safety essentials

• The statin-plus-fibrate combination carries a real risk of rhabdomyolysis. Tell every prescriber you take both, and get muscle symptoms checked the same day they start.
• Kidney function can rise slightly on fenofibrate; your doctor will monitor this and may adjust your dose if your kidneys are already impaired.
• Do not stop a statin or fenofibrate on your own because of mild muscle aches, but do call your prescriber to be assessed.

This page is educational and does not replace advice from a doctor or pharmacist who knows your health history.