Fibrate: Difference between revisions

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{{Short description|Class of medications used to lower lipid levels}}
== Fibrate ==
{{Use dmy dates|date=October 2023}}


==Overview==
[[File:Fenofibrate_structure.svg|thumb|right|Chemical structure of Fenofibrate]]
'''Fibrates''' are a class of medications primarily used to treat abnormal blood lipid levels, particularly to lower elevated triglyceride levels and, to a lesser extent, to increase high-density lipoprotein (HDL) cholesterol levels. They are often prescribed to patients with [[dyslipidemia]], especially when [[statins]] are not sufficient or are contraindicated.


==Mechanism of Action==
'''Fibrates''' are a class of [[amphipathic carboxylic acids]] used primarily as [[lipid-lowering agents]]. They are particularly effective in reducing [[triglyceride]] levels and are also used to increase [[high-density lipoprotein]] (HDL) cholesterol levels. Fibrates are often prescribed to patients with [[dyslipidemia]], especially those with elevated triglycerides and low HDL cholesterol.
Fibrates work by activating the [[peroxisome proliferator-activated receptor alpha]] (PPAR_), a type of nuclear receptor that regulates the expression of genes involved in lipid metabolism. Activation of PPAR_ leads to increased oxidation of fatty acids in the liver, decreased production of very-low-density lipoprotein (VLDL) cholesterol, and increased levels of HDL cholesterol.


==Clinical Uses==
== Mechanism of Action ==
Fibrates are primarily used to treat:
* [[Hypertriglyceridemia]]: Elevated levels of triglycerides in the blood.
* Mixed dyslipidemia: A condition characterized by elevated triglycerides and low HDL cholesterol.


They are often used in combination with statins in patients who have not achieved their lipid goals with statin therapy alone.
[[File:PPAR-diagram.png|thumb|left|Diagram of PPAR activation]]


==Common Fibrates==
Fibrates exert their effects by activating the [[peroxisome proliferator-activated receptor alpha]] (PPARα), a type of nuclear receptor. Activation of PPARα leads to increased expression of genes involved in fatty acid oxidation, lipoprotein metabolism, and [[apolipoprotein]] synthesis. This results in decreased triglyceride levels, increased HDL cholesterol, and a modest reduction in [[low-density lipoprotein]] (LDL) cholesterol.
Some of the commonly prescribed fibrates include:
* [[Gemfibrozil]]
* [[Fenofibrate]]
* [[Bezafibrate]]


==Side Effects==
== Clinical Uses ==
Fibrates are generally well-tolerated, but they can cause side effects in some patients. Common side effects include:
* Gastrointestinal disturbances such as nausea and abdominal pain.
* Muscle pain or weakness, especially when used in combination with statins.
* Elevated liver enzymes.


==Contraindications==
Fibrates are primarily used to treat hypertriglyceridemia and mixed dyslipidemia. They are particularly beneficial in patients with metabolic syndrome or [[type 2 diabetes mellitus]], where triglyceride levels are often elevated. Fibrates can be used alone or in combination with other lipid-lowering agents such as [[statins]].
Fibrates should be used with caution in patients with:
* Severe liver or kidney disease.
* Gallbladder disease.


==Interactions==
== Common Fibrates ==
Fibrates can interact with other medications, including:
* Statins: Increased risk of muscle-related side effects.
* Anticoagulants: Fibrates can potentiate the effects of [[warfarin]], requiring careful monitoring of [[INR]] levels.


==Images==
=== Fenofibrate ===
[[File:Fibrate_structure.png|thumb|right|Chemical structure of a typical fibrate.]]
 
[[File:Fenofibrate_structure.svg|thumb|right|Chemical structure of Fenofibrate]]
 
Fenofibrate is one of the most commonly prescribed fibrates. It is used to reduce cholesterol levels in patients at risk of cardiovascular disease.
 
=== Clofibrate ===
 
[[File:Clofibrate.svg|thumb|left|Chemical structure of Clofibrate]]
 
Clofibrate was one of the first fibrates developed but is less commonly used today due to concerns about its safety profile.
 
=== Bezafibrate ===
 
[[File:Bezafibrate.svg|thumb|right|Chemical structure of Bezafibrate]]
 
Bezafibrate is used to treat hyperlipidemia and has a broad spectrum of action on lipid parameters.
 
=== Ciprofibrate ===
 
[[File:Ciprofibrate.svg|thumb|left|Chemical structure of Ciprofibrate]]
 
Ciprofibrate is another fibrate used to manage lipid disorders, particularly in patients with high triglyceride levels.
 
=== Choline Fenofibrate ===
 
[[File:Choline_fenofibrate.svg|thumb|right|Chemical structure of Choline Fenofibrate]]
 
Choline fenofibrate is a newer formulation designed to improve the bioavailability of fenofibrate.
 
=== Clinofibrate ===
 
[[File:Clinofibrate.svg|thumb|left|Chemical structure of Clinofibrate]]
 
Clinofibrate is used in some countries for the treatment of hyperlipidemia.
 
=== Aluminium Clofibrate ===
 
[[File:Aluminium_clofibrate.svg|thumb|right|Chemical structure of Aluminium Clofibrate]]
 
Aluminium clofibrate is a derivative of clofibrate, used in certain formulations.
 
== Side Effects ==
 
Common side effects of fibrates include gastrointestinal disturbances, such as nausea and abdominal pain. Muscle pain and weakness can occur, particularly when fibrates are used in combination with statins. Rarely, fibrates can cause liver dysfunction and gallstones.
 
== Related Pages ==


==Related Pages==
* [[Statin]]
* [[Statin]]
* [[Cholesterol]]
* [[Cholesterol]]
* [[Triglyceride]]
* [[Triglyceride]]
* [[Lipid metabolism]]
* [[Lipoprotein]]
* [[Peroxisome proliferator-activated receptor]]


[[Category:Hypolipidemic agents]]
[[Category:Hypolipidemic agents]]
[[Category:Peroxisome proliferator-activated receptor agonists]]
[[Category:Carboxylic acids]]

Latest revision as of 14:18, 21 February 2025

Fibrate[edit]

Chemical structure of Fenofibrate

Fibrates are a class of amphipathic carboxylic acids used primarily as lipid-lowering agents. They are particularly effective in reducing triglyceride levels and are also used to increase high-density lipoprotein (HDL) cholesterol levels. Fibrates are often prescribed to patients with dyslipidemia, especially those with elevated triglycerides and low HDL cholesterol.

Mechanism of Action[edit]

Diagram of PPAR activation

Fibrates exert their effects by activating the peroxisome proliferator-activated receptor alpha (PPARα), a type of nuclear receptor. Activation of PPARα leads to increased expression of genes involved in fatty acid oxidation, lipoprotein metabolism, and apolipoprotein synthesis. This results in decreased triglyceride levels, increased HDL cholesterol, and a modest reduction in low-density lipoprotein (LDL) cholesterol.

Clinical Uses[edit]

Fibrates are primarily used to treat hypertriglyceridemia and mixed dyslipidemia. They are particularly beneficial in patients with metabolic syndrome or type 2 diabetes mellitus, where triglyceride levels are often elevated. Fibrates can be used alone or in combination with other lipid-lowering agents such as statins.

Common Fibrates[edit]

Fenofibrate[edit]

Chemical structure of Fenofibrate

Fenofibrate is one of the most commonly prescribed fibrates. It is used to reduce cholesterol levels in patients at risk of cardiovascular disease.

Clofibrate[edit]

Chemical structure of Clofibrate

Clofibrate was one of the first fibrates developed but is less commonly used today due to concerns about its safety profile.

Bezafibrate[edit]

Chemical structure of Bezafibrate

Bezafibrate is used to treat hyperlipidemia and has a broad spectrum of action on lipid parameters.

Ciprofibrate[edit]

Chemical structure of Ciprofibrate

Ciprofibrate is another fibrate used to manage lipid disorders, particularly in patients with high triglyceride levels.

Choline Fenofibrate[edit]

Chemical structure of Choline Fenofibrate

Choline fenofibrate is a newer formulation designed to improve the bioavailability of fenofibrate.

Clinofibrate[edit]

Chemical structure of Clinofibrate

Clinofibrate is used in some countries for the treatment of hyperlipidemia.

Aluminium Clofibrate[edit]

Chemical structure of Aluminium Clofibrate

Aluminium clofibrate is a derivative of clofibrate, used in certain formulations.

Side Effects[edit]

Common side effects of fibrates include gastrointestinal disturbances, such as nausea and abdominal pain. Muscle pain and weakness can occur, particularly when fibrates are used in combination with statins. Rarely, fibrates can cause liver dysfunction and gallstones.

Related Pages[edit]