Fibrate

Class of medications used to lower lipid levels

Overview

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 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

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.

Common Fibrates

Some of the commonly prescribed fibrates include:

• Gemfibrozil
• Fenofibrate
• Bezafibrate

Side Effects

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 should be used with caution in patients with:

• Severe liver or kidney disease.
• Gallbladder disease.

Interactions

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

File:Fibrate structure.png

Chemical structure of a typical fibrate.

Related Pages

• Statin
• Cholesterol
• Triglyceride
• Lipid metabolism