Clofibride
Clofibride is a lipid-lowering agent that was used in the past to manage hyperlipidemia, a condition characterized by elevated levels of lipids in the blood. It belongs to the class of drugs known as fibrates, which work by activating a specific receptor in the body known as the peroxisome proliferator-activated receptor alpha (PPARα). This activation leads to an increase in the oxidation of fatty acids, reduction of triglycerides, and an increase in high-density lipoprotein (HDL) levels, often referred to as "good cholesterol."
Mechanism of Action
Clofibride exerts its therapeutic effects by activating PPARα, a nuclear receptor that plays a crucial role in the metabolism of lipids. Upon activation, PPARα stimulates the expression of genes involved in the transport and breakdown of fatty acids in the liver, leading to decreased triglyceride levels and increased HDL cholesterol levels. This mechanism helps in reducing the risk of atherosclerosis and associated cardiovascular diseases.
Clinical Use
Historically, clofibride was used in the treatment of various forms of hyperlipidemia, particularly in cases where elevated triglyceride levels were a significant concern. However, its use has declined over the years, with newer and more effective lipid-lowering agents, such as statins and newer fibrates, taking precedence due to their improved efficacy and safety profiles.
Side Effects
Like other fibrates, clofibride could cause a range of side effects, including gastrointestinal disturbances, liver enzyme elevations, and myopathy. The risk of these adverse effects, particularly myopathy, increases when fibrates are used in combination with statins.
Current Status
As of the current medical and pharmaceutical landscape, clofibride is not widely used. The development of more effective lipid-lowering agents with better safety profiles has led to a decrease in the prescription of older fibrates like clofibride. Healthcare professionals now have a broader range of options for managing hyperlipidemia, allowing for more personalized and effective treatment plans.
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Contributors: Prab R. Tumpati, MD