Anti-hyperlipidemia ( Fibrates )
Drugs:
1- Gemfibrozil
2- Fenofibrate
Mechanism of action:
Fenofibrate stimulates Peroxisome proliferator activated receptors-alpha (PPAR-Alpha), which in turn increases lipoprotein lipase and thus reduces the level of triglycerides.
Pharmacological action:
In terms of pharmacological action, Fenofibrate reduces both low density lipoprotein-C and triglycerides and raises the concentration of high density lipoprotein-C.
Uses:
Fenofibrate is used in the treatment of dysbetalipoproteinemia (classified as a third type of hyperlipidemia with equal cholesterol and triglycerides). It is a rare type, but it quickly leads to an increased risk of cardiovascular disease.
Side effect:
1- gastrointestinal disturbances.
2- myosotis
3- gallstones ( They are terms for stones present in the gallbladder)
Drug interactions:
1- Do not use statins with fibrates because combined use leads to increased muscle weakness and thus results in myopathy and rhabdomyolysis (therefore there are fibrates contraindications with statins.
2- Fibrates inhibit platelets thrombus formation, so when warfarin is used with fibrates, this leads to increased warfarin toxicity, which increases the risk of bleeding (as advice when using warfarin with fibrates, the international normalized ratio must be constantly monitored)
Fibrates should be avoided in patients suffering from:
1- liver dysfunction
2-kidney dysfunction
3- gallbladder disease ( Fibrates lead to an increased risk of stones forming in the gallbladder because fibrates increase biliary cholesterol excretion)