fenofibrate

(fee no fye' brate)

Tricor

Pregnancy Category C

Drug class
Antihyperlipidemic drug

Therapeutic actions
Inhibits triglyceride synthesis in the liver resulting in a reduction in VLDL released into
circulation; may also stimulate the breakdown of triglyceride-rich lipoproteins.

Indications
• Adjunct to diet in treating adults with primary hypercholesterolemia or mixed
dyslipidemia
• Adjunct to diet for treatment of adults with hypertriglyceridemia
• Unlabeled use: Polymetabolic syndrome x

Contraindications and cautions

• Contraindicated with allergy to fenofibrate, hepatic or severe renal dysfunction,
primary biliary cirrhosis, gall bladder disease, pregnancy.
• Use cautiously with the elderly, lactation.

Available forms
Tablets—54, 160 mg; capsules—67, 134, 200 mg

Dosages
ADULTS
• Hypertriglyceridemia: Initially, 54–160 mg/day (tablet form) or 67–200 mg
(capsule) PO with a meal.
• Primary hypercholesterolemia or mixed dyslipidemia: 160 mg/day PO with a
meal.
PEDIATRIC PATIENTS
Safety and efficacy not established.
GERIATRIC PATIENTS
Initial dose, 54 mg/day PO; titrate slowly with close monitoring.
PATIENTS WITH RENAL IMPAIRMENT
Initiate therapy with 54 mg/day PO; monitor renal function tests carefully for 4–8 wk
before increasing.

Pharmacokinetics
Route Onset Peak Duration
Oral Varies 6–8 hr Weeks

Metabolism: Hepatic; T1/2: 20 hr

Distribution: Crosses placenta; enters breast milk
Excretion: Urine

Adverse effects
• CV: Angina, arrhythmias, swelling, phlebitis, thrombophlebitis
• Dermatologic: Rash, alopecia, dry skin, dry and brittle hair, pruritus, urticaria
• GI: Nausea, vomiting, diarrhea, dyspepsia, flatulence, bloating, stomatitis,
gastritis, pancreatitis, peptic ulcer, GI hemorrhage
• GU: Impotence, decreased libido, dysuria, hematuria, proteinuria, decreased urine
output
• Hematologic: Leukopenia, anemia, eosinophilia, increased AST and ALT,
increased CPK
• Other: Myalgia, flulike syndromes, arthralgia, weight gain, polyphagia, increased
perspiration, systemic lupus erythematosus, blurred vision, gynecomastia

Interactions
Drug-drug
• Increased bleeding tendencies if oral anticoagulants are given with fenofibrate;
reduce dosage of anticoagulant
• Possible rhabdomyolysis, acute renal failure if given with any statins; avoid this
combination
• Decreased absorption and effectiveness if given with bile acid sequestrants;
administer at least 1 hr before or 4–6 hr after these drugs
• Increased risk of renal toxicity if combined with immunosuppressants or other
nephrotoxic drugs; use caution and monitor patient carefully

Nursing considerations
Assessment
• History: Allergy to fenofibrate, hepatic dysfunction, primary biliary cirrhosis,
gall bladder disease, pregnancy, renal impairment, lactation
• Physical: Skin lesions, color, temperature; P, BP, auscultation, baseline ECG,
peripheral perfusion, edema; bowel sounds, normal output, liver evaluation; lipid
studies, CBC, liver function tests, renal function tests, urinalysis

Interventions
• Administer drug with meals.
• Monitor patient carefully.
• Ensure that patient continues strict dietary restrictions and exercise program.
• Arrange for regular follow-up including blood tests for lipids, liver function, and
CBC during long-term therapy.
• Give frequent skin care to deal with rashes and dryness.

Teaching points
• Take the drug with meals.
• Continue to follow strict dietary regimen and exercise program.
 • Arrange to have regular follow-up visits to your health care provider, which will
include blood tests.
• These side effects may occur: Diarrhea, loss of appetite (ensure ready access to
the bathroom if this occurs; eat frequent small meals).
• Report chest pain, shortness of breath, palpitations, myalgia, malaise, excessive
fatigue, fever.

Adverse effects in Italic are most common; those in Bold are life-threatening.