cholesterol (fenofribate)

Composition  : fenofribate 100mg, 200mg and 300mg

Indications
Especially for adults: patients with hypercholesterolemia (type IIa) or pure endogen hypertriglyceridemia (type IV)or combination (type-IIb and III)

• When appropriate caloric restriction did not reach the expected lipid reduction
• especially if cholesterol level remain high after dietetic treatment and/or there are risk factors
• dietetic control should be continued as an addition to above treatment 

Mechanism of action

      fenofibrate increases lipolysis and elimination of TG-rich particles from plasma by activating lipoprotein lipase.

Contraindications

• pregnant and lactating women
• patient with hypersensitivity to fenofibrate
• children
• severe liver dysfunction 
• renal dysfunction
• gall bladder disease

Dosage

• Adult: for treatment give fenofibrate 3X 100mg or 1X 300mg daily.
• the response to therapy should be determined by monitoring serum lipid and lipoprotein profiles and dosage may be adjussted within the range of 200mg to 400mg daily
• if a satisfactory response has not been reached after therapy and diet, the dosage may be increased to 4x 100mg or 2X 200mg daily
• however, this situation must be controlled again every 3 months. if there is an increase in blood lipid levels again, then the dose my be increased again to 3x 100mg or 1X 300mg daily

Warnings and precautions

• not recomended for children because there are little evidences about safety in children
• not recomended for pregnant and lactating women.
• if there is no satisfactory decrease of serum lipid levels after 3-6 months administration of fenofibrate,then the supplemental or replacement therapy should be considered
• do periodic monitoring of transaminase levels (every 3 months) during the first 12 months of use 
• stop using fenofibrate for a while when there is an inacrease of SGPT excedeed 100 IU
• it is not recommended to combine fenofibrate with hepatotoxic drugs

Adverse reactions

      gastrointestinal disturbances, skin allergic reaction, muscle ache with CPK elevation, moderate elevation of serum transaminase, haematologic changes, alopecia, sexual asthenia

Drud interactions

       concomitant use with oral anticoagulant drugs will increase the effect of anticoagulant drugs and bleeding risk. it is recomended to control protrombin levels more frequently and oral anticoagulant dosage shoul be adjusted during treatment with fenofubrate