Drug Interactions of Fibrates:
© Fibrates (Fibric acid derivatives) include Gemfibrozil, Clofibrate, Ciprofibrate, Fenofibrate and Bezafibrate.
© Fibrates are used as the firstline drugs to treat primary hypertriglyceridemia.
© Mechanism of Action of Fibrates:
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| Mechanism of action of Fibrates |
© It is contraindicated to use Ciprofibrate with other Fibrates and Gemfibrozil with Repaglinide, Simvastatin or Dasabuvir, concomitantly.
© Fibrates can interact majorly with drugs such as Ezetimibe and Sulfonylurea Antidiabetics (Glyburide, Glipizide, Glimepiride, etc).
© The major interactions of Gemfibrozil include Other Statins (Lovastatin, Atorvastatin, Fluvastatin, Pravastatin) and Colchicine.
© The concomitant use of Fibrates and Ciprofibrate is contraindicated due to an increased risk of rhabdomyolysis and myoglobulinuria.
© To avoid cholelithiasis, the coadministration of Ezetimibe and fibrates (except Fenofibrate), is not recommended.
© Close monitoring of blood glucose is recommended, if Fibrates and Sulfonylurea Antidiabetics (Glyburide, Glipizide, Glimepiride, etc) are used concurrently.
© Due to elevated risk of hypoglycemia, the combined use of Gemfibrozil and Repaglinide, is contraindicated.
© The concomitant use of Gemfibrozil and Simvastatin may increase the risk of developing myopathy or rhabdomyolysis and is contraindicated.
© Concomitant use of Dasabuvir and Gemfibrozil is contraindicated due to a 10-fold increase in dasabuvir exposure and an increased risk of QT prolongation.
© The concomitant use of Gemfibrozil and Statins should be avoided, if possible.
© Patients receiving Gemfibrozil and Colchicine should be monitored closely for signs and symptoms of myopathy or rhabdomyolysis.
© Concomitant use of Fenofibrate and Anticoagulants, requires the monitoring of INR value.
© The interaction between Bezafibrate and Bile acid Sequestrants (Cholestyramine, Colestipol, Colesevelam) can be avoided by separating the administration of the two drugs by at least 2 hours.
© The occurrence of significant morbidity and mortality can be reduced by minimizing the risk for drug interactions.
© The hyperlipidemic patients should bring a list of all the drugs they are taking including prescription drugs, over-the-counter drugs, and any supplements, herbal or otherwise, during their visit to the doctor or pharmacist.
© The risk of adverse effects could be reduced and the quality of life for patients improved by healthcare professionals through the screening, education, and follow up on suspected drug interactions.
© If possible, the hyperlipidemic patients are recommended to fill all their prescriptions at one pharmacy.
