Fenofibrate

About Fenofibrate

The body converts fenofibrate to fenofibric acid, which lowers triglycerides by activating a receptor called PPAR alpha. Its labels approve it alongside diet in adults with severe hypertriglyceridemia (triglycerides of 500 mg/dL or more) and to lower LDL cholesterol in primary hyperlipidemia; the brand labels revised in 2025 add "when use of recommended LDL-C lowering therapy is not possible", while some older generic labels still describe broader cholesterol uses. Safety and effectiveness in children have not been established. Each product has its own doses: 48 or 145 mg tablets, 54 or 160 mg tablets, 40 or 120 mg tablets, 43 or 130 mg capsules, 50 or 150 mg capsules, or 67, 134 or 200 mg micronized capsules, the highest strength of each being the usual dose for cholesterol. Triglycerides can be rechecked as early as four to eight weeks after starting, and it is stopped if the response is not adequate after two months.

There is no boxed warning. Serious liver injury, including cases needing a transplant and deaths, has been reported, so liver tests are checked at the start and periodically. Muscle damage (myopathy and rhabdomyolysis) is more likely with a statin, at age 65 or older and with kidney disease or uncontrolled hypothyroidism; the 2025 labels say to avoid a statin unless the benefit of further triglyceride lowering outweighs that risk, and unexplained muscle pain or weakness should be reported at once. It can raise creatinine, cause gallstones and strengthen warfarin; pancreatitis, falls in blood counts, severe allergic and skin reactions and a paradoxical fall in HDL have been reported, and leg and lung clots were more frequent than with placebo in one large trial. It must not be taken with severe kidney impairment or dialysis, active liver disease or existing gallbladder disease. Abnormal liver tests, abdominal pain, raised muscle enzymes and constipation are among the common side effects.

With mild to moderate kidney impairment, each product starts at its lowest strength and is raised only after kidney function and triglycerides are rechecked. The labels state that it did not reduce coronary heart disease illness or deaths in large trials of people with type 2 diabetes, and they advise against breastfeeding during treatment and for five days after the final dose. Fenofibric acid, once sold as Trilipix and Fibricor (both discontinued), is a separate prescription; in 2016 the FDA withdrew the approved uses with a statin for fenofibric acid delayed-release capsules and niacin extended-release tablets, finding that the benefits no longer outweighed the risks, and the notice did not name fenofibrate.

Taking Fenofibrate

How to take it

Once a day, alongside the low-fat diet your prescriber recommends. Lipofen, the micronized capsules and the 54, 160, 40 and 120 mg tablets are taken with food, and those tablets are swallowed whole; the 48 and 145 mg tablets and the 43 and 130 mg capsules can be taken with or without food.

If you miss a dose

If you miss a dose, do not take an extra one; take the next dose at the usual time, as the label advises.

Storage

At room temperature in a closed container, protected from moisture and away from heat, out of reach of children. Use a take-back program for unused medicine.

Interactions to know about

Statins and colchicine add to the risk of muscle damage. It strengthens warfarin and similar anticoagulants, so INR is checked more often. Cyclosporine, tacrolimus and other medicines that can harm the kidneys add to the risk of kidney problems. Take it at least 1 hour before or 4 to 6 hours after cholestyramine, colesevelam or colestipol.

This summarizes the official prescribing information. Your prescriber’s and pharmacist’s instructions, and the leaflet that comes with your medicine, take priority.

Why the cash price for Fenofibrate differs from pharmacy to pharmacy

Fenofibrate products are not rated equivalent to one another, so a pharmacy can fill only the product written or one rated equivalent to it. The 48 and 145 mg and the 54 and 160 mg tablets are made by many companies, while the 40 and 120 mg tablets, the 43 and 130 mg capsules and the micronized capsules have fewer makers, and Lipofen is a brand whose only alternative is its authorized generic, so quotes for those forms can differ more between pharmacies, and a less common form may be quoted much higher than a common tablet.

Ways to pay less for Fenofibrate without insurance

• Check which product and strength the prescription names, and compare quotes for that exact product at more than one pharmacy.
• If it names Tricor, Fenoglide or Triglide, which are discontinued, make sure it allows a generic rated equivalent, or ask the prescriber to rewrite it.
• If you take Lipofen or a less common form, ask the prescriber whether a 145 mg or 160 mg generic tablet would suit you; only the prescriber can switch products.
• Ask for a ninety-day supply once your lipids are stable.
• Upload the prescription to Script Unlock so licensed pharmacies can quote their cash price. You pay the pharmacy directly.

Questions to ask your pharmacist about Fenofibrate

1. 1.Which fenofibrate product is this, and do I take it with food?
2. 2.Is it safe with my statin, warfarin or colchicine?
3. 3.When will my liver tests, kidney function and lipids be checked?
4. 4.Which muscle, stomach or skin symptoms mean I should call?

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