Clofibrate drug interactions

The clinical documentation seems to be limited to these reports. It appears to be a combination of a drug-drug interaction (clofibrate with furosemide) with or without a drug-disease interaction (clofibrate with nephrotic syndrome). The authors of one report suggest that serum proteins and renal function should be checked before giving clofibrate to any patient. If serum albumin is low, the total daily dosage of clofibrate should not exceed 500 mg for each 1 g per 100 mL of the albumin concentration. However, note that this guidance is old. 

Drugs that may interact with dantrolene include clofibrate, estrogens, warfarin, and verapamil. 

In those species, which are responsive (i.e., have a functioning receptor) such as the rat, treatment with drugs, which interact with the PPARa receptor such as clofibrate, will cause a number of effects, such as induction of a number of enzymes, increased cell growth and turnover, and liver tumors in almost all the animals as a direct result of interaction with the receptor and changes in gene transcription. This will be discussed in more detail in chapter 7. 

Interactions with the following drugs may increase the risk of hypoglycemia other hypoglycemics, sulfonamides, propranolol, salicylates, clofibrate, probenecid, pentamidine, valproic acid, dicumarol, cimetidine, MAO inhibitors, and alcohol. In addition, co-ingestion of alcohol may occasionally produce a disulfiram-like interaction (see p 186). 

Colestyramine does not alter the pharmacokinetics of clofibrate when both drugs are given at the same time. Similarly colestipol does not alter the pharmacokinetics of clofibrate or fenofibrate, and colesevelam does not alter the pharmacokinetics of fenofibrate. Colestipol can reduce the absorption of gemfibrozil if given at the same time, but not if administration is separated by 2 hours. A similar interaction occurs between bezafibrate and colestyramine... 

In view of these reports, and since clofibrate is very likely to be used in diabetic patients because of lipid disturbances, there is every reason to be alert for possible interactions in patients in whom both types of drug are considered to be indicated. 

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