Fenofibrate adverse effects

Rare adverse effects of fibrates include rashes, gastrointestinal symptoms, myopathy, arrhythmias, hypokalemia, and high blood levels of aminotransferases or alkaline phosphatase. A few patients show decreases in white blood count or hematocrit. Both agents potentiate the action of coumarin and indanedione anticoagulants, and doses of these agents should be adjusted. Rhabdomyolysis has occurred rarely. Risk of myopathy increases when fibrates are given with reductase inhibitors. The use of fenofibrate with rosuvastatin appears to minimize this risk. Fibrates should be avoided in patients with hepatic or renal dysfunction. There appears to be a modest increase in the risk of cholesterol gallstones. 

The adverse events of the fibrates are essentially the same with all members of the class and are generally mild or absent during short-term treatment. The observed frequency of adverse effects with a micronized formulation of fenofibrate is comparable to that associated with the usual formulation (SEDA-22, 490). 

Non-specific rashes have been reported in patients taking fibrates. With fenofibrate, rashes are reported significantly more often than with placebo (35), and occur in some 0.6% of patients (23). In a double-bhnd trial, the incidence of cutaneous adverse effects was 11% with fenofibrate and less than 1% with placebo they included hives and urticaria (20). In another study, the difference was 6% (36). 

In patients taking fenofibrate and atorvastatin, increased concentrations of plasma homocysteine were attributed to an action of the fibrates themselves and not indirectly via their lipid-lowering effect (8). Concomitant administration of folic acid, at least in part, offset this adverse effect... 

Adverse effects due to fenofibrate use often relate to the skeletal muscle, kidney or liver. A 51-year-old female patient who was on fenofibrate therapy for 2 years developed rhabdomyolysis complicated with acute renal failure after discontinuation of the drug for a short period of time [27]. 

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