Fenofibrate drug interactions

TOLBUTAMIDE FIBRATES Fibrates may t efficacy of sulphonylureas Uncertain postulated that fibrates displace sulphonylureas from plasma proteins and l their hepatic metabolism. In addition, fenofibrate may inhibit CYP2C9-mediated metabolism of tolbutamide Monitor blood glucose levels closely. Warn patients about hypoglycaemia - For signs and symptoms of hypoglycaemia, see Clinical Features of Some Adverse Drug Interactions, Hypoglycaemia... 

It has been an attractive option to use combination therapy of statin and fibrate when HDL remains low but there is no data from RCTs to support this approach. It is ironic that gemfibrozil with the best outcome data should not be used in this context given drug interactions. The results of the FIELD trial with fenofibrate as sole therapy were disappointing [59] however, a combination trial with fenofibrate and statin in type 2 diabetes, the ACCORD study, is in progress. 

Drug-drug interactions Fenofibrate Urothelial cells co-express PPARa and PPARy, and an interaction study with rosiglitazone (PPARy agonist) and fenofibrate (PPARa agonist), alone or in combination, showed S5mergy in inducing... 

Drug/Food interactions The absorption of micronized fenofibrate is increased when administered with food. 

Several interactions between warfarin and hypohpidemic drugs have been described (SEDA-21, 459), including clinically important potentiation of warfarin by bezafibrate (73) and gemfibrozil (74). Two patients developed a significantly increased anticoagulant effect of warfarin while taking fenofibrate (75). 

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... 

The authors of a major review of rosuvastatin concluded that its adverse reaction profile resembles that of other commonly used statins [34 ]. Increments in fiver enzymes are in most cases minor and of minimal concern, renal dysfunction is quite uncommon, myopathy is unusual, and rhab-domyolysis is rare. Interactions with other drugs are fisted but no new information given. Combinations with fenofibrate, omega-3 fatty acids, ezetimibe, rifampicin, and clopidogrel appear to be safe. 

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