Fibrate: Difference between revisions
| Line 19: | Line 19: | ||
* [[Gemfibrozil]] (e.g. Lopid®, available in USA) | * [[Gemfibrozil]] (e.g. Lopid®, available in USA) | ||
* [[Fenofibrate]] (e.g. TriCor®, available in USA) | * [[Fenofibrate]] (e.g. TriCor®, available in USA) | ||
Fenofibric acid (Trilipix) is | Fenofibric acid (Trilipix) is FDA approved for combination use with [[statin]], in patients with mixed [[dyslipidemia]]. | ||
==Indications== | ==Indications== | ||
Revision as of 14:50, 27 September 2011
|
WikiDoc Resources for Fibrate |
|
Articles |
|---|
|
Most recent articles on Fibrate |
|
Media |
|
Evidence Based Medicine |
|
Clinical Trials |
|
Ongoing Trials on Fibrate at Clinical Trials.gov Clinical Trials on Fibrate at Google
|
|
Guidelines / Policies / Govt |
|
US National Guidelines Clearinghouse on Fibrate
|
|
Books |
|
News |
|
Commentary |
|
Definitions |
|
Patient Resources / Community |
|
Directions to Hospitals Treating Fibrate Risk calculators and risk factors for Fibrate
|
|
Healthcare Provider Resources |
|
Causes & Risk Factors for Fibrate |
|
Continuing Medical Education (CME) |
|
International |
|
|
|
Business |
|
Experimental / Informatics |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Please Join in Editing This Page and Apply to be an Editor-In-Chief for this topic: There can be one or more than one Editor-In-Chief. You may also apply to be an Associate Editor-In-Chief of one of the subtopics below. Please mail us [2] to indicate your interest in serving either as an Editor-In-Chief of the entire topic or as an Associate Editor-In-Chief for a subtopic. Please be sure to attach your CV and or biographical sketch.
Overview
In pharmacology, the fibrates are a class of amphipathic carboxylic acids. They are used for a range of metabolic disorders, mainly hypercholesterolemia (high cholesterol), and are therefore hypolipidemic agents.
Members
Fibrates prescribed commonly are:
- Bezafibrate (e.g. Bezalip®, available in Europe not approved in USA)
- Ciprofibrate (e.g. Modalim®, available in Europe not approved in USA)
- Clofibrate (largely obsolete due to side-effect profile, e.g. gallstones)
- Gemfibrozil (e.g. Lopid®, available in USA)
- Fenofibrate (e.g. TriCor®, available in USA)
Fenofibric acid (Trilipix) is FDA approved for combination use with statin, in patients with mixed dyslipidemia.
Indications
Fibrates are used as accessory therapy in many forms of hypercholesterolemia, usually in combination with statins. Trials do support its use as monotherapy.
Although less effective in lowering LDL, fibrates improve HDL and triglyceride levels, and seem to improve insulin resistance when the dyslipidemia is associated with other features of Syndrome X (hypertension and diabetes mellitus type 2).
Side effects
Most fibrates can cause mild stomach upset and myopathy (muscle pain with CPK elevations).
In combination with statin drugs, fibrates cause an increased risk of rhabdomyolysis (idiosyncratic destruction of muscle tissue, leading to renal failure). A powerful statin drug, cerivastatin (Lipobay®), was withdrawn because of this complication. The less lipophilic statins are less prone to cause this reaction, and are probably safer when combined with fibrates.
Pharmacology
Although used clinically since the early 1970s, the mechanism of action of fibrates remained unelucidated until, in the 1990s, it was discovered that fibrates activate PPAR (peroxisome proliferator-activated receptors), especially PPARα.
The PPARs are a class of intracellular receptors that modulate carbohydrate, fat metabolism and adipose tissue differentiation.
Activation of PPARs causes transcription of a number of genes on the DNA that facilitate lipid metabolism.
Fibrates are structurally and pharmacologically related to the thiazolidinediones, a novel class of anti-diabetic drugs that also act on PPARs (more specifically PPARγ)