Fenofibrate — NZ Medication Guide
📋 Reviewed by a Registered Pharmacist NZ — This information is for general educational purposes only and does not replace professional medical advice. Always consult your doctor or pharmacist before starting, stopping, or changing any medication.
What is Fenofibrate?
Fenofibrate is a fibrate medicine used to lower elevated triglycerides and increase HDL cholesterol in patients with dyslipidaemia. This medication is funded by Pharmac for hypertriglyceridaemia under Special Authority.
What is Fenofibrate Used For?
Fenofibrate is used for hypertriglyceridaemia (very high triglycerides — particularly where pancreatitis risk is elevated), mixed hyperlipidaemia (elevated triglycerides with low HDL), and as an adjunct to statins in patients with residual triglyceride elevation.
How Does Fenofibrate Work?
Fenofibrate is a prodrug converted to fenofibric acid, which activates PPAR-alpha nuclear receptors in the liver. This increases the expression of lipoprotein lipase (LPL) and apolipoprotein A-I (ApoAI), enhancing triglyceride hydrolysis and HDL synthesis, while reducing VLDL production — lowering triglycerides by 30–50% and raising HDL by 5–20%.
How to Take Fenofibrate
Taken once daily with food (fat enhances absorption). Standard dose: 145–200 mg/day (as micronised or nanoparticle formulations). Dose reduction required in moderate renal impairment; contraindicated in severe renal impairment. Monitor liver and renal function.
Common Side Effects of Fenofibrate
- Nausea and abdominal discomfort
- Headache
- Elevated liver enzymes
- Rash
- Myalgia (muscle pain)
Serious Side Effects — Seek Medical Attention
Contact your doctor or call 111 immediately if you experience any of the following:
- Myopathy and rhabdomyolysis (risk increased when combined with statins — monitor creatine kinase if symptoms develop)
- Hepatotoxicity (rare)
- Pancreatitis (paradoxically rare — fenofibrate is used to prevent pancreatitis in severe hypertriglyceridaemia)
- Gallstones (fibrates increase bile cholesterol saturation)
- Renal impairment (elevation in creatinine — monitor renal function)
- Venous thromboembolism (possible modest increased risk)
Drug Interactions
Fenofibrate may interact with other medicines. Always inform your doctor and pharmacist of all medications you are taking. Key interactions include:
- Statins (combined myopathy risk — particularly with gemfibrozil; fenofibrate is safer than gemfibrozil to combine with statins)
- Warfarin (fenofibrate enhances anticoagulant effect — monitor INR)
- Colchicine and ciclosporin (increased fenofibrate levels and renal risk)
- Ezetimibe (increased gallstone risk)
New Zealand Prescribing Information
Fenofibrate (145 mg, 160 mg, 200 mg tablets — Lipidil® Supra, Triglide® and generics) is funded by Pharmac under Special Authority. It is particularly valued in patients with mixed dyslipidaemia (elevated TG, low HDL) who remain at cardiovascular risk despite adequate LDL control on a statin. Monitoring of renal function (creatinine/eGFR) and LFTs is recommended at baseline and 3 months after starting.
Frequently Asked Questions
Can I combine fenofibrate with a statin?
Yes — fenofibrate is generally safe to combine with statins (unlike gemfibrozil, which carries a much higher myopathy risk). Monitor for muscle symptoms (myalgia, weakness) and check creatine kinase if symptoms develop. Report any unusual muscle pain or weakness to your doctor promptly.
Does fenofibrate lower the risk of heart attacks?
Fenofibrate primarily lowers triglycerides and raises HDL, but its benefit in reducing cardiovascular events beyond triglyceride lowering has not been consistently proven in large trials. It is mainly used to reduce pancreatitis risk in severe hypertriglyceridaemia and as an adjunct to statins for residual dyslipidaemia.
⚠️ Disclaimer: This page is for educational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your doctor or a qualified health provider. In New Zealand, medication availability and funding may vary — check with Pharmac or your pharmacist for current information.
Reviewed by a Registered Pharmacist NZ
References & Further Information
The following New Zealand and international resources were used to inform this page: