[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Pharmacology](https://durgical.com/en/pharmacology/) › [Fibrates](https://durgical.com/en/pharmacology/classes/fibrates/) › Fenofibrate [Pharmacology](https://durgical.com/en/pharmacology/) · [Fibrates](https://durgical.com/en/pharmacology/classes/fibrates/) # Fenofibrate A fibrate that lowers triglycerides by activating PPAR-alpha. The fibrate usually chosen when one is needed together with a statin. Updated 2026-11-01 - Class: [Fibrates](https://durgical.com/en/pharmacology/classes/fibrates/) - Receptor: PPARα (nuclear receptor) - ATC code: C10AB05 ◎**PPARα (nuclear receptor)**Fenofibrate ⓘ The figure shows fenofibric acid, the active form of fenofibrate, in the ligand-binding domain of human PPARα. **Target in 3D:** PPARα (nuclear receptor). PDB structure 6LX4 (RCSB PDB, public domain). [View the structure at RCSB PDB](https://www.rcsb.org/structure/6LX4) · Drag to rotate · pinch to zoom ## Mechanism of action Fenofibrate is a prodrug rapidly converted to fenofibric acid, which activates PPARα. The receptor switches on genes for fatty acid oxidation and lipoprotein lipase and lowers apolipoprotein C-III, so triglyceride-rich lipoproteins are cleared faster and VLDL output falls. HDL rises modestly through more apo A-I and A-II. - Prodrug becomes fenofibric acid - Fenofibric acid activates the nuclear receptor PPARα - More lipoprotein lipase activity, less apo C-III - Triglycerides fall; HDL rises modestly ## Pharmacokinetics **Absorption** Oral; absorption increases when taken with food (depends on the formulation). **Metabolism** Hydrolyzed to fenofibric acid, then conjugated with glucuronic acid. **Elimination** Mainly in urine; it accumulates in kidney impairment. **Half-life** Fenofibric acid: about 20 hours. ## Indications - Severe hypertriglyceridemia, to lower triglycerides (as an adjunct to diet) [Familial hypertriglyceridaemia →](https://durgical.com/en/conditions/familial-hypertriglyceridaemia/) - Primary hypercholesterolemia or mixed dyslipidemia, as an adjunct to diet [Atherosclerosis and dyslipidaemia →](https://durgical.com/en/conditions/atherosclerosis-and-dyslipidaemia/) - Mixed hyperlipidemia [Familial combined hyperlipidaemia →](https://durgical.com/en/conditions/familial-combined-hyperlipidaemia/) ## Adverse effects ### Common - Abdominal pain, nausea, constipation - Raised liver transaminases - Reversible rise in serum creatinine - Muscle aches ### Serious (rare, important) - Drug-induced liver injury - Myopathy and rhabdomyolysis, more with a statin - Gallstones (cholelithiasis) - Pancreatitis; venous thromboembolism; severe hypersensitivity (rare) ## Contraindications - Severe kidney impairment, including dialysis - Active liver disease, including primary biliary cholangitis - Pre-existing gallbladder disease - Breastfeeding; hypersensitivity to fenofibrate ## Key interactions **Warfarin and other coumarins** Potentiate the anticoagulant effect; the INR is checked and the warfarin dose often reduced. **Statins** Add to myopathy risk; the combination is used only when the benefit is judged greater. **Bile acid resins** Bind fenofibrate; it is given at least 1 hour before or 4–6 hours after the resin. **Cyclosporine, tacrolimus** Nephrotoxicity can reduce fenofibrate clearance; kidney function is watched. ## What is monitored - Lipid panel, especially triglycerides - Liver tests (ALT, AST, bilirubin) at baseline and periodically - Kidney function - Blood count and INR if on warfarin ## Administration and safety - Oral, once daily; many formulations are taken with meals for better absorption. - Formulations are not interchangeable milligram for milligram: the product name and strength are checked. - Separated in time from bile acid resins. ## Nursing care - Before: lipid panel, liver and kidney function, gallbladder history, anticoagulants. - Teach the warning signs of gallstones or pancreatitis (upper abdominal pain) and of liver injury (jaundice, dark urine). - Ask about muscle pain, more so if a statin is also taken. - Check the INR more often after starting it in a patient on warfarin. ## Pregnancy and breastfeeding Few human data; generally used in pregnancy only for very severe hypertriglyceridemia with pancreatitis risk. Breastfeeding is avoided during treatment. ## Memory aid «Feno = Fine with statins»: of the fibrates it is the one combined with a statin. All fibrates: TG down, gallstones up, warfarin up. ## Test yourself Think of the answer, then tap the question to see it. ## What is the active form of fenofibrate? Fenofibric acid, formed by rapid hydrolysis of the prodrug. ## Which anticoagulant interaction is classic for fenofibrate? It potentiates warfarin and other coumarins, raising the INR and bleeding risk. ## Which kidney laboratory change is common and usually reversible on fenofibrate? A rise in serum creatinine, which tends to return to baseline after stopping. [Add to my cards (3)](https://durgical.app/estudiar/?add=/en/pharmacology/fenofibrate/) ## Related drugs - [Gemfibrozil](https://durgical.com/en/pharmacology/gemfibrozil/) - [Rosuvastatin](https://durgical.com/en/pharmacology/rosuvastatin/) - [Ezetimibe](https://durgical.com/en/pharmacology/ezetimibe/) ## Related conditions - [Familial hypertriglyceridaemia](https://durgical.com/en/conditions/familial-hypertriglyceridaemia/) - [Atherosclerosis and dyslipidaemia](https://durgical.com/en/conditions/atherosclerosis-and-dyslipidaemia/) - [Familial combined hyperlipidaemia](https://durgical.com/en/conditions/familial-combined-hyperlipidaemia/) [← Back to the class: Fibrates](https://durgical.com/en/pharmacology/classes/fibrates/) Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given. Sources: [Fenofibrate: MedlinePlus Drug Information](https://medlineplus.gov/druginfo/meds/a601052.html) (MedlinePlus (U.S. National Library of Medicine), 2026); [DailyMed - FENOFIBRATE tablet](https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=35ba17d9-0dd7-4f15-8f74-be5fd15f1917) (DailyMed (U.S. National Library of Medicine), 2026); [X-ray structure of human PPARalpha ligand binding domain-fenofibric acid co-crystals obtained by delipidation and co-crystallization](https://www.rcsb.org/structure/6LX4) (RCSB Protein Data Bank, 2020); [ATCDDD - ATC/DDD Index](https://atcddd.fhi.no/atc_ddd_index/?code=C10AB05) (WHO Collaborating Centre for Drug Statistics Methodology, 2026). ## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake Representative model, for educational purposes only. --- Source: https://durgical.com/en/pharmacology/fenofibrate/ License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/pharmacology/fenofibrate/