page187
Bezalip
c
Mono
(Actavis) A
Tablets
, m/r, f/c, bezafibrate 400 mg, net price 30-tab
pack = £7.63.
Label:
21,
25
Dose
400 mg once daily (dose form not appropriate in patients
with renal
impairment)
CIPROFIBRATE
Indications
hyperlipidaemias of types IIa, IIb, III, and
IV in patients who have not responded adequately to
diet;
also see notes above
Cautions
see under Bezafibrate
Contra-indications
see under Bezafibrate
Hepatic impairment
avoid in severe liver disease
Renal impairment
manufacturer advises reduce dose
to 100 mg on alternate days in moderate impairment;
avoid in severe impairment; see also Myotoxicity
under Bezafibrate
Pregnancy
manufacturers advise avoid—embryotoxi-
city in
animal
studies
Breast-feeding
manufacturer advises avoid—present
in milk in
animal
studies
Side-effects
see under Bezafibrate
Dose
. 100 mg daily
Ciprofibrate
(Non-proprietary) A
Tablets
,
ciprofibrate 100 mg,
net price 28-tab pack =
£28.00
FENOFIBRATE
Indications
hyperlipidaemias of types IIa,
IIb,
III,
IV,
and V in patients who have not responded adequately
to diet and other appropriate measures; also see notes
above
Cautions
see under Bezafibrate;
liver function tests
recommended every 3 months for first year (discon-
tinue treatment if significantly raised)
Contra-indications
gall bladder disease;
pancreatitis
(unless due to severe hypertriglyceridemia);
photo-
sensitivity to ketoprofen
Hepatic impairment
avoid in severe liver disease
Renal impairment
reduce dose to 134 mg daily if
eGFR less than 60 mL/minute/1.73 m
2
;
reduce dose
to 67 mg daily if eGFR less than 20 mL/minute/
1.73 m
2
;
avoid if eGFR less than 15 mL/minute/
1.73 m
2
;
see also Myotoxicity under Bezafibrate
Pregnancy
manufacturers advise avoid—embryotoxi-
city in
animal
studies
Breast-feeding
manufacturer advises avoid—no
information available
Side-effects
see under Bezafibrate;
also
very rarely
hepatitis,
pancreatitis,
and interstitial
pneumopathies
Dose
. See preparations below
Fenofibrate
(Non-proprietary) A
Capsules
,
fenofibrate (micronised) 200 mg,
net price
28-cap pack = £3.53.
Label:
21
Dose
1 capsule daily (dose form not appropriate for children or
in renal
impairment)
Capsules
,
fenofibrate (micronised) 267 mg,
net price
28-cap pack = £11.69.
Label:
21
Dose
severe hyperlipidaemia,
1 capsule daily (dose form not
appropriate for children or in renal
impairment)
Lipantil
c
(Solvay) A
Lipantil
c
Micro 67 capsules
,
yellow,
fenofibrate
(micronised) 67 mg,
net price 90-cap pack = £23.30.
Label:
21
Dose
initially 3 capsules daily in divided doses; usual range 2–4
capsules daily;
CHILD 4–15 years 1 capsule/20 kg daily
Lipantil
c
Micro 200 capsules
,
orange,
fenofibrate
(micronised) 200 mg, net price 28-cap pack = £17.95.
Label:
21
Dose
initially 1 capsule daily (dose form not appropriate for
children or in renal
impairment)
Lipantil
c
Micro 267 capsules
,
orange/cream,
feno-
fibrate (micronised) 267 mg,
net price 28-cap pack =
£21.75.
Label:
21
Dose
severe hyperlipidaemia,
1 capsule daily (dose form not
appropriate for children or in renal
impairment)
Supralip
c
160
(Abbott) A
Tablets
,
f/c,
fenofibrate (micronised) 160 mg,
net
price 28-tab pack = £6.69.
Label:
21
Dose
160 mg daily (dose form not appropriate for children or in
renal
impairment)
GEMFIBROZIL
Indications
hyperlipidaemias of types IIa,
IIb,
III,
IV
and V in patients who have not responded adequately
to diet and other appropriate measures; primary pre-
vention of cardiovascular disease in men with hyper-
lipidaemias that have not responded to diet and other
appropriate measures;
also see notes above
Cautions
lipid profile, blood counts, and liver-function
tests before initiating long-term treatment; preferably
avoid use with statins (high risk of rhabdomyolysis);
correct hypothyroidism before initiating treatment
(see p.
161);
elderly; interactions: Appendix 1
(fibrates)
Contra-indications
alcoholism,
biliary-tract disease
including gallstones;
photosensitivity to fibrates
Hepatic impairment
avoid in liver disease
Renal impairment
initially 900 mg daily if eGFR 30–
80 mL/minute/1.73 m
2
;
avoid if eGFR less than
30 mL/minute/1.73 m
2
;
see also Myotoxicity under
Bezafibrate
Pregnancy
manufacturers advise avoid—embryotoxi-
city in
animal
studies
Breast-feeding
manufacturer advises avoid—no
information available
Side-effects
gastro-intestinal disturbances;
headache,
fatigue,
vertigo;
eczema,
rash;
less commonly
atrial
fibrillation;
rarely
pancreatitis,
appendicitis,
distur-
bances in liver function including hepatitis and cho-
lestatic jaundice,
dizziness,
paraesthesia,
sexual dys-
function,
thrombocytopenia, anaemia,
leucopenia,
eosinophilia,
bone-marrow suppression,
myalgia,
myopathy,
myasthenia,
myositis accompanied by
increase in creatine kinase (discontinue if raised sig-
nificantly),
blurred vision,
exfoliative dermatitis,
alo-
pecia,
and photosensitivity)
Dose
. 1.2 g daily, usually in 2 divided doses; range 0.9–1.2 g
daily;
CHILD
not recommended
Gemfibrozil
(Non-proprietary) A
Capsules
, gemfibrozil 300 mg, net price 112-cap pack
= £35.57.
Label:
22
Tablets
,
gemfibrozil 600 mg,
net price 30-tab pack =
£13.88,
56-tab pack = £31.43.
Label:
22
BNF 61
2.12 Lipid-regulating drugs
167
2
Cardiovascular system