Fibrates

What are fibrates?

Fibrates are medications to help lower triglyceride levels and increase the levels of high-density lipoprotein (HDL) cholesterol. Triglycerides are a certain type of fat transported in the blood, mostly after a meal and then stored in fat cells. High triglycerides are associated with cardiovascular disease and can cause pancreatitis, an inflammation of the pancreas gland.

Taking fibrates can also increase your high-density lipoprotein (HDL) cholesterol, or “good” cholesterol. But fibrates don’t lower your low-density lipoprotein (LDL) cholesterol much, or “bad” cholesterol.

How do fibrate drugs work?

Fibrates reduce the amount of very-low-density lipoprotein (VLDL) your liver makes. VLDL particles carry triglycerides to other parts of your body. By limiting how much VLDL your body makes, these medicines lower your triglyceride levels.

Fibrate drugs also increase the amount of apolipoproteins A-I and A-II your liver makes. These two proteins help create HDL cholesterol. Creating more of these proteins increases your HDL cholesterol levels.

Who should use fibrates?

Your healthcare provider may prescribe fibrates to reduce your triglycerides and/or raise your HDL cholesterol levels. Although triglycerides are associated with cardiovascular disease, it has not been consistently established that taking fibrates reduces the risk of a heart attack or stroke. Lowering triglycerides using fibrate medications is a key step in reducing the risk for pancreatitis.

What are the types of fibrate drugs?

There are several types of fibrates. You may take:

• Clofibrate (Atromid-S®).
• Fenofibrate (TriCor®, Fibricor®, Lofibra®).
• Gemfibrozil (Lopid®).

How effective are fibrates?

Fibrates are highly effective for some people. Research shows that certain fibrates can:

• Decrease triglycerides by about 50%.
• Increase HDL cholesterol by about 20%.
• Lower total cholesterol by about 10%.

Are fibrates a standalone treatment?

Fibrates may be the only medication you take to lower triglycerides and to reduce your risk of pancreatitis. To reduce the risk for cardiovascular disease, your provider will likely prescribe them together with statins, another type of cholesterol-lowering drug.

If you take both fibrates and statins, your provider closely monitors side effects. Many people safely take both medications, although some may have an increased risk of muscle problems.

Along with medication, your provider may also recommend:

• Eating a heart-healthy diet to help lower cholesterol levels.
• Exercising at least 150 minutes per week.
• Managing stress with healthy coping techniques.
• Sleeping at least seven to eight hours per night.
• Quitting smoking and using tobacco products.

Are fibrates safer than statins?

Both fibrates and statins are safe medications. Statins are established to reduce the risk for cardiovascular disease, but this has not been consistently proven for fibrate medications. Fibrates may be mainly given to reduce the risk of pancreatitis.

What are the benefits of using fibrates?

Although high triglycerides are associated with an increase in heart attack and stroke, lowering triglycerides with fibrates hasn’t consistently been shown to reduce the risk for cardiovascular disease. In people with elevated triglycerides, fibrates reduce the risk for pancreatitis.

What side effects do fibrate drugs have?

Like all medications, some people may experience side effects after taking fibrates. Fibrates may cause:

• Abdominal pain.
• Constipation.
• Diarrhea.
• Dizziness.
• Headaches.
• Leg cramps.

What interactions should I watch out for?

Fibrates can increase the effects of some blood thinners. If you take warfarin (Coumadin®), your provider may need to adjust your dose to decrease bleeding risks.

Gemfibrozil, a specific type of fibrate, can interact with certain statins, such as simvastatin (Zocor®) and lovastatin (Altoprev®, Mevacor®). If your provider prescribes both fibrates and statins, you’ll receive instructions about risks, benefits and side effects to watch for.

How long should I take fibrates?

While taking fibrates, you need to visit a healthcare provider regularly. Your provider will do blood tests to check if the medicine is improving your cholesterol. You should continue to take the medicine as long as your healthcare provider prescribes it.

Who should not take fibrates?

Fibrates aren’t right for everyone. You may not be able to take them if you’re pregnant, breastfeeding or have:

• Allergies.
• Diabetes.
• Gallbladder, liver or kidney conditions.
• Scheduled surgery or dental work.

When should I call my healthcare provider?

Call your healthcare provider right away if you experience:

• Muscle pain or weakness.
• Severe or persistent belly (abdominal) pain.
• Skin rash.
• Skin yellowing (jaundice).

A note from Cleveland Clinic

Fibrates are a type of cholesterol-lowering medication. They work by decreasing your triglycerides and increasing your HDL cholesterol. In people with high triglycerides, fibrates can significantly reduce the risk of heart disease, heart attack and stroke. Your provider may prescribe fibrates alone. Or you may take them with another medication, such as a statin. Typically, fibrates are one part of an overall treatment plan that includes healthy lifestyle habits.