Fenofibrate Dosage

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Usual Adult Dose for Hyperlipoproteinemia Type IIa (Elevated LDL)

Tricor (R): 145 mg orally once a day.
Lofibra (R) and others: 160 mg to 200 mg orally once a day with food.
Antara (R): 130 mg orally once a day.
Triglide (R): 160 mg orally once a day.
Lipofen (R): 150 mg orally once a day with food.
Fenoglide (R): 120 mg orally once a day with food.

Individualize dosage according to patient response and adjust if necessary following repeat lipid determinations at 4 to 8 week intervals.

Usual Adult Dose for Hyperlipoproteinemia Type IIb (Elevated LDL + VLDL)

Tricor (R): 145 mg orally once a day.
Lofibra (R) and others: 160 mg to 200 mg orally once a day with food.
Antara (R): 130 mg orally once a day.
Triglide (R): 160 mg orally once a day.
Lipofen (R): 150 mg orally once a day with food.
Fenoglide (R): 120 mg orally once a day with food.

Individualize dosage according to patient response and adjust if necessary following repeat lipid determinations at 4 to 8 week intervals.

Usual Adult Dose for Hyperlipoproteinemia Type IV (Elevated VLDL)

Tricor (R): 48 to 145 mg orally once a day.
Lofibra (R) and others: 54 mg to 200 mg orally once a day with food.
Antara (R): 43 mg to 130 mg orally once a day.
Triglide (R): 50 mg to 160 mg orally once a day.
Lipofen (R): 50 mg to 150 mg orally once a day with food.
Fenoglide (R): 40 mg to 120 mg orally once a day with food.

Individualize dosage according to patient response and adjust if necessary following repeat lipid determinations at 4 to 8 week intervals.

Usual Adult Dose for Hyperlipoproteinemia Type V (Elevated Chylomicrons + VLDL)

Tricor (R): 48 to 145 mg orally once a day.
Lofibra (R) and others: 54 mg to 200 mg orally once a day with food.
Antara (R): 43 mg to 130 mg orally once a day.
Triglide (R): 50 mg to 160 mg orally once a day.
Lipofen (R): 50 mg to 150 mg orally once a day with food.
Fenoglide (R): 40 mg to 120 mg orally once a day with food.

Individualize dosage according to patient response and adjust if necessary following repeat lipid determinations at 4 to 8 week intervals.

Usual Geriatric Dose for Hyperlipoproteinemia

Tricor (R): 48 mg orally once a day. Increases in dosage should occur only after evaluating the effects on renal function and lipid levels at this dose, with a maximum recommended dose of 145 mg/24 hours.

Lofibra (R) and others: 54 mg to 67 mg orally once a day with food. Individualize dosage according to patient response and adjust if necessary following repeat lipid determinations at 4 to 8 week intervals.

Antara (R): 43 mg orally once a day. Individualize dosage according to patient response and adjust if necessary following repeat lipid determinations at 4 to 8 week intervals.

Triglide (R): 50 mg orally once a day. Individualize dosage according to patient response and adjust if necessary following repeat lipid determinations at 4 to 8 week intervals.

Lipofen (R): 50 mg orally once a day with food. Individualize dosage according to patient response and adjust if necessary following repeat lipid determinations at 4 to 8 week intervals.

Fenoglide (R): 40 mg to 120 mg orally once a day with food

Renal Dose Adjustments

CrCl less than 50 mL/min (or CrCl less than or equal to 30 mL/min for Fenoglide (R)): fenofibrate is contraindicated for use in patients with severe renal dysfunction.

CrCl less than 80 mL/min and greater than or equal to 50 mL/min (or CrCl less than 80 mL/min and greater than 30 mL/min for Fenoglide (R)):
Tricor (R):
Initial dose is 48 mg orally once a day. Increases in dosage should occur only after evaluating the effects on renal function and lipid levels at this dose. In patients with severe renal failure, total clearance is significantly decreased and accumulation occurs with chronic dosing. Clearance and volume of distribution are increased in patients with mild to moderate renal dysfunction when compared to patients with normal renal function. Although Tricor (R) dosage should be reduced in patients with severe renal dysfunction, dosage modifications are not required for patients with mild to moderate renal dysfunction.

Lofibra (R):
67 mg orally once a day with food, and increased only after evaluation of the effects on renal function and lipid levels at this dose.

Antara (R):
43 mg orally once a day with food, and increased only after evaluation of the effects on renal function and lipid levels at this dose.

Triglide (R):
50 mg orally once a day with food, and increased only after evaluation of the effects on renal function and lipid levels at this dose.

Fenoglide (R):
40 mg orally once a day with food, and increased only after evaluation of the effects on renal function and lipid levels at this dose.

Liver Dose Adjustments

Fenofibrate is considered contraindicated in patients with hepatic failure, including biliary cirrhosis and unexplained persistent liver function abnormality.

Precautions

Safety and effectiveness have not been established in pediatric patients (less than 18 years of age).

Dialysis

Fenofibric acid is not removed by hemodialysis. The drug is highly bound to plasma proteins and protein binding is not altered by severe renal dysfunction.

Other Comments

Fenofibrate is a cytochrome P450 enzyme system inhibitor and potentiates the actions of several drugs such as warfarin, cyclosporine, and the HMG Co-A reductase inhibitors. Doses of these drugs and others that use the same enzyme system may have to be substantially decreased to prevent potentially toxic levels from accumulating.

The dosage formulations of Antara, Tricor and Triglide allow them to be taken without regard to food.

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