Fenobate Uses

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What is Fenobate?

Fenobate (Fenobate) helps reduce cholesterol and triglycerides (fatty acids) in the blood. High levels of these types of fat in the blood are associated with an increased risk of atherosclerosis (clogged arteries).

Fenobate is used to treat high cholesterol and high triglyceride levels.

Fenobate may also be used for purposes not listed in this medication guide.

Fenobate indications

An indication is a term used for the list of condition or symptom or illness for which the medicine is prescribed or used by the patient. For example, acetaminophen or paracetamol is used for fever by the patient, or the doctor prescribes it for a headache or body pains. Now fever, headache and body pains are the indications of paracetamol. A patient should be aware of the indications of medications used for common conditions because they can be taken over the counter in the pharmacy meaning without prescription by the Physician.
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Treatment of Severe Hypertriglyceridemia

Fenobate is indicated as adjunctive therapy to diet to reduce ​triglycerides (TG) in patients with severe hypertriglyceridemia. Improving glycemic control in diabetic patients showing fasting chylomicronemia will usually obviate the need for pharmacological intervention. Markedly elevated levels of serum triglycerides (e.g. > 2,000 mg/dL) may increase the risk of developing pancreatitis. The effect of Fenobate therapy on reducing this risk has not been adequately studied.

Treatment of Primary Hypercholesterolemia or Mixed Dyslipidemia

Fenobate is indicated as adjunctive therapy to diet to reduce elevated low-density lipoprotein cholesterol (LDL-C), total cholesterol (Total-C), triglycerides (TG), and apolipoprotein B (Apo B), and to increase high-density lipoprotein cholesterol (HDL-C) in patients with primary hypercholesterolemia or mixed dyslipidemia.

Limitations of Use

​ Fenobate at a dose equivalent to 135 mg of Fenobate did not reduce coronary heart disease morbidity and mortality in 2 large, randomized controlled trials of patients with type 2 diabetes mellitus.

General Considerations for Treatment

Laboratory studies should be performed to establish that lipid levels are abnormal before instituting Fenobate therapy.

Every reasonable attempt should be made to control serum lipids with non-drug methods including appropriate diet, exercise, weight loss in obese patients, and control of any medical problems such as diabetes mellitus and hypothyroidism that may be contributing to the lipid abnormalities. Medications known to exacerbate hypertriglyceridemia (beta-blockers, thiazides, estrogens) should be discontinued or changed if possible, and excessive alcohol intake should be addressed before triglyceride-lowering drug therapy is considered. If the decision is made to use lipid-altering drugs, the patient should be instructed that this does not reduce the importance of adhering to diet.

Drug therapy is not indicated for patients who have elevations of chylomicrons and plasma triglycerides, but who have normal levels of VLDL.

How should I use Fenobate?

Use Fenobate capsules as directed by your doctor. Check the label on the medicine for exact dosing instructions.

Ask your health care provider any questions you may have about how to use Fenobate capsules.

Uses of Fenobate in details

There are specific as well as general uses of a drug or medicine. A medicine can be used to prevent a disease, treat a disease over a period or cure a disease. It can also be used to treat the particular symptom of the disease. The drug use depends on the form the patient takes it. It may be more useful in injection form or sometimes in tablet form. The drug can be used for a single troubling symptom or a life-threatening condition. While some medications can be stopped after few days, some drugs need to be continued for prolonged period to get the benefit from it.
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Use: Labeled Indications

Hypercholesterolemia or mixed dyslipidemia: Adjunctive therapy to diet for the reduction of low-density lipoprotein cholesterol (LDL-C), total cholesterol (total-C), triglycerides, and apolipoprotein B (apo B), and to increase high-density lipoprotein cholesterol (HDL-C) in adults with primary hypercholesterolemia or mixed dyslipidemia (Fredrickson types IIa and IIb). Use lipid-altering agents in addition to a diet restricted in saturated fat and cholesterol when response to diet and nonpharmacological interventions alone has been inadequate.

Note: While FDA-approved for hypercholesterolemia, Fenobate is not a first- or second-line choice; other agents may be more suitable (ACC/AHA [Stone 2013]). In addition, use is not recommended to lower LDL-C or raise HDL-C in the absence of hypertriglyceridemia.

Hypertriglyceridemia: Adjunctive therapy to diet for treatment of adult patients with severe hypertriglyceridemia (Fredrickson types IV and V hyperlipidemia).

Off Label Uses

Primary biliary cholangitis

Data from a single-center, retrospective cohort study support the use of Fenobate (in combination with ursodiol) in patients with primary biliary cholangitis (PBC) who have had an incomplete biochemical response to ursodiol monotherapy and showed significant improvement in alkaline phosphatase, a reduction in hepatic decompensation, and transplant-free survival improvement.

Fenobate description

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Each film-coated tablet contains Fenofibrate BP 160 mg. It also contains the following excipients: Pregelatinized starch maize, povidone, sodium lauryl sulphate, microcrystalline cellulose, crospovidone, anhydrous colloidal silica, sodium stearyl fumarate, purified water and opadry AMB OY-B-28920.

Fenobate is a lipid-regulating agent. The empirical formula is C20H21O4Cl and the molecular weight is 360.83. Fenobate is 2-[4-(4-chlorobenzoyl) phenoxy]-2-methyl-propanoic acid, 1-methylethyl ester.

Fenobate dosage

General Considerations

Fenobate Capsules should be given with meals thereby optimizing the absorption of the medication.

Patients should be advised to swallow Fenobate Capsules whole. Do not open, crush, dissolve or chew capsules.

Patients should be placed on an appropriate lipid-lowering diet before receiving Fenobate Capsules, and should continue this diet during treatment with Fenobate Capsules.

The initial treatment for dyslipidemia is dietary therapy specific for the type of lipoprotein abnormality. Excess body weight and excess alcoholic intake may be important factors in hypertriglyceridemia and should be addressed prior to any drug therapy. Physical exercise can be an important ancillary measure. Diseases contributory to hyperlipidemia, such as hypothyroidism or diabetes mellitus should be looked for and adequately treated. Estrogen therapy, thiazide diuretics and beta-blockers, are sometimes associated with massive rises in plasma triglycerides, especially in subjects with familial hypertriglyceridemia. In such cases, discontinuation of the specific etiologic agent may obviate the need for specific drug therapy of hypertriglyceridemia.

Periodic determination of serum lipids should be obtained during initial therapy in order to establish the lowest effective dose of Fenobate. Therapy should be withdrawn in patients who do not have an adequate response after two months of treatment with the maximum recommended dose of 150 mg per day.

Consideration should be given to reducing the dosage of Fenobate if lipid levels fall significantly below the targeted range.

Primary Hypercholesterolemia or Mixed Dyslipidemia

The dose of Fenobate Capsules is 150 mg once daily.

Severe Hypertriglyceridemia

The initial dose is 50 to 150 mg per day. Dosage should be individualized according to patient response, and should be adjusted if necessary following repeat lipid determination at 4 to 8 week intervals.

The maximum dose of Fenobate Capsules is 150 mg once daily.

Impaired Renal Function

In patients with mild-to-moderate renal impairment, treatment with Fenobate Capsules should be initiated at a dose of 50 mg per day, and increased only after evaluation of the effects on renal function and lipid levels at this dose. The use of Fenobate should be avoided in patients with severe renal impairment.

Geriatric Patients

Dose selection for the elderly should be made on the basis of renal function.

Fenobate interactions

See also:
What other drugs will affect Fenobate?

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Anticoagulants: Fenobate enhances oral anticoagulant effect and may increase risk of bleeding. Therefore, this combination is not recommended.

Potentiation of coumarin-type anticoagulant effects has been observed with prolongation of the PT/INR.

Caution should be exercised when coumarin anticoagulants are given in conjunction with Fenobate. The dosage of the anticoagulants should be reduced to maintain the PT/INR at the desired level to prevent bleeding complications. Frequent PT/INR determinations are advisable until it has been definitely determined that the PT/INR has stabilized.

Hydroxy methylglutaryl coenzyme A (HMG-CoA) Reductase Inhibitors (Statins): The combined use of Fenobate and HMG-CoA reductase inhibitors should be avoided unless the benefit of further alterations in lipid levels is likely to outweigh the increased risk of this drug combination.

The risk of serious muscle toxicity is increased if Fenobate is used concomitantly with HMG-CoA reductase inhibitors or other fibrates. Such combination therapy should be used with caution and patients monitored closely for signs of muscle toxicity.

Bile Acid Resins: Since bile acid sequestrants may bind other drugs given concurrently, patients should take Fenobate at least 1 hr before or 4-6 hrs after a bile acid binding resin to avoid impeding its absorption.

Immunosuppressants: Immunosuppressants eg, cyclosporine and tacrolimus can produce nephrotoxicity with decreases in CrCl and rises in serum creatinine, and because renal excretion is the primary elimination route of fibrate drugs including Fenobate, there is a risk that an interaction will lead to deterioration. The benefits and risks of using Fenobate with immunosuppressants and other potentially nephrotoxic agents should be carefully considered and the lowest effective dose employed and renal function monitored.

Some severe cases of reversible renal function impairment have been reported during concomitant administration of Fenobate and cyclosporine. The renal function of these patients must therefore be closely monitored and the treatment with Fenobate stopped in the case of severe alteration of laboratory parameters.

Cytochrome P450 (CYP450) Enzymes: In vitro studies using human liver microsomes indicate that Fenobate and fenofibric acid are not inhibitors of CYP450 isoforms CYP3A4, CYP2D6, CYP2E1 or CYP1A2. They are weak inhibitors of CYP2C19 and CYP2A6 and mild to moderate inhibitors of CYP2C9 at therapeutic concentrations. Patients co-administered Fenobate and CYP2C19, CYP2A6 and especially CYP2C9 metabolised drugs with a narrow therapeutic index should be carefully monitored and if necessary, dose adjustment of these drugs is recommended.

Fenobate side effects

See also:
What are the possible side effects of Fenobate?

Clinical Trials Experience

Because clinical studies are conducted under widely varying conditions, adverse reaction rates observed in the clinical studies of a drug cannot be directly compared to rates in the clinical studies of another drug and may not reflect the rates observed in practice.

Fenofibric acid is the active metabolite of Fenobate. Adverse events reported by 2% or more of patients treated with Fenobate and greater than placebo during double-blind, placebocontrolled trials are listed in Table 1. Adverse events led to discontinuation of treatment in 5.0% of patients treated with Fenobate and in 3.0% treated with placebo. Increases in liver tests were the most frequent events, causing discontinuation of Fenobate treatment in 1.6% of patients in double-blind trials.

Table 1: Adverse Events Reported by 2% or More of Patients Treated with Fenobate and Greater than Placebo During the Double-Blind, Placebo-Controlled Trials

BODY SYSTEM Adverse Event Fenobate*

(N = 439)

Placebo

(N = 365)

BODY AS A WHOLE
Abdominal Pain 4.6% 4.4%
Back Pain 3.4% 2.5%
Headache 3.2% 2.7%
DIGESTIVE
Nausea 2.3% 1.9%
Constipation 2.1% 1.4%
INVESTIGATIONS
Abnormal Liver Tests 7.5% 1.4%
Increased AST 3.4% 0.5%
Increased ALT 3.0% 1.6%
Increased Creatine Phosphokinase 3.0% 1.4%
RESPIRATORY
Respiratory Disorder 6.2% 5.5%
Rhinitis 2.3% 1.1%
* Dosage equivalent to 135 mg Fenobate

Clinical trials with Fenobate did not include a placebo-control arm. However, the adverse event profile of Fenobate was generally consistent with that of Fenobate. The following adverse events not listed above were reported in ≥ 3% of patients taking Fenobate alone:

Gastrointestinal Disorders: Diarrhea, dyspepsia

General Disorders and Administration Site Conditions: Pain

Infections and Infestations: Nasopharyngitis, sinusitis, upper respiratory tract infection

Musculoskeletal and Connective Tissue Disorders: Arthralgia, myalgia, pain in extremity

Nervous System Disorders: Dizzinesss

Postmarketing Experience

The following adverse events have been identified during postapproval use of Fenobate: rhabdomyolysis, pancreatitis, renal failure, muscle spasms, acute renal failure, hepatitis, cirrhosis, anemia, asthenia, and severely depressed HDL-cholesterol levels.

Because these events are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure.

Fenobate contraindications

See also:
What is the most important information I should know about Fenobate?

Hypersensitivity to Fenobate or to any of the excipients of Fenobate, Fenobate Supra 160 mg and Fenobate 67M.

Patients with hepatic insufficiency (including biliary cirrhosis, and unexplained persistent liver function abnormality) and renal insufficiency.

Known photoallergy or phototoxic reaction during treatment with fibrates or ketoprofen, chronic or acute pancreatitis with the exception of acute pancreatitis due to severe hypertriglyceridemia, gallbladder disease and severe chronic kidney disease.

Fenobate/Fenobate Supra 160 mg: It should not be taken by patients allergic to peanut or arachis oil or soya/soybean lecithin or related products due to the risk of hypersensitivity reactions.

Use in pregnancy: Fenobate/Fenobate 67M: There are no adequate data from the use of Fenobate in pregnant woman. Animal studies have not demonstrated and teratogenic effects. Embryotoxic effects have been shown at doses in the range of maternal toxicity. The potential risk for humans is unknown. Therefore, film-coated tablet should only be used during pregnancy after a careful benefit/risk assessment.

Fenobate Supra 160 mg is contraindicated during pregnancy, in the absence of data. If unexpected pregnancy occurs while taking Fenobate, treatment should be interrupted and consult a doctor.

Use in lactation: It is unknown whether Fenobate is excreted in human milk. A risk to the newborns/infants cannot be excluded. Fenobate Supra 160 mg is contraindicated during breastfeeding in the absence of data. Therefore, Fenobate should not be used during breastfeeding in nursing mother.

Use in children: Fenobate 67M: The safety and efficacy of Fenobate in children have not yet been established. Only limited pediatric data are available. Therefore, the use of Fenobate is not recommended in pediatric subjects <18 years.



Active ingredient matches for Fenobate:

Fenofibrate in India.


Unit description / dosage (Manufacturer)Price, USD
Fenobate 67mg CAP / 10$ 0.90
Fenobate 160mg CAP / 10$ 1.37
Fenobate 200mg CAP / 10$ 1.57
67 mg x 10's$ 0.90
160 mg x 10's$ 1.37
200 mg x 10's$ 1.57
Fenobate 160 mg Capsule$ 0.14
Fenobate 67 mg Capsule$ 0.09
Fenobate 200 mg Capsule$ 0.16
FENOBATE 200MG CAPSULE 1 strip / 10 capsules each (East West Pharma)$ 1.57
FENOBATE cap 67 mg x 10's (East West)$ 0.90
FENOBATE cap 160 mg x 10's (East West)$ 1.37
FENOBATE cap 200 mg x 10's (East West)$ 1.57
Fenobate 200mg Capsule (East West Pharma)$ 0.16

List of Fenobate substitutes (brand and generic names):

Feno-TG 160mg Tablet (Troikaa)$ 0.22
Capsule, Retard; Oral; Fenofibrate 250 mg (Betapharm)
Capsule, Retard; Oral; Fenofibrate 250 mg
Fenocard 40mg Tablet (Avinash Health Products Pvt Ltd)$ 0.08
FENOCARD 20MG TABLET 1 strip / 10 tablets each (Avinash Health Products Pvt Ltd)$ 0.44
FENOCARD 40MG TABLET 1 strip / 10 tablets each (Avinash Health Products Pvt Ltd)$ 0.79
FENOCARD H TABLET 1 strip / 10 tablets each (Avinash Health Products Pvt Ltd)$ 0.95
Fenocor 67mg CAP / 10 (Ordain Health Care (P) Ltd.)$ 0.79
Fenocor 200mg CAP / 10 (Ordain Health Care (P) Ltd.)$ 3.17
67 mg x 10's (Ordain Health Care (P) Ltd.)$ 0.79
200 mg x 10's (Ordain Health Care (P) Ltd.)$ 3.17
Fenocor 67 mg Capsule (Ordain Health Care (P) Ltd.)$ 0.08
Fenocor 200 mg Capsule (Ordain Health Care (P) Ltd.)$ 0.32
FENOCOR 105 MG TABLET 1 strip / 10 tablets each (Ordain Health Care (P) Ltd.)$ 2.36
FENOCOR 200 MG CAPSULE 1 strip / 10 capsules each (Ordain Health Care (P) Ltd.)$ 2.29
FENOCOR 35 MG TABLET 1 strip / 10 tablets each (Ordain Health Care (P) Ltd.)$ 1.31
FENOCOR 67 MG CAPSULE 1 strip / 10 capsules each (Ordain Health Care (P) Ltd.)$ 1.30
FENOCOR 67 MG TABLET 1 strip / 20 tablets each (Ordain Health Care (P) Ltd.)$ 3.35
FENOCOR cap 67 mg x 10's (Ordain Health Care (P) Ltd.)$ 0.79
FENOCOR cap 200 mg x 10's (Ordain Health Care (P) Ltd.)$ 3.17
Fenocor 105mg Tablet (Ordain Health Care (P) Ltd.)$ 0.29
Fenocor 200mg Capsule (Ordain Health Care (P) Ltd.)$ 0.23
Fenocor 35mg Tablet (Ordain Health Care (P) Ltd.)$ 0.14
Fenocor 67mg Capsule (Ordain Health Care (P) Ltd.)$ 0.14
FENODAC 135 MG CAPSULE 1 strip / 10 capsules each (Cadila)$ 1.90
FENODAC suscap 45 mg x 10's (Cadila)$ 6.60
FENODAC suscap 135 mg x 10's (Cadila)$ 1.73
Fenodac 135mg Capsule (Cadila)$ 0.19
Fenof 200 200 mg x 20's$ 11.11
Capsule, Retard; Oral; Fenofibrate 250 mg (Juta)
Capsule, Retard; Oral; Fenofibrate 250 mg
Fenofib 100 mg x 5 Blister x 4 Tablet
Fenofib 100 mg x 5 Blister x 6 Tablet
Fenofib 100 mg x 7 Blister x 4 Tablet
Fenofib 200 mg x 5 Blister x 4 Tablet

References

  1. DailyMed. "FENOFIBRATE: DailyMed provides trustworthy information about marketed drugs in the United States. DailyMed is the official provider of FDA label information (package inserts).". https://dailymed.nlm.nih.gov/dailyme... (accessed September 17, 2018).
  2. PubChem. "fenofibrate". https://pubchem.ncbi.nlm.nih.gov/com... (accessed September 17, 2018).
  3. DrugBank. "fenofibrate". http://www.drugbank.ca/drugs/DB01039 (accessed September 17, 2018).

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