A fibrate for high triglycerides
Bezafibrate
A fibrate used mainly to lower high triglycerides (a type of blood fat); it can cause muscle aches and needs liver and kidney checks.
What is Bezafibrate?
Bezafibrate is a fibrate medicine used mainly to lower high triglycerides, a type of fat in the blood, and to modestly raise 'good' HDL cholesterol. It is often used when triglycerides are very high or when a statin alone has not controlled them. It can cause muscle aches, especially if combined with a statin, and needs liver and kidney blood tests.
Education and reference only. This is a plain-language guide to Bezafibrate — it deliberately contains no doses. Doses depend on the person, the brand and the reason for treatment, and belong with your prescriber. Always check the BNF, the product labelling (SmPC) and follow medical advice.
What it is
Bezafibrate is a fibrate used in the UK mainly to lower high triglycerides, a type of fat in the blood, and to a lesser extent to raise 'good' HDL cholesterol. It is generally used when triglycerides are markedly raised, when there is a mixed pattern of blood fats, or when a statin alone has not brought triglycerides down enough. Statins remain the first choice for lowering 'bad' LDL cholesterol and reducing heart and stroke risk, so bezafibrate is usually an add-on or alternative for specific fat problems. It is taken long-term, often with or after food, and is available in a modified-release form.
How it works
Bezafibrate activates a cell receptor (PPAR) that controls how the body handles fats. This boosts the breakdown and clearance of triglyceride-rich particles from the blood and encourages the production of 'good' HDL cholesterol. The overall effect is a marked fall in triglycerides and a modest rise in HDL, which is why bezafibrate is used particularly when triglycerides are high rather than mainly to lower LDL cholesterol.
Company & origin
Originated / developed by: Developed by Boehringer Mannheim (later part of Roche)..
Bezafibrate is a fibrate introduced in the 1970s and used to lower blood fats, particularly triglycerides.
What it treats
Conditions Bezafibrate is used for
Practical use
How to take Bezafibrate
General, dose-free guidance — always follow your prescriber's and the leaflet's specific instructions.
- Take it with or after food, as advised, and swallow modified-release tablets whole rather than crushing them.
- Take it regularly and long-term, alongside a healthy diet and lifestyle, as it works quietly on your blood fats.
- Report any unexplained muscle pain, tenderness or weakness promptly, especially if you also take a statin or notice dark urine.
- Attend your liver and kidney blood tests before starting and during treatment, as advised by your team.
- Tell your prescriber if you develop tummy pain, which could rarely relate to gallstones.
- If you miss a dose, take your next dose as usual rather than doubling up, and ask your pharmacist if unsure.
Weighing it up
Advantages & disadvantages of Bezafibrate
Advantages
- It is effective at lowering high triglycerides, more so than statins for this particular blood fat.
- It can modestly raise 'good' HDL cholesterol.
- It is useful when triglycerides are very high or when a statin alone has not controlled them.
Disadvantages
- It can cause muscle aches, with a higher risk of muscle problems when combined with a statin.
- It can affect the liver and kidneys, so blood tests are needed and the dose may need adjusting in kidney problems.
- It mainly targets triglycerides and is not a substitute for a statin in lowering 'bad' LDL cholesterol and heart-attack risk.
Practical use
Good to know
The key thing to watch for is muscle pain. Fibrates can cause muscle aches or, rarely, more serious muscle damage, and the risk is greater when bezafibrate is combined with a statin — so report any unexplained muscle pain, tenderness or weakness, especially with dark urine. It is often taken with or after food. Liver and kidney blood tests are done before and during treatment, as it can affect both, and the dose may be adjusted if kidney function is reduced. Fibrates can also slightly increase the risk of gallstones. It works in the background to improve your blood fats, so you will not notice a day-to-day difference.
Who should not take it / use with caution
- People with severe liver disease, gallbladder disease or significant kidney problems.
- Pregnant or breastfeeding women.
- Anyone who has had a serious allergic or photosensitivity reaction to bezafibrate or a related fibrate.
Monitoring
- Blood fat (lipid) levels to check the medicine is working.
- Liver and kidney function blood tests before and during treatment.
- Watching for muscle pain or weakness, particularly when combined with a statin.
Side effects
- Muscle aches or tenderness; rarely, more serious muscle damage (report unexplained muscle pain, especially with dark urine).
- Digestive upset such as nausea, loss of appetite or tummy discomfort.
- Changes in liver or kidney blood tests.
- A slightly increased risk of gallstones.
Key interactions
- Statins increase the risk of muscle problems when combined with bezafibrate, so the combination is used with care.
- Warfarin and similar blood thinners may need closer monitoring, as fibrates can increase their effect.
- Some diabetes medicines may need review, as fibrates can affect blood sugar; tell your prescriber about all your medicines.
Available as: Tablets, including a modified-release form, taken by mouth.
Answers
Bezafibrate: frequently asked questions
What is bezafibrate used for?
Bezafibrate is a fibrate used mainly to lower high triglycerides, a type of fat in the blood, and to modestly raise 'good' HDL cholesterol. It is often used when triglycerides are very high or when a statin alone has not controlled them.
Why should I report muscle pain?
Fibrates can cause muscle aches and, rarely, more serious muscle damage. This risk is higher when bezafibrate is taken with a statin, so report any unexplained muscle pain, tenderness or weakness promptly, especially if your urine looks dark.
Should I take bezafibrate with food?
It is usually taken with or after food. If you have modified-release tablets, swallow them whole rather than crushing or chewing them, so the medicine is released slowly as intended.
Is bezafibrate the same as a statin?
No. Statins are the first choice for lowering 'bad' LDL cholesterol and reducing heart-attack and stroke risk. Bezafibrate mainly lowers triglycerides, so it is usually used as an add-on or alternative for specific blood-fat problems rather than instead of a statin.
Why do I need blood tests with bezafibrate?
Bezafibrate can affect the liver and kidneys, so blood tests are done before and during treatment to check these are working well. The dose may be adjusted if your kidney function is reduced, and your blood fats are checked to confirm it is helping.
The wider class
About Fibrates
Bezafibrate belongs to the fibrates class. For how the class as a whole works, its shared safety principles and monitoring, see the full guide.
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Authoritative sources
- BNF
- NICE CKS
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