A fibrate for high triglycerides
Fenofibrate
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 Fenofibrate?
Fenofibrate 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; it is usually taken with food.
Education and reference only. This is a plain-language guide to Fenofibrate — 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
Fenofibrate 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 fenofibrate is usually an add-on or alternative for specific fat problems rather than the main cholesterol medicine. It is taken long-term, usually with food.
How it works
Fenofibrate activates a cell receptor (PPAR-alpha) 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 fenofibrate is used particularly when triglycerides are high rather than mainly to lower LDL cholesterol.
Company & origin
Originated / developed by: Developed by Groupe Fournier (now part of Abbott/Mylan)..
Fenofibrate is a fibrate developed in France and used to lower blood fats, particularly triglycerides.
What it treats
Conditions Fenofibrate is used for
Practical use
How to take Fenofibrate
General, dose-free guidance — always follow your prescriber's and the leaflet's specific instructions.
- Take it with food, as this helps the medicine be absorbed properly.
- Take it regularly and long-term, alongside a healthy diet and lifestyle, as it works in the background 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 Fenofibrate
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.
- 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 most important thing to watch for is muscle pain. Fibrates can cause muscle aches or, rarely, more serious muscle damage, and this risk is greater when fenofibrate is combined with a statin — so report any unexplained muscle pain, tenderness or weakness, especially with dark urine. It is usually taken with food, which helps it be absorbed. Liver and kidney blood tests are done before and during treatment, as it can affect both. Fibrates can also slightly increase the risk of gallstones. It works in the background to improve your blood fats, so you will not feel 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 reaction to fenofibrate or who has had a photosensitivity reaction to a related medicine.
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, tummy discomfort or diarrhoea.
- 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 fenofibrate, so the combination is used with care.
- Warfarin and similar blood thinners may need closer monitoring, as fenofibrate can increase their effect.
- Tell your prescriber about all your medicines, including other cholesterol or diabetes medicines, so interactions can be checked.
Available as: Tablets and capsules taken by mouth.
Answers
Fenofibrate: frequently asked questions
What is fenofibrate used for?
Fenofibrate 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 fenofibrate is taken with a statin, so report any unexplained muscle pain, tenderness or weakness promptly, especially if your urine looks dark.
Should I take fenofibrate with food?
Yes, fenofibrate is usually taken with food, as this helps it be absorbed properly. Taking it at the same time each day, with a meal, makes it easier to remember and keeps the effect steady.
Is fenofibrate the same as a statin?
No. Statins are the first choice for lowering 'bad' LDL cholesterol and reducing heart-attack and stroke risk. Fenofibrate 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 fenofibrate?
Fenofibrate can affect the liver and kidneys, so blood tests are done before and during treatment to check these are working well, alongside checks of your blood fats to confirm the medicine is helping.
The wider class
About Fibrates
Fenofibrate 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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