DrugindexOnline^{2nd edition}

Generic name: Fenofibrate
Brand names: Lofibra, Tricor

Why is Lofibra prescribed?

Tricor is used, along with a special diet, to treat people with very high levels of triglycerides (a fatty substance in the blood). Tricor also improves cholesterol levels by lowering total cholesterol--including "bad" LDL cholesterol--and raising "good" HDL cholesterol. It works by promoting the dissolution and elimination of fat particles in the blood.

Tricor is usually added to a treatment regimen only when other measures have failed to produce adequate results. Often, diet and exercise are enough to bring blood fats under control. Likewise, it's sometimes sufficient to simply treat an underlying problem such as diabetes, underactive thyroid, kidney disease, liver dysfunction, or alcoholism. And in some cases, just discontinuing a medication is enough to do the job. For instance, certain water pills and "beta-blocker" heart medications are capable of causing a massive increase in triglyceride levels. Estrogen replacement therapy is another potential culprit.

Whatever your other treatment measures may be, it's important to remember that Tricor is intended to supplement them, rather than replace them outright. To get the full benefit of the medication, you need to stick to the diet, exercise program, and other treatments your doctor prescribes. All these efforts to keep your cholesterol and triglyceride levels normal are important because together they may lower your risk of heart disease. If you're judged to be at high risk of heart disease, current guidelines call for considering drug therapy when LDL levels reach 130. For people at lower risk, the cut-off is 160. For those at little or no risk, it's 190.

Most important fact about Lofibra

Drugs such as Tricor have caused rare cases of a muscle-wasting disease called rhabdomyolysis. The chances of this problem rise dramatically when Tricor is combined with another type of cholesterol-lowering drug called "statins." Among these drugs are Altocor, Lescol, Lipitor, Mevacor, Pravachol, and Zocor. Avoid combining Tricor with any of them unless your doctor feels it's absolutely necessary. Inform the doctor immediately if you develop muscle pain or weakness, especially if these symptoms are accompanied by fatigue or fever: You'll probably have to stop taking Tricor.

How should you take Lofibra?

Tricor should be taken with meals. If you've also been prescribed a cholesterol-lowering drug such as Questran or Colestid, take Tricor at least 1 hour before or 4 to 6 hours after the other drug to make sure Tricor is properly absorbed.

--If you miss a dose...

Take it as soon as you remember. If it is almost time for your next dose, skip the one you missed and go back to your regular schedule. Never take 2 doses at the same time.

--Storage instructions...

Store at room temperature and protect from moisture.

What side effects may occur?

Side effects cannot be anticipated. If any develop or change in intensity, inform your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking Tricor.

• More common side effects may include:
  Abdominal pain, back pain, headache, respiratory disorders

Why should Lofibra not be prescribed?

You should not take Tricor if you have liver or gallbladder disease, or severe kidney problems. You'll also have to avoid Tricor if it gives you an allergic reaction.

Special warnings about Lofibra

Tricor has the potential to cause gallstones. Your doctor will discontinue the drug if gallstones develop.

Tricor may also affect liver function. Your doctor should perform periodic blood tests to monitor the health of your liver.

Tricor has not been tested in children.

Possible food and drug interactions when taking Lofibra

If Tricor is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining Tricor with the following:

Blood thinners such as warfarin (Coumadin)
The cholesterol-lowering drugs Colestid and Questran
Cyclosporine (Sandimmune, Neoral)
"Statins" (the cholesterol-lowering drugs Altocor, Lescol, Lipitor, Mevacor, Pravachol, and Zocor)

Special information if you are pregnant or breastfeeding

Pregnancy tests have not been conducted in humans, but high doses of Tricor have proven harmful in animal studies. If you are pregnant or plan to become pregnant, inform your doctor immediately.

Tricor should not be used in nursing mothers. If Lofibra is essential to your health, your doctor will advise you to stop nursing your baby.

Recommended dosage

ADULTS

High cholesterol levels or a combination of high cholesterol and high triglycerides

The initial dose of Tricor is 160 milligrams per day.

High triglyceride levels

The starting dose of Tricor ranges from 54 to 160 milligrams per day. The usual starting dose of Lofibra is 67 milligrams a day. Your doctor may increase the dose every 4 to 8 weeks if your triglycerides do not improve. The maximum dose of Tricor is 160 milligrams a day. For Lofibra, the maximum dose is about 200 milligrams a day.

OLDER ADULTS

The starting dose of Tricor for older adults and those with poor kidney function is 54 milligrams per day. For Lofibra, the starting dose is 67 milligrams a day.

Overdosage

There is no information on the effects of a Tricor overdose. However, any medication taken in excess can have serious consequences. If you suspect an overdose, seek medical attention immediately.