Fenofibrates for Hypercholesterolemia or Hyperlipidemia

June 1, 2021
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Illustration of pill bottle surrounded by pills.

Matt Malachowski, Pharm.D., sizes up fenofibrate formulations. With little clinical variation but big price differences, selecting this recommended dose could help save patients hundreds of dollars each month.

“The Dose” is a monthly pharmacy message from Ochsner Health Pharmacy’s System Director ofPopulation Health and Ambulatory Care, Matthew Malachowski, Pharm.D., MHA, BCPS. In the first edition, Matt evaluates fenofibrate formulations that have little clinical variation but big price differences.

In conjunction with diet and exercise, fenofibrates are indicated for the treatment of adults with hypertriglyceridemia and hypercholesterolemia. Fibrate therapy can reduce TG levels by as much as 50 percent. When choosing a fibrate, fenofibrate has some advantages over gemfibrozil such as fewer drug-drug interactions, and better patient compliance due to once-daily dosing. Fenofibrate is associated with a lower incidence of myopathy when used in conjunction with statins.

One of the major differences between generic formulations of fenofibrate is the cost. In the chart below, you can see how slight changes in dosage (and little to no change in efficacy) can increase the cost up to 97%. "While there’s no one-size-fits-all dose, the next time you prescribe fenofibrate to a patient, consider the 134 mg, once daily micronized capsule" says Malachowski. An estimated 30 days’ supply is only $13.

Chart showing Hypercholesterolemia or hyperlipidemia dosage form, amounts and estimated cost for 30 day supply

Fibrates can inhibit the metabolism of warfarin and should be used with caution when prescribed concurrently. Clinicians should monitor liver enzymes in patients taking fenofibrate.

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