Fenofibrate

Medically Reviewed by Dr. Harshi Dhingra, M.D.

Last Reviewed: Jul 08, 2022

Warnings

What are the risks of taking fenofibrate?

Fenofibrate can cause serious health complications in some people. Talk to your healthcare provider or pharmacist if these risks concern you:

LIVER DISEASE: Fenofibrate can seriously damage the liver, leading to liver failure and even death. This can occur at any time during fenofibrate treatment. Your doctor will order blood tests to check liver function before starting you on this medication. People who have active liver disease should not take fenofibrate. The risk of liver damage is higher with higher doses of fenofibrate. You should seek emergency medical attention if you have symptoms of liver problems, such as nausea, vomiting, right upper stomach pain, yellowing of the skin or whites of the eyes, black or tarry stools, or mental confusion.
MYOPATHY OR RHABDOMYOLYSIS: Fenofibrate can lead to a serious muscle problem called rhabdomyolysis, in which there is widespread muscle breakdown. The proteins released into the blood due to muscle breakdown can lead to kidney damage and heart damage. The risk of this occurring is higher if you are on other medications, such as statins, that can also cause muscle damage. The risk is also higher in older adults, those with certain medical conditions like kidney failure, diabetes, and low thyroid hormones, and those taking higher doses of fenofibrate. You should seek immediate medical attention if you develop fever, unexplained muscle pain, unusual tiredness, weakness, cramps, or dark urine while on this medicine.
SEVERE KIDNEY DISEASE: Fenofibrate can cause severe kidney disease. The risk is higher in older adults, those with pre-existing kidney problems, or people with diabetes. Your healthcare professional will monitor your renal function through blood tests while on fenofibrate. Tell your doctor if you notice dark urine or changes in urination while on fenofibrate.
ALLERGIC REACTION: A small number of people can develop severe allergic reactions to fenofibrate, including anaphylaxis which is a life-threatening allergic reaction with mouth and face swelling and closing of the throat. Stop taking fenofibrate and seek emergency medical help if you notice hives, lip or tongue swelling, difficulty swallowing, or trouble breathing. Allergic reactions to fenofibrate can also manifest as a severe skin reaction with fever, blistering, and peeling skin. Seek emergency medical attention if this occurs.
GALLBLADDER DISEASE: Fenofibrate can increase the risk of developing gallstones. People who have pre-existing gallbladder problems should not take fenofibrate. Tell your healthcare provider if you experience stomach pain, nausea, vomiting, or backache so that they can check you for gallbladder disease.
PANCREATITIS: In a small number of people, fenofibrate can cause pancreatitis (inflammation of the pancreas). Your doctor may want to monitor certain enzyme levels to monitor your pancreas while you are on fenofibrate. Contact your doctor right away if you develop symptoms such as nausea, vomiting, stomach pain, or bloating.
BLOOD CLOTS: Fenofibrate can increase the risk of blood clots in the legs (deep vein thrombosis or DVT) or the lungs (pulmonary embolism or PE). Call your doctor immediately or seek emergency medical attention if you have chest pain, trouble breathing, or swelling in your leg with warmth and redness.

What should I tell my doctor before starting fenofibrate?

Tell your doctor if you are allergic to fenofibrate, any active or inactive ingredients in fenofibrate tablets or capsules, other cholesterol-lowering medicines, or any other drugs. Your pharmacy can provide you with a list of ingredients.

Give your doctor and pharmacist a complete list of all your other medicines, including prescription drugs, nonprescription drugs (over-the-counter medicines), vitamins, supplements, and herbal products. This can help avoid a serious drug reaction.

Give your doctor a complete medical history. Specifically, tell your doctor if you have any kidney disease, liver disease, or gallbladder disease. Fenofibrate may not be right for you. Also, inform your doctor if you have diabetes, poorly controlled hypothyroidism (underactive thyroid), or if you drink large amounts of alcohol.

Tell your doctor if you are pregnant, could be pregnant, plan to become pregnant, or are breastfeeding.

What precautions should I take while on fenofibrate?

Keep all your appointments with your healthcare provider. Your doctor may order lab tests to monitor your liver, kidneys, gallbladder, and pancreas. Fenofibrate can put you at an increased risk of problems with these organs. If you have abnormal laboratory tests, you may need to stop fenofibrate.

Call your doctor right away if you experience serious symptoms such as trouble breathing; chest pain; tongue or throat swelling; unexplained muscle pain, tenderness, or weakness; unusual tiredness; rash, hives; dark urine; blistering or peeling skin; nausea, vomiting, sharp stomach pain spreading from the right upper part of the abdomen; swelling, redness, and pain in one leg; or systemic symptoms like fever.

If you are taking other medicines called bile acid sequestrants (for example, cholestyramine (Questran), colestipol (Colestid), or colesevelam (WelChol)), be sure to take these medications 1 hour after or 4-6 hours before fenofibrate.

Tell your doctor if you become pregnant while on fenofibrate. Do not breastfeed while on fenofibrate

What drugs can interact with fenofibrate?

A drug combination of fenofibrate and certain other medicines can affect how the medications work and increase the risk of severe side effects. Your physician may choose a different medication, change the dose or frequency of your medicines, and/or monitor you carefully for side effects if there are known drug interactions between fenofibrate and your other drugs. There can be interactions between fenofibrate and the following medicines:

Anticoagulants or blood thinners like warfarin (Coumadin)
Diuretics or water pills
Beta-blockers like atenolol (Tenormin), metoprolol (Lopressor, Toprol XL), labetalol (Normodyne), propranolol (Inderal), and nadolol (Corgard)
Colchicine (Colcrys, in Col-Probenecid)
Hormone replacement therapy and hormonal contraceptives (birth control pills, implants, injections, patches, or rings)
Cholesterol-lowering drugs (HMG-CoA reductase inhibitors or statins) like atorvastatin (Lipitor), simvastatin (Zocor), pravastatin (Pravachol), lovastatin (Mevacor), and rosuvastatin (Crestor).
Immunosuppressant medications like tacrolimus (Prograf) and cyclosporine (Sandimmune, Neoral)

All possible drug interactions of fenofibrate are not included in this list. Give your doctor or pharmacist a complete list of your medications, including prescription drugs, over-the-counter medicines, dietary supplements, vitamins, and herbal remedies. Also, tell your healthcare providers if you smoke, drink alcohol, or use illegal drugs because some of these substances can cause serious health complications when used with prescription drugs.

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