From the Guidelines
The typical starting dose of fenofibrate is 54-160 mg once daily, as indicated in the study 1. This medication is usually taken orally with food. For patients with severe renal impairment, the recommended starting dose is not explicitly stated in the most recent and highest quality study, but it is generally recommended to start with a lower dose and adjust as needed based on response and tolerability. Fenofibrate is available in different formulations, including tablets and capsules. The exact dosage may vary slightly depending on the specific product used. It's essential to take fenofibrate consistently at the same time each day for best results. The medication works by reducing triglycerides and increasing HDL cholesterol levels in the blood, helping to manage lipid disorders and reduce cardiovascular risk. Patients should have their lipid levels monitored regularly while taking fenofibrate to assess its effectiveness. Liver function tests should also be performed periodically, as fenofibrate can rarely cause liver problems. Always consult with a healthcare provider for personalized dosing instructions, as they may adjust the dose based on individual factors such as kidney function, response to treatment, and potential drug interactions. Some key points to consider when prescribing fenofibrate include:
- Monitoring renal function before and during treatment, as fenofibrate may increase the risk of renal impairment 1
- Avoiding concomitant use with gemfibrozil due to increased risk of muscle symptoms and rhabdomyolysis 1
- Considering alternative treatments for patients with moderate or severe renal impairment, as fenofibrate may not be suitable for these patients 1
From the FDA Drug Label
2.2 Primary Hypercholesterolemia or Mixed Dyslipidemia The initial dose of fenofibrate tablet is 160 mg once daily. 2.3 Severe Hypertriglyceridemia The initial dose is 54 mg per day to 160 mg per day. 2.4 Impaired Renal Function Treatment with fenofibrate tablets should be initiated at a dose of 54 mg per day in patients having mild to moderately impaired renal function and increased only after evaluation of the effects on renal function and lipid levels at this dose. The maximum dose is 160 mg once daily.
The dosage of Fenofibrate is:
- Initial dose: 160 mg once daily for primary hypercholesterolemia or mixed dyslipidemia
- Initial dose: 54 mg per day to 160 mg per day for severe hypertriglyceridemia
- Maximum dose: 160 mg once daily
- Dosage for impaired renal function: 54 mg per day, increased as needed and tolerated 2
From the Research
Dosage of Fenofibrate
The dosage of fenofibrate varies depending on the formulation and the patient's condition.
- The recommended dosage of fenofibrate is 200 to 400 mg daily 3.
- A study compared the effectiveness of a fenofibrate 145-mg nanoparticle tablet formulation with the standard 160-mg tablet in patients with dyslipidemia and coronary heart disease 4.
- Another study used a single 105-mg dose of fenofibric acid or a single 145-mg dose of fenofibrate 5.
- Fenofibrate therapy has also been tested at a dose of 145 mg once-daily in persons with spinal cord injury 6.
- Different formulations of fenofibrate have resulted in low-dose (40 - 67) mg and standard-dose (120 - 200 mg) formulations, and are not equivalent on a milligram-to-milligram basis 7.
Formulations and Bioavailability
- Fenofibrate is highly lipophilic, virtually insoluble in water, and poorly absorbed 7.
- Coadministration with meals was necessary to maximize bioavailability of early formulations 7.
- Micronized and nanoparticle formulations of fenofibrate with reduced particle sizes were developed, resulting in greater solubility, improved bioavailability, and in some cases, the ability to be given irrespective of food 7.
- A hydrophilic choline salt of fenofibric acid can be taken without regard to meals, is absorbed throughout the gastrointestinal tract, has the highest bioavailability among marketed formulations, and is approved for coadministration with a statin 7.