From the Guidelines
Triglide, a brand name for fenofibrate, is a medication that should be used with caution, particularly in patients with renal impairment, as it may increase the risk of adverse effects, and its benefits should be weighed against potential harms 1. When prescribing Triglide, it is essential to evaluate renal status before initiation, within 3 months after initiation, and every 6 months thereafter, and to assess renal safety with both a serum creatinine level and an eGFR based on creatinine 1.
- The dose of Triglide should not exceed 54 mg/day if the eGFR is between 30 and 59 mL/min per 1.73 m2, and it should be discontinued if the eGFR decreases persistently to 30 mL/min per 1.73 m2 1.
- Triglide may be considered concomitantly with a low- or moderate-intensity statin only if the benefits from ASCVD risk reduction or triglyceride lowering when triglycerides are 500 mg/dL are judged to outweigh the potential risk for adverse effects 1.
- The medication is particularly effective for patients with hypertriglyceridemia, mixed dyslipidemia, or those who cannot tolerate statins, and common side effects include digestive issues, muscle pain, and potential liver enzyme elevations 1.
- Patients should inform their healthcare provider about all other medications they're taking, as Triglide can interact with blood thinners, immunosuppressants, and certain other drugs, and lifestyle modifications including diet, exercise, and smoking cessation should accompany medication therapy for optimal results 1.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Triglyceride Management
- Triglycerides are a type of fat found in the blood, and elevated levels can increase the risk of cardiovascular disease 2.
- Fenofibrate, a fibric acid derivative, has been shown to be effective in reducing triglyceride levels in patients with hypertriglyceridemia and metabolic syndrome 3, 4.
- The mechanism of action of fibrates, such as fenofibrate, involves the activation of peroxisome proliferator-activated receptors (PPAR-alpha), which mediates changes in lipoprotein metabolism 4, 5.
- Reducing triglyceride levels and increasing HDL-cholesterol levels can slow down coronary artery luminal narrowing and decrease cardiovascular morbidity and mortality 5, 6.
Treatment Options
- Fenofibrate has been shown to significantly reduce triglyceride levels, as well as LDL-cholesterol and non-HDL-cholesterol levels, in patients with hypertriglyceridemia and metabolic syndrome 3.
- Combination therapy with a statin and a fibrate, such as fenofibrate, may be necessary to address multiple lipid targets and reduce residual cardiovascular disease risk 6.
- Niacin and fenofibric acid are also options for combination therapy with a statin to treat multiple lipid abnormalities 6.
Clinical Considerations
- Hypertriglyceridemia is a common dyslipidemia seen in clinical practice, and studies have demonstrated a causal relationship between triglyceride-rich lipoproteins and cardiovascular disease 2.
- Factors influencing the atherogenicity of triglyceride-rich lipoproteins include apolipoprotein CIII-directed proinflammatory signaling pathways and triglyceride enrichment of low-density lipoprotein 2.
- Familial and metabolic disorders, as well as certain medications, can impair triglyceride-rich lipoprotein hydrolysis and contribute to hypertriglyceridemia 2.