From the Research
Fenofibrate is not the lipid-lowering agent that causes an increase in uric acid levels, but rather it has been shown to decrease serum uric acid levels. The most recent and highest quality study, 1, demonstrated that fenofibrate significantly reduced serum uric acid levels (WMD -1.32 mg/dL, 95%CI -1.61 to -1.03, p < 0.001) in patients with lipid disorders. Some key points to consider when prescribing fenofibrate include:
- Typical dosing ranges from 48-145mg daily depending on the formulation
- Patients with existing hyperuricemia, gout, or kidney disease should be monitored closely when taking fenofibrate
- Fenofibrate has been shown to have a uricosuric property, which may be a useful adjunctive attribute in patients with gout or hyperuricemia
- The mechanism of fenofibrate's effect on uric acid levels involves increasing the clearance of purine bases and oxypurinol, rather than competing with uric acid for renal tubular secretion. It is essential to note that the provided evidence does not support the notion that fenofibrate increases uric acid levels, but rather it has a hypouricemic effect. Therefore, fenofibrate may be a suitable option for patients with dyslipidemia who also have gout or hyperuricemia.