Is Lipanthyl (fenofibrate) the same as fenofibrate for a 42‑year‑old man with refractory severe hypertriglyceridaemia, hypercholesterolaemia on rosuvastatin and ezetimibe, and fatty liver disease?

Is Lipanthyl a Fenofibrate?

Yes, Lipanthyl is a brand name formulation of fenofibrate, the same active pharmaceutical ingredient used to treat dyslipidemia. 1, 2

Brand Name vs. Generic Equivalence

• Lipanthyl contains fenofibrate as its active ingredient and functions identically to generic fenofibrate formulations in lowering triglycerides and modifying lipid profiles 3, 4
• Different brand names and formulations of fenofibrate (including Lipanthyl, micronized capsules, and suprabioavailable tablets) may have varying bioavailability, but they contain the same active drug 3
• The 67 mg and 200 mg micronized capsules are equivalent to 54 mg and 160 mg suprabioavailable tablet formulations respectively, demonstrating that dosing may vary by formulation while maintaining therapeutic equivalence 3

Clinical Relevance for Your Patient

For your 42-year-old man with severe hypertriglyceridemia (refractory despite rosuvastatin and ezetimibe) and fatty liver disease, fenofibrate (regardless of brand name) is appropriate as add-on therapy, though cardiovascular outcome benefits remain unproven. 5, 6

Key Treatment Considerations:

• Fenofibrate added to statin therapy reduces triglycerides by 23-59% (mean ~38%) and minimally increases HDL-C by 1-2 mg/dL 5, 6
• The combination of fenofibrate with rosuvastatin requires mandatory monitoring of hepatic transaminases (ALT, AST) and renal function (creatinine, eGFR) before initiation and periodically thereafter 5, 6
• Patients with triglycerides ≥204 mg/dL and HDL-C ≤40 mg/dL may derive cardiovascular benefit from fenofibrate-statin combination, though evidence is limited 5, 6

Critical Safety Monitoring:

• Evaluate liver function before starting fenofibrate, within 3 months after initiation, and every 6 months thereafter 7
• Monitor for ALT elevations >5 times upper limit of normal, which would necessitate discontinuation 5, 7
• For patients with fatty liver disease, fenofibrate can cause transient increases in liver enzymes, requiring careful monitoring 8
• The combination of fenofibrate with statins increases risk of myopathy and rhabdomyolysis, though this risk appears low in clinical trials 5, 1

Renal Function Adjustments:

• Reduce fenofibrate dose to 54 mg daily if eGFR is 30-59 mL/min/1.73 m² 6
• Discontinue fenofibrate immediately if eGFR drops persistently to <30 mL/min/1.73 m² 6
• Fenofibrate causes a transient, reversible rise in serum creatinine that does not necessarily indicate renal toxicity 8

Expected Outcomes:

• Fenofibrate reduces triglycerides substantially (26-50% reduction) and decreases LDL cholesterol by 10-28% 8, 1
• In patients with severe hypertriglyceridemia (>500 mg/dL), fenofibrate-statin combination reduces pancreatitis risk 6
• Lipid parameter changes occur within 4-6 weeks of treatment initiation 8

Important Caveats:

• Fenofibrate-statin combination did not reduce cardiovascular events in the overall ACCORD trial population, though a subgroup with high triglycerides and low HDL-C showed potential benefit 5, 6, 8
• Women with well-controlled diabetes may have higher cardiovascular event rates with fenofibrate-statin combination compared to statin alone 5, 6
• The primary goal remains LDL cholesterol reduction with statin therapy; fenofibrate is adjunctive for persistent hypertriglyceridemia 8