Clofibrate

Oral
Hyperlipidaemias

CrCl (mL/min)	Dosage
<10	Avoid.
10-50	Administer every 12-18 hr.

May be taken with or without food. May be taken w/ meals to reduce GI discomfort.

Severe renal or hepatic impairment; hypoalbuminaemia; primary biliary cirrhosis; gallbladder disease; nephrotic syndrome; pregnancy; lactation.

Renal impairment; discontinue if myotoxicity is suspected or creatine kinase conc increases significantly. Caution in patients with peptic ulcer.

Anorexia; nausea; gastric discomfort; stomatitis; headache; dizziness; vertigo; fatigue; skin reactions; alopoecia; impotence; anaemia; leucopenia; myotoxicity; thrombocytopenia; vomiting; diarrhoea; dyspepsia; flatulence; wt gain; drowsiness; hepatomegaly. Increased incidence of cholecystitis, gallstones and pancreatitis.

May increase anticoagulant effects of acenocoumarol, warfarin and phenindione. Increased risk of muscle toxicity with HMG-CoA reductase inhibitors. May enhance hypoglycaemic effect of antidiabetic drugs. May cause rhabdomyolysis or neuromyopathy when used with colchicine. Risk of rhabdomyolysis with sirolimus. May increase risk of gallstone formation when used with ezetimibe. Clearance may be increased by oral contraceptives. Efficacy may be reduced with rifampicin. Serum levels may be doubled by probenecid.

Raised serum aminotransferase and creatine phosphokinase concentrations.

Description:
Mechanism of Action: Clofibrate reduces elevated concentrations of very low-density lipoproteins and LDL cholesterol and increases conc of high-density lipoprotein cholesterol.
Pharmacokinetics:
Absorption: Readily absorbed in the GI tract.
Distribution: Clofibric acid: ≥95% bound to plasma proteins.
Metabolism: Rapidly hydrolysed to its active metabolite, chlorophenoxyisobutyric acid (clofibric acid).
Excretion: Elimination half-life (Clofibric acid): 18-22 hr. Excreted in the urine, mainly as glucuronide conjugate.

Dyslipidaemic Agents