Fibric acids are FDA indicated to treat patients with primary hypercholesterolemia or mixed dyslipidemia. In adults, they reduce low-density lipoprotein cholesterol (LDL-C), total cholesterol, triglycerides
Triglyceride
A triglyceride is an ester derived from glycerol and three fatty acids. Triglycerides are the main constituents of body fat in humans and other vertebrates, as well as vegetable fat. They are also present in the blood to enable the bidirectional transference of adipose fat and blood glucose fr…
High-density lipoprotein
High-density lipoprotein is one of the five major groups of lipoproteins. Lipoproteins are complex particles composed of multiple proteins which transport all fat molecules around the body within the water outside cells. They are typically composed of 80–100 proteins per particle and transporting up to hundreds of fat molecules per particle.
What are fibric acid derivatives?
Fibric acid derivatives. What are Fibric acid derivatives? Fibric acid derivatives or fibrates are regarded as broad-spectrum lipid lowering drugs. Their main action is to decrease triglyceride levels but they also tend to reduce low density lipoprotein (LDL) cholesterol levels and help to raise high density lipoprotein (HDL) cholesterol.
What is the role of fenofibric acid in the treatment of heart disease?
Fibric acids have pleiotropic effects that work to reduce atherosclerotic plaque formation, and thus, decrease the incidence of cardiovascular complications including coronary heart disease (CHD). [2] Go to: Administration In the class of fibric acids, there are three agents of choice: fenofibric acid, fenofibrate, and gemfibrozil.
How do fibrates lower triglyceride levels?
Fibric acid derivatives (also known as fibrates) lower blood triglyceride levels by increasing degradation and reducing the hepatic production of VLDL. 139,145 The drug also increases the production of apoA-I, resulting in higher HDL cholesterol levels.
What are the treatment options for fibric acid toxicity?
Fibric acids are highly protein-bound, which rules out the use of hemodialysis. Emesis or gastric lavage may be used in cases of fibric acid overdose so long as the usual precautions for airway maintenance are in place. Enhancing Healthcare Team Outcomes
What are fibric acid derivatives used for?
What are Fibric acid derivatives? Fibric acid derivatives or fibrates are regarded as broad-spectrum lipid lowering drugs. Their main action is to decrease triglyceride levels but they also tend to reduce low density lipoprotein (LDL) cholesterol levels and help to raise high density lipoprotein (HDL) cholesterol.
What do fibric acid derivatives primarily affect?
The fibric acid derivatives or fibrates reduce triglyceride and increase HDL cholesterol levels, effects that would be expected to affect cardiovascular events.
Which of the following drug is fibric acid derivative used for treatment of atherosclerosis?
Fenofibrate is used as an adjunct to dietary therapy in treating hyperlipidemias (including types IV and V) associated with hypertriglyceridemia.
What are fibrates used to treat?
Fibrates are medicines prescribed to help lower high triglyceride levels. Triglycerides are a type of fat in your blood. Fibrates also may help raise your HDL (good) cholesterol. High triglycerides along with low HDL cholesterol increase the risk of heart disease and stroke.
Does Bezafibrate lower cholesterol?
What is bezafibrate? Bezafibrate is used to lower cholesterol (mainly triglycerides) levels in your blood. Bezafibrate is usually used in combination with a statin in people with high triglyceride levels or it is prescribed when statins cannot be used to lower cholesterol.
How do fibrates decrease triglycerides?
Fibrates stimulate cellular fatty acid uptake, conversion to acyl-CoA derivatives, and catabolism by the β-oxidation pathways, which, combined with a reduction in fatty acid and triglyceride synthesis, results in a decrease in VLDL production.
Which conditions are the serious adverse effects of fibric acids?
Fibric acid agents can cause the following side effects:Abdominal pain.Back pain.Headache.Nausea.Constipation.Muscle spasms.Kidney failure.Anemia.More items...•
Why do fibrates increase LDL?
Patients with severe hypertriglyceridemia frequently have low levels of LDL cholesterol, and treatment with fibrates may raise their LDL cholesterol levels by increasing intravascular lypolysis of very low-density lipoproteins (VLDL) through lipoprotein lipase, with resultant accumulation of newly formed LDL ('beta- ...
What is the difference between statins and fibrates?
Statins lower LDL-cholesterol (LDL-C), with limited effects on other lipid parameters. Fibrates improve atherogenic dyslipidemia characterized by high triglyceride and/or low HDL-C levels and elevated concentrations of small dense LDL particles, with or without high LDL-C levels.
When should fibrates be used?
[1] The FDA approved indications of fibrates include : For use as an adjunct to dietary modifications (restricted in saturated fats and cholesterol) in adults with primary hypercholesterolemia or mixed dyslipidemia (Fredrickson type IIa and IIb).
When do you give fibrates?
Niacin may be most appropriate in patients with low HDL-C and high LDL-C levels, whereas a fibrate may be most appropriate in patients at their LDL-C and HDL-C goals but who have elevated triglyceride levels.
When should fibrates be started?
Fibrate therapy is started after discussing the benefits and risks with the patient. (See 'Fibrates' below.) If the TG level remains 500 to 999 mg/dL despite fibrate therapy, we suggest addition of marine omega-3 fatty acid therapy.
What is the purpose of fibrates?
Fibric acid derivatives or fibrates are regarded as broad-spectrum lipid lowering drugs. Their main action is to decrease triglyceride levels but they also tend to reduce low density lipoprotein (LDL) cholesterol levels and help to raise high density lipoprotein (HDL) cholesterol. Fibrates appear to activate a protein called peroxisome ...
What does PPAR-alpha do?
PPAR-alpha activates the enzyme lipoprotein lipase and ultimately results in decreased formation of very low-density lipoprotein (VLDL) cholesterol (which is converted into LDL cholesterol) and triglycerides and an increase in HDL cholesterol.
Lipid disorders in children and adolescents
Stephen R. Daniels MD, PhD, Sarah C. Couch PhD, RD, in Pediatric Endocrinology (Fourth Edition), 2014
Cardiovascular Disease
Peter P. Toth, ... Blair Foreman, in Textbook of Family Medicine (Eighth Edition), 2012
Lipid Disorders in Children and Adolescents
SARAH C. COUCH PhD, RD, STEPHEN R. DANIELS MD, PhD, in Pediatric Endocrinology (Third Edition), 2008
Lipoprotein and Lipid Metabolism
Fibric acid derivatives or fibrates, such as gemfibrozil, fenofibrate, bezafibrate and ciprofibrate (of which the latter two are not available in the United States) can reduce plasma TG by up to 50%, and can raise plasma HDL cholesterol by up to 20%, although these percentages vary between patients.
Cardiology
The fibric acid derivatives, or fibrates, work to increase the clearance of VLDL-C by enhancing lipolysis, as they increase lipoprotein lipase activity, reduce hepatic cholesterol synthesis, and increase cholesterol excretion in the bile.
Neurotoxic Effects of Pharmaceutical Agents V: Miscellaneous Agents
The two fibric acid derivatives that are available in the United States are gemfibrozil and fenofibrate. Myopathy can be seen with both of these agents, but it is more common with gemfibrozil (15.7 per 1 million prescriptions versus 8.8 per 1 million prescriptions).
High-Density Lipoprotein and High-Density Lipoprotein Cholesterol
Gemfibrozil is in the fibric acid derivatives drug class, which inhibits the production of very-low-density lipoproteins (VLDLs) and enhances VLDL clearance by stimulating lipoprotein lipase activity.
What are fibric acids? What are their uses?
Fibric acids should be used in conjunction with a restriction of cholesterol and fat intake and exercise if the response to diet and nonpharmacological interventions alone has been inadequate. This activity outlines the indications, mechanism of action, significant adverse effects, contraindications, monitoring, and toxicity of fibrate drugs so that providers can direct patient therapy to optimal outcomes.
What are the different types of fibric acid?
In the fibric acids drug class, there are three agents of choice: fenofibric acid, fenofibrate , and gemfibrozil. All of these agents are administered orally as either tablets or capsules. Fenofibric acid and fenofibrate are each marketed under several different trade names and available in various strengths. In regards to the difference between the two, fenofibrate is the choline salt of fenofibric acid. Fenofibric acid is more hydrophilic and has better bioavailability than its choline salt counterpart. [3] Fenofibrate and fenofibric acid are each dosed once daily without regard to meals.
What are the symptoms of fibric acid overdose?
Signs and symptoms of overdose may include increased CPK, abnormal liver function tests, abdominal pain, diarrhea, joint and muscle pain, nausea, and vomiting. Fibric acids are highly protein-bound, which rules out the use of hemodialysis. Emesis or gastric lavage may be used in cases of fibric acid overdose so long as the usual precautions for airway maintenance are in place.
Can fibric acid be used during pregnancy?
Therefore, fibric acids are contraindicated in women who are breastfeeding. Fibric acids, as a class, are pregnancy category C. There is a documented case of a 30-year-old female who received fenofibrate for the treatment of hypertriglyceridemia. The patient was on fenofibrate therapy for one year. Afterward, it was discovered during a gynecologic visit that this patient had an unplanned pregnancy at eight weeks gestation, and abruptly, fenofibrate therapy was discontinued. It is worth noting that the patient delivered a healthy male infant without congenital malformation. [4] However, fibric acids should only be considered in pregnancy if the benefit outweighs the risk of potential toxicity to the fetus; there is a lack of safety and efficacy data in the pediatric population; fenofibric acids are not recommended for use in pediatric patients with lipid disorders. [5]