Fenofibrate (Lipantil / Supralip 160)

Fenofibrate (Lipantil / Supralip 160) is a fibrate that is used to treat elevations in triglyceride levels in the blood. It can also improve levels of cholesterol. This can reduce a patient’s chances of experiencing a heart attack or stroke.

Fenofibrate can be used alone, or in combination with a statin to treat blood fat alterations. The standard dose is 200mg once a day.

Side-effects of fenofibrate include upset stomach, muscle pain, and rare cases of muscle tissue being broken down.

In HIV-positive patients, fenofibrate is effective in improving the blood fat alterations caused by antiretroviral therapy, particularly protease inhibitors. Two studies including a total of 75 patients with altered blood fat levels saw reduced triglyceride levels after six months of fenofibrate treatment.1 2

Combinations of fenofibrate and pravastatin (Lipostat) are also effective in treating fat alterations.3 However, fenofibrate seems to be less useful in treating the alterations in insulin resistance and blood pressure that can accompany long-term antiretroviral therapy.4

Fenofibrate does not interact with any currently available protease inhibitors or non-nucleoside reverse transcriptase inhibitors (NNRTIs).

References

  1. Rao A et al. Fenofibrate is effective in treating hypertriglyceridemia associated with HIV lipodystrophy. Am J Med Sci 327: 315-318, 2004
  2. Palacios R et al. Efficacy and safety of fenofibrate for the treatment of hypertriglyceridemia associated with antiretroviral therapy. J Acquir Immune Defic Syndr 31: 2, 2002
  3. Aberg JA et al. A randomized trial of the efficacy and safety of fenofibrate versus pravastatin in HIV-infected subjects with lipid abnormalities: AIDS Clinical Trials Group Study 5087. AIDS Res Hum Retroviruses 21: 757-767, 2005
  4. Gavrila A et al. Improvement in highly active antiretroviral therapy-induced metabolic syndrome by treatment with pioglitazone but not with fenofibrate: a 2 x 2 factorial, randomized, double-blinded, placebo-controlled trial. Clin Infect Dis 40: 745-749, 2005