Fibrates

Fibrates (fibric acid derivatives):
• eg gemfibrozil, fenofibrate, bezafibrate, clofibrate
• ineffective in patients with elevated cholesterol but normal triglycerides (only reduces high triglycerides)
• mechanisms:
• stimulation of lipoprotein lipase  reduces triglyceride content of VLDL’s and chylomicrons
• stimulation of hepatic LDL clearance by increasing hepatic LDL uptake
• decreasing plasma triglycerides, LDL and VLDL
• increase HDL concentration
• side effects – myositis like syndrome, gastrointestinal problems, dermatitis, pruritis, rash, urticaria

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