Archived Comments for:
Treatment of chronic hemodialysis patients with low-dose fenofibrate effectively reduces plasma lipids and affects plasma redox status
In the US, fenofibrate is contraindicated in severe renal failure (including those on chronic dialysis). It has significant renal excretion, and is not removed by hemodialysis. Those with negligible creatinine clearances would be at risk for cumulative toxicity. Neuromyopathies (including rhabdomyolysis) have been documented in this patient population. Co-administered drugs such as colchicine can potentiate this effect.
Competing interests
None
Fenofibrate Contraindications in United States
Jeffrey Minniti, Martel Corporation
9 January 2015
In the US, severe renal disease is an absolute contraindication to the use of fenofibrate. This advisory is supported by the maker of Tricor and Trilipix (Abott), The National Kidney Foundation, and the National Lipid Association. The drug is significantly excreted by the kidneys, and is negligibly removed by hemodialysis. This study's duration was a mere 63 days. Toxic accumulation of fenofibrate has been documented in this patient population with more prolonged regimens. Many didn't become symptomatic until several months (or years) had passed. Neuromyopathy is not uncommon in this clinical setting. Gemfibrozil is the only fibrate that is OK'd for use in hemodialysis in the US. Even then, it requires regular monitoring of Creatine Kinase levels......and vigilance by the nephrologist. Idiopathic proximal weakness requires a thorough inquiry, with anuric patients being especially vulnerable in this scenario.
Lipids in Health and Disease
Renal Dosing
21 October 2013
In the US, fenofibrate is contraindicated in severe renal failure (including those on chronic dialysis). It has significant renal excretion, and is not removed by hemodialysis. Those with negligible creatinine clearances would be at risk for cumulative toxicity. Neuromyopathies (including rhabdomyolysis) have been documented in this patient population. Co-administered drugs such as colchicine can potentiate this effect.
Competing interests
None
Fenofibrate Contraindications in United States
9 January 2015
In the US, severe renal disease is an absolute contraindication to the use of fenofibrate. This advisory is supported by the maker of Tricor and Trilipix (Abott), The National Kidney Foundation, and the National Lipid Association. The drug is significantly excreted by the kidneys, and is negligibly removed by hemodialysis. This study's duration was a mere 63 days. Toxic accumulation of fenofibrate has been documented in this patient population with more prolonged regimens. Many didn't become symptomatic until several months (or years) had passed. Neuromyopathy is not uncommon in this clinical setting. Gemfibrozil is the only fibrate that is OK'd for use in hemodialysis in the US. Even then, it requires regular monitoring of Creatine Kinase levels......and vigilance by the nephrologist. Idiopathic proximal weakness requires a thorough inquiry, with anuric patients being especially vulnerable in this scenario.
Competing interests
None