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Lipid modification - primary and secondary CVD prevention - Management
What are the adverse effects of fibrates?
- Gastrointestinal adverse effects (e.g. abdominal pain, nausea, vomiting, diarrhoea, and flatulence) are the most commonly reported adverse effects.
- Moderately elevated levels of serum transaminases have been reported with fibrate treatment:
- Discontinue the fibrate if serum transaminases are three or more times the upper limit of the normal.
- Serious muscular adverse effects (e.g. rhabdomyolysis and myopathy) are rare:
- Advise the person to seek medical advice and to stop the statin if they develop unexplained muscle symptoms (pain, tenderness, weakness).
- Check creatine kinase if myopathy or rhabdomyolysis is suspected.
- As with statins, discontinue treatment if the creatine kinase level is five times the upper limit of normal or greater.
- The risk of serious adverse effects is increased when combined with a statin. Do not combine gemfibrozil with a statin [MHRA, 2007].
[ABPI Medicines Compendium, 2006b; ABPI Medicines Compendium, 2007b; ABPI Medicines Compendium, 2007d; ABPI Medicines Compendium, 2007e; ABPI Medicines Compendium, 2008b]
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