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Lofibra (Fenofibrate) - Drug Interactions, Contraindications, Overdosage, etc

 
 



DRUG INTERACTIONS

Coumarin Anticoagulants

Potentiation of coumarin-type anticoagulant effects has been observed with prolongation of the PT/INR.

Caution should be exercised when coumarin anticoagulants are given in conjunction with LOFIBRA. The dosage of the anticoagulants should be reduced to maintain the PT/INR at the desired level to prevent bleeding complications. Frequent PT/INR determinations are advisable until it has been definitely determined that the PT/INR has stabilized [see Warnings and Precautions (5.6)].

Immunosuppressants

Immunosuppressants such as cyclosporine and tacrolimus can produce nephrotoxicity with decreases in creatinine clearance and rises in serum creatinine, and because renal excretion is the primary elimination route of fibrate drugs including LOFIBRA, there is a risk that an interaction will lead to deterioration of renal function. The benefits and risks of using LOFIBRA (fenofibrate tablets) with immunosuppressants and other potentially nephrotoxic agents should be carefully considered, and the lowest effective dose employed and renal function monitored.

Bile Acid Binding Resins

Since bile acid binding resins may bind other drugs given concurrently, patients should take LOFIBRA at least 1 hour before or 4 to 6 hours after a bile acid binding resin to avoid impeding its absorption.

Colchicine

Cases of myopathy, including rhabdomyolysis, have been reported with fenofibrates co-administered with colchicine, and caution should be exercised when prescribing fenofibrate with colchicine.

OVERDOSAGE

There is no specific treatment for overdose with LOFIBRA. General supportive care of the patient is indicated, including monitoring of vital signs and observation of clinical status, should an overdose occur. If indicated, elimination of unabsorbed drug should be achieved by emesis or gastric lavage; usual precautions should be observed to maintain the airway. Because fenofibric acid is highly bound to plasma proteins, hemodialysis should not be considered.

CONTRAINDICATIONS

LOFIBRA is contraindicated in:

  • patients with severe renal impairment, including those receiving dialysis [see Clinical Pharmacology (12.3)].
  • patients with active liver disease, including those with primary biliary cirrhosis and unexplained persistent liver function abnormalities [see Warnings and Precautions (5.3)].
  • patients with preexisting gallbladder disease [see Warnings and Precautions (5.5)].
  • nursing mothers [see Use in Specific Populations (8.3)]
  • patients with known hypersensitivity to fenofibrate or fenofibric acid [see Warnings and Precautions (5.9)].

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