TRICOR (fenofibrate tablets), is a lipid regulating agent available as tablets for oral administration. Each tablet contains 48 mg or 145 mg of fenofibrate.
Treatment of Hypercholesterolemia
TRICOR is indicated as adjunctive therapy to diet to reduce elevated LDL-C, Total-C, Triglycerides and Apo B, and to increase HDL-C in adult patients with primary hypercholesterolemia or mixed dyslipidemia (Fredrickson Types IIa and IIb). Lipid-altering agents should be used in addition to a diet restricted in saturated fat and cholesterol when response to diet and non-pharmacological interventions alone has been inadequate (see National Cholesterol Education Program [NCEP] Treatment Guidelines, below).
Treatment of Hypertriglyceridemia
TRICOR is also indicated as adjunctive therapy to diet for treatment of adult patients with hypertriglyceridemia (Fredrickson Types IV and V hyperlipidemia). Improving glycemic control in diabetic patients showing fasting chylomicronemia will usually reduce fasting triglycerides and eliminate chylomicronemia thereby obviating the need for pharmacologic intervention.
Markedly elevated levels of serum triglycerides (e.g. > 2,000 mg/dL) may increase the risk of developing pancreatitis. The effect of TRICOR therapy on reducing this risk has not been adequately studied.
Drug therapy is not indicated for patients with Type I hyperlipoproteinemia, who have elevations of chylomicrons and plasma triglycerides, but who have normal levels of very low density lipoprotein (VLDL). Inspection of plasma refrigerated for 14 hours is helpful in distinguishing Types I, IV and V hyperlipoproteinemia2.
The initial treatment for dyslipidemia is dietary therapy specific for the type of lipoprotein abnormality. Excess body weight and excess alcoholic intake may be important factors in hypertriglyceridemia and should be addressed prior to any drug therapy. Physical exercise can be an important ancillary measure. Diseases contributory to hyperlipidemia, such as hypothyroidism or diabetes mellitus should be looked for and adequately treated. Estrogen therapy, thiazide diuretics and beta-blockers, are sometimes associated with massive rises in plasma triglycerides, especially in subjects with familial hypertriglyceridemia. In such cases, discontinuation of the specific etiologic agent may obviate the need for specific drug therapy of hypertriglyceridemia.
The use of drugs should be considered only when reasonable attempts have been made to obtain satisfactory results with non-drug methods. If the decision is made to use drugs, the patient should be instructed that this does not reduce the importance of adhering to diet. (See WARNINGS and PRECAUTIONS).
Fredrickson Classification of Hyperlipoproteinemias
C = cholesterol
TG = triglycerides
LDL= low density lipoprotein
VLDL= very low density lipoprotein
IDL = intermediate density lipoprotein
NCEP Treatment Guidelines: LDL-C Goals and Cutpoints for Therapeutic Lifestyle Changes and Drug Therapy in Different Risk Categories
LDL Level at Which to Initiate Therapeutic
LDL Level at Which to Consider Drug Therapy
CHD = coronary heart disease
Some authorities recommend use of LDL-lowering drugs in this category if an LDL-C level of < 100 mg/dL cannot be achieved by therapeutic lifestyle changes. Others prefer use of drugs that primarily modify triglycerides and HDL-C, e.g., nicotinic acid or fibrate. Clinical judgement also may call for deferring drug therapy in this subcategory.
Almost all people with 0-1 risk factor have 10-year risk < 10%; thus, 10-year risk assessment in people with 0-1 risk factor is not necessary.
|CHD or CHD risk equivalents
(10-year risk > 20%)
(100-129: drug optional)
|2+ Risk Factors
(10-year risk ≤ 20%)
||10-year risk 10%-20%: ≥ 130
10-year risk < 10%: ≥ 160
|0-1 Risk Factor
(160-189: LDL-lowering drug optional)
After the LDL-C goal has been achieved, if the TG is still ≥ 200 mg/dL, non HDL-C (total-C minus HDL-C) becomes a secondary target of therapy. Non-HDL-C goals are set 30 mg/dL higher than LDL-C goals for each risk category.
Published Studies Related to Tricor (Fenofibrate)
Paradoxical reduction in HDL-C with fenofibrate and thiazolidinedione therapy in
type 2 diabetes: the ACCORD Lipid Trial. 
CONCLUSIONS: Idiosyncratic and marked reduction in HDL-C can occur in some
Long-term safety and efficacy of fenofibrate/pravastatin combination therapy in high risk patients with mixed hyperlipidemia not controlled by pravastatin monotherapy. [2011.11]
OBJECTIVE: To assess the long-term safety and efficacy of a fenofibrate/pravastatin 160/40 mg fixed-dose combination in high-risk patients with mixed hyperlipidemia not controlled by pravastatin 40 mg monotherapy... CONCLUSIONS: Long-term co-administration of fenofibrate/pravastatin 160/40 mg in a single capsule was well tolerated and produced complementary benefits on the overall lipid profile of high-risk patients with mixed hyperlipidemia not controlled by pravastatin 40 mg.
Fenofibrate: a review of its lipid-modifying effects in dyslipidemia and its vascular effects in type 2 diabetes mellitus. [2011.08.01]
Fenofibrate is a fibric acid derivative with lipid-modifying effects that are mediated by the activation of peroxisome proliferator-activated receptor-alpha... In conclusion, monotherapy with fenofibrate remains a useful option in patients with dyslipidemia, particularly in atherogenic dyslipidemia characterized by high TG and low HDL-C levels.
Combination of niacin and fenofibrate with lifestyle changes improves dyslipidemia and hypoadiponectinemia in HIV patients on antiretroviral therapy: results of "heart positive," a randomized, controlled trial. [2011.07]
CONTEXT: HIV patients on antiretroviral therapy (ART) have a unique dyslipidemia [elevated triglycerides and non-high-density lipoprotein-cholesterol (HDL-C), low HDL-C] with insulin resistance (characterized by hypoadiponectinemia). OBJECTIVE: The aim was to test a targeted, comprehensive, additive approach to treating the dyslipidemia... CONCLUSIONS: A combination of fenofibrate and niacin with low-saturated-fat D/E is effective and safe in increasing HDL-C, decreasing non-HDL-C and hypertriglyceridemia, and ameliorating hypoadiponectinemia in patients with HIV/ART-associated dyslipidemia.
Single-dose bioequivalence of 105-mg fenofibric acid tablets versus 145-mg fenofibrate tablets under fasting and fed conditions: a report of two phase I, open-label, single-dose, randomized, crossover clinical trials. [2011.06]
BACKGROUND: Fenofibrate is used to treat primary hypercholesterolemia, mixed lipidemia, and hypertriglyceridemia in adults who do not respond to nonpharmacologic measures. Fenofibrate is a prodrug that is rapidly and completely hydrolyzed to fenofibric acid, the active moiety. A new orally administered agent, fenofibric acid, was developed as an alternative to fenofibrate. OBJECTIVE: Two separate studies were conducted to evaluate the bioequivalence of fenofibric acid relative to fenofibrate under fasted and fed (standard breakfast) conditions, characterize the pharmacokinetic profile, and assess the safety and tolerability of fenofibric acid... CONCLUSIONS: In these 2 single-dose studies, these healthy volunteers administered a single oral dose of 105-mg fenofibric acid met the US Food and Drug Administration regulatory criteria for assuming bioequivalence to a single oral dose of 145-mg fenofibrate tablets with respect to the rate and extent of fenofibric acid absorption in both fed and fasted states. Fenofibric acid at the dose studied was well tolerated in this population. Copyright (c) 2011 Elsevier HS Journals, Inc. All rights reserved.
Clinical Trials Related to Tricor (Fenofibrate)
A Study to Evaluate Daily Pravastatin, Fenofibrate or Pravafen in the Treatment of Combined Hyperlipidemia [Active, not recruiting]
This is a multi-center, double blind, prospective, longitudinal, randomized, 12-week study
with a 52-week open-label follow-up to evaluate the safety and efficacy of daily
administration of Pravastatin 40 mg or Fenofibrate 160 mg or Pravafen (the combination of
both Pravastatin and Fenofibrate 40/160 mg) in the treatment of combined hyperlipidemia.
There will be an open-label, 8-week, Selection Phase prior to randomization in which all
patients will be stabilized on Pravastatin 40 mg/day. Following the Selection Phase, and if
the patients meet all inclusion/exclusion criteria, they will be randomized to a three arm,
double blind, 12-week Efficacy Phase during which they would receive either Pravastatin 40 mg
or Fenofibrate 160 mg or Pravafen (the combination of Pravastatin and Fenofibrate 40/160 mg).
The 12-week Efficacy Phase will be followed by an open-label, 52-week, Safety Phase in which
all patients will receive Pravafen.
After the 8-week Selection Phase, patients that still meet the inclusion/exclusion criteria
will be randomized on a 1: 1:2 ratio to Pravastatin 40 mg or Fenofibrate 160 mg or Pravafen
(the combination of both Pravastatin and Fenofibrate 40/160 mg) for 12 weeks. After the
completion of the 12-week double-blind phase of the study, all patients that haven't had
changes in their well being, will be allowed to roll-over into the 52-week, open-label,
follow-up portion of the study. During the 52 week, open label, Safety Phase of the study,
all patients will receive Pravafen (the combination of Pravastatin and Fenofibrate 40/160
Patients will be evaluated at baseline and every three weeks thereafter throughout the
initial 12-week Efficacy Phase of the study. Patients that roll-over into the 52-week,
open-label, follow-up Safety Phase will be evaluated at 12, 24, 36 and 52 weeks.
Participation in the study can be up to 72 weeks.
Evaluation of Efficacy and Safety of Omacor (Omega-3-Acid Ethyl Esters) as Add-on Therapy in Hypertriglyceridemic Subjects Treated With Antara (Fenofibrate) Followed by 2 Extensions [Completed]
To evaluate efficacy and safety of Omacor (omega-3-acid ethyl esters) as add-on therapy to
Antara (fenofibrate) and diet for the treatment of patients with very high triglycerides.
The Fenofibrate and Metformin for Atherogenic Dyslipidemia (FAMA) Study [Active, not recruiting]
Patients with metabolic syndrome, insulin resistance, and elevated triglycerides of 150 mg/dl
or higher will be randomized to one of four groups: 1) placebo; 2) metformin; 3) fenofibrate;
or 4) combined metformin and fenofibrate for a period of 12 weeks after titration to target
dose. We are interested in the effects of these therapies on triglyceride levels, HDL-C,
insulin resistance, and markers of inflammation.
Effect of Fenofibrate on Endothelial Function and High-density Lipoproteins (HDL) Physicochemical and Functional Characteristics in Patients With Coronary Heart Disease [Recruiting]
Fenofibrate is a drug that acts on the PPAR alpha receptors, increasing HDL-cholesterol and
decreasing triglyceride levels. The interaction with these receptors has antiatherogenic
actions by regulating the expression con key proteins that participate in vascular
inflammation, plaque stability and thrombosis.
Fenofibrate reduces triglycerides and increases HDL-C in plasma. It also decreases small,
dense LDL particles. The use of this drug has resulted in improvement of vascular function
measured by endothelial function. Our hypotheses state that fenofibrate will improve:
endothelial function, improve HDL antioxidant capacity and size distribution towards a
predominance of small HDL particles.
Predictors of Response to Fenofibrate [Recruiting]
Fenofibrate is one of the best options for treating hypertriglyceridemia. In the majority of
patients, fenofibrate lowers triglycerides (TG) by 24-55% and improves HDL- and
LDL-cholesterol. However, the response to fenofibrate is highly variable and currently there
are no screening tests to identify poor responders. Genetic and environmental factors may
explain the high variability in response. Although exploratory in nature, this study is of
clinical and public health importance because prediction of drug response among those with
hypertriglyceridemia is clinically challenging and fenofibrate prescription costs are large
($90 to $130/patient/month); targeting the responsive patients at the outset will help
improve treatment outcomes at a lower cost. If successful, the investigators will propose to
conduct a large, randomized trial on the effect of pre-prescription genotyping on
Reports of Suspected Tricor (Fenofibrate) Side Effects
Drug Ineffective (13),
Muscular Weakness (13),
Muscle Spasms (12),
Hepatic Enzyme Increased (12),
Pain in Extremity (11), more >>
Page last updated: 2014-11-30