Q-Dipils Drug Interactions

Fenofibrate is highly protein-bound and may displace other drugs from protein binding sites.
Interactions may also occur through changes in the activity of cytochrome P450 isoenzymes, particularly CYP3A4.
Fenofibrate may enhance the effects of oral anticoagulants; the dose of anticoagulant should be reduced when treatment with a fibrate is started, and then adjusted gradually if necessary. Recommendations vary; licensed product information for Fenofibrate suggests a reduction of upto 50% in the dosage of anticoagulant. The mechanism of the interaction is unclear; fibrates have been reported to displace warfarin from protein binding sites but other mechanisms are probably also involved.
Other drugs that may be displaced from plasma proteins by Fenofibrate include tolbutamide and other sulfonylurea antidiabetics, phenytoin, and in patients with hypoalbuminaemia, furosemide. The interaction with antidiabetics is complex since fibrates may alter glucose tolerance in diabetic patients. The dosage of antidiabetics may need adjusting during bezafibrate therapy.
There is an increased risk of myopathy if Fenofibrate are used with statins.
Fenofibrate may interact with ciclosporin, although reports have been conflicting.
However, nephrotoxicity associated with increased ciclosporin concentrations has been reported with bezafibrate and renal function should be monitored.
Cholestasis has been reported in a patient given Fenofibrate with raloxifene.