Fibric acid derivatives
Fibric acid is produced by several fungi. Two derivatives
of thisacid are fenofibrate and gemfibrozil. These drugs are used to re-duce
high triglyceride levels and, to a lesser extent, high LDL lev-els.
Fenofibrate and gemfibrozil are absorbed readily
from the GI tract and are highly protein-bound. Fenofibrate is hy-drolyzed
while gemfibrozil undergoes extensive metabo-lism in the liver. Both drugs are
excreted in the urine.
Although the exact mechanism of action for these
drugs isn’t known, researchers believe that fibric acid derivatives may:
·
reduce cholesterol production early in its formation
·
mobilize cholesterol from the tissues
·
increase cholesterol excretion
·
decrease synthesis and secretion of lipoproteins
·
decrease synthesis of triglycerides.
Gemfibrozil produces two other effects:
·
It increases high-density lipoprotein (HDL) levels in the blood
(remember, this is “good” cholesterol).
·
It increases the serum’s capacity to dissolve additional choles-terol.
Fibric acid drugs are used primarily to reduce
triglyceride levels, especially very-low-density triglycerides, and secondarily
to re-duce blood cholesterol levels. They’re typically used to treat pa-tients
with types II, III, IV, and mild type V hyperlipoproteinemia.
Fibric acid drugs may displace acidic drugs, such
as barbitu-rates, phenytoin, thyroid derivatives, and cardiac glycosides.
·
The risk of bleeding increases when fibric acid derivatives are taken
with oral anticoagulants.
·
Fibric acid derivatives can lead to adverse GI effects.
·
The hypoglycemic effects of repaglinide may be increased and prolonged
if taken with gemfibrozil.
·
Use of fibric acid derivatives and HMG-CoA reductase inhibitors may
increase the risk of rhabdomyolysis.
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