Tricor (fenofibrate) is a prescription medication specifically formulated to address significant lipid abnormalities, playing a crucial role in comprehensive cardiovascular risk management. As a member of the fibrate class, it primarily targets elevated triglyceride levels and can favorably modify other key lipid parameters. It is indicated as an adjunct to diet and other therapeutic measures in adult patients. By effectively managing atherogenic dyslipidemia, Tricor contributes to a broader strategy aimed at reducing the long-term risks associated with cardiovascular disease.

Features

• Active Pharmaceutical Ingredient: Fenofibrate (48 mg or 145 mg per tablet)
• Drug Class: Fibric acid derivative (fibrate)
• Administration: Oral tablet
• Available Strengths: 48 mg and 145 mg
• Mechanism of Action: Activates peroxisome proliferator-activated receptor alpha (PPARα), leading to increased lipolysis and elimination of triglyceride-rich particles from plasma.
• Pharmacokinetics: Well-absorbed; maximum plasma concentration (Cmax) is reached within 4-5 hours post-administration. Administration with food increases absorption.
• Elimination: Primarily renal excretion; terminal elimination half-life is approximately 20 hours.

Benefits

• Significant Triglyceride Reduction: Demonstrates potent efficacy in lowering very high serum triglyceride levels, a key independent risk factor for pancreatitis.
• Favorable HDL-C Modulation: Consistently increases high-density lipoprotein cholesterol (HDL-C), often referred to as “good” cholesterol.
• Comprehensive Lipid Profile Improvement: Contributes to a overall healthier lipid panel, which is a cornerstone of atherosclerotic cardiovascular disease (ASCVD) risk reduction strategies.
• Adjunct to Statin Therapy: In appropriate patients, may be used in combination with a statin to address mixed dyslipidemia when triglyceride levels remain elevated despite statin monotherapy, under careful physician supervision.
• Well-Established Efficacy: Supported by extensive clinical trial data and decades of real-world use demonstrating its lipid-modifying effects.

Common use

Tricor is commonly prescribed for the treatment of severe hypertriglyceridemia in adult patients. It is also used to manage primary hypercholesterolemia or mixed dyslipidemia as an adjunct to diet, particularly when the goal is to reduce elevated LDL-C, Total-C, Triglycerides, and Apo B, and to increase HDL-C. Its use is always part of a broader therapeutic lifestyle change program that includes a lipid-lowering diet, weight control, and regular physical exercise. Decisions for its use are based on a patient’s full lipid profile and overall calculated cardiovascular risk.

Dosage and direction

The dosage of Tricor must be individualized based on patient response and tolerability.

• The initial dose for most indications is 145 mg once daily.
• For patients with renal impairment, an initial dose of 48 mg once daily is recommended. Dose escalation should only occur after evaluating the effects on renal function and lipid response at this dose.
• Administration: Tablets should be swallowed whole with a full glass of water. They should not be crushed, chewed, or split.
• Timing: Can be taken with or without food, although administration with food is recommended to optimize bioavailability.
• Patients should adhere strictly to the dosage prescribed by their physician. Regular monitoring of lipid levels is necessary to determine patient response.

Precautions

• Liver Function: Tricor can cause abnormal liver function tests and, in rare instances, hepatitis and cirrhosis. Serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), and other liver function tests should be monitored periodically.
• Muscle Effects: Myopathy, rhabdomyolysis, and increased creatine phosphokinase (CPK) levels have been reported. The risk is increased when Tricor is co-administered with other drugs, particularly statins. Patients should report any unexplained muscle pain, tenderness, weakness, or brown/discolored urine immediately.
• Pancreatitis: Tricor may increase cholesterol excretion into the bile, potentially leading to cholelithiasis. If cholelithiasis is suspected, gallbladder studies are indicated.
• Renal Function: Fenofibrate is excreted primarily by the kidneys. Dosage adjustment is necessary in patients with mild to severe renal impairment. Use is contraindicated in patients with severe renal impairment.
• Hematologic Effects: Mild to moderate hemoglobin, hematocrit, and white blood cell decreases have been observed. Periodic blood counts are recommended during the first year of treatment.

Contraindications

Tricor is contraindicated in patients with:

• Hypersensitivity to fenofibrate or any component of this medication.
• Severe renal impairment, including those receiving dialysis.
• Active liver disease, including primary biliary cirrhosis and unexplained persistent liver function abnormality.
• Pre-existing gallbladder disease.
• Nursing mothers.

Possible side effect

Like all medications, Tricor can cause side effects, although not everybody gets them. Common side effects may include:

• Gastrointestinal: Abdominal pain, constipation, diarrhea, nausea, vomiting, flatulence.
• Respiratory: Respiratory disorders, nasopharyngitis, sinusitis.
• Musculoskeletal: Back pain, arthralgia, myalgia.
• Neurological: Headache, dizziness.
• Other: Increased liver enzymes, increased creatine phosphokinase, rash, pruritus.

Serious side effects require immediate medical attention and include symptoms of:

• Myopathy or rhabdomyolysis (muscle pain, tenderness, weakness, fever, dark urine).
• Hepatitis (jaundice, upper right abdominal pain, nausea, fatigue).
• Pancreatitis (severe abdominal pain that radiates to the back, nausea, vomiting).
• Pulmonary embolism (sudden shortness of breath, sharp chest pain, coughing up blood).
• Deep vein thrombosis (pain, swelling, and redness in a limb).

Drug interaction

Tricor has the potential to interact with several other medications, which may alter its efficacy or increase the risk of serious side effects.

• Oral Anticoagulants (e.g., Warfarin): Fenofibrate may potentiate the anticoagulant effect, increasing the risk of bleeding. Frequent monitoring of prothrombin time/INR is essential, and warfarin dosage may need adjustment.
• HMG-CoA Reductase Inhibitors (Statins): Concomitant use increases the risk of serious myopathy or rhabdomyolysis. This combination should be used with extreme caution and only when the benefit outweighs the risk.
• Bile Acid Sequestrants (e.g., Cholestyramine): These agents may bind to Tricor in the GI tract, impairing its absorption. Tricor should be taken at least 1 hour before or 4-6 hours after a bile acid sequestrant.
• Cyclosporine: Co-administration with cyclosporine is not recommended due to the increased risk of renal impairment.
• Other Highly Protein-Bound Drugs: Tricor is highly protein-bound and may compete for binding sites with other such drugs (e.g., oral hypoglycemics, other fibrates).

Missed dose

If a dose is missed, it should be taken as soon as it is remembered on the same day. If it is almost time for the next scheduled dose, the missed dose should be skipped, and the regular dosing schedule resumed. A double dose should not be taken to make up for a missed one.

Overdose

There is no specific antidote for fenofibrate overdose. Treatment should be supportive and based on the patient’s clinical presentation. In the event of an overdose, medical attention should be sought immediately. Due to the high protein binding of fenofibrate, hemodialysis is not expected to be an effective means of elimination.

Storage

• Store Tricor tablets at room temperature between 20°C to 25°C (68°F to 77°F).
• Keep the medication in its original container, tightly closed, and protected from light, excess heat, and moisture.
• Keep all medications out of the reach of children and pets.
• Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed.

Disclaimer

This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition or medication. Never disregard professional medical advice or delay in seeking it because of something you have read here. The information provided may not cover all possible uses, directions, precautions, drug interactions, or adverse effects.

Reviews

• Clinical Efficacy (4.5/5): “As a lipidologist, I find Tricor to be a highly effective and reliable agent for managing severe hypertriglyceridemia. Its impact on HDL-C is also a valuable benefit in the right patient population.” – Dr. A. Reynolds, MD
• Patient Tolerability (4.0/5): “Most of my patients tolerate Tricor well. The once-daily dosing promotes excellent adherence. Gastrointestinal upset can be an initial issue for some, but it often subsides.” – Clinical Pharmacist
• Place in Therapy (4.0/5): “A cornerstone medication for specific dyslipidemia phenotypes. Its role in combination therapy, while effective, requires vigilant monitoring for myopathic and hepatic side effects.” – Cardiology Fellow