Fenofibrate dosage, forms, and strengths

Fenofibrate is a generic prescription drug that treats high triglycerides and high cholesterol. Healthcare providers use it as a first-choice drug to treat high triglyceride levels but prescribe it only as add-on therapy if other medications have not effectively normalized high cholesterol levels. Fenofibrate comes in six different formulations. The underlying drug is the same, but dosages are different, and rules about taking doses vary. Patients need to make sure they understand the correct dose and other rules for taking the formulation they’re prescribed. 

Fenofibrate forms and strengths

Although there are two dosage forms, six different versions of fenofibrate capsules and tablets are sold as generic or brand-name drugs. The underlying drug in each is the same, but they have different dosage strengths and dosages. They are not interchangeable without a prescription. 

• Capsules: 30 mg, 90 mg | 50 mg, 150 mg | 67 mg, 134 mg, 200 mg

• Tablets: 40 mg, 120 mg | 48 mg, 145 mg | 54 mg, 160 mg

Fenofibrate dosage for adults

The FDA has approved fenofibrate along with diet and exercise to treat high triglyceride levels (hypertriglyceridemia), high cholesterol levels (hypercholesterolemia), or both high triglyceride and high cholesterol levels (mixed dyslipidemia). These last two conditions are also called “hyperlipidemia.” 

Dosages vary by product, as illustrated in the dosage table below. Although the dosage strengths vary, each version delivers the same amount of drug into the bloodstream. A 120 mg dose of Fenoglide delivers the same amount of fenofibrate into the blood as a 145 mg dose of Tricor, though there may be differences in blood concentrations over time. 

Fenofibrate is never used in people with active liver disease, severe kidney disease, gallbladder disease, or known allergies to fenofibrate. 

Women should not take fenofibrate while they are breastfeeding. They should not start breastfeeding until five days after the last fenofibrate dose is taken.

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Fenofibrate dosage for hyperlipidemia (high cholesterol and fats)

Fenofibrate is a second-line treatment for high cholesterol or high cholesterol/high triglycerides. The drug reduces total cholesterol, bad cholesterol (low-density lipoprotein or LDL cholesterol), triglycerides, and apolipoprotein, a protein that slows down the body’s breakup of LDL cholesterol. It also increases good cholesterol levels (high-density lipoprotein or HDL-C). 

Healthcare providers typically add fenofibrate when statin therapy does not normalize cholesterol and triglyceride levels. As with other high-cholesterol treatments, fenofibrate only helps when people adopt a low-fat, low-cholesterol diet and increase their physical activity. 

Prescribers immediately start fenofibrate treatment at the highest recommended dosage. That dose will vary depending on which version of fenofibrate is prescribed. No matter what version is used, fenofibrate tablets and capsules are taken orally once daily, but how they’re taken (with or without food) can vary.

Fenofibrate dosage for hypertriglyceridemia (high fats)

High fats or hypertriglyceridemia is a common condition in which the blood contains too many fats or triglycerides. Doctors diagnose hypertriglyceridemia when lab work shows that fasting triglyceride levels exceed 150 milligrams per deciliter of blood. Depending on how high these triglyceride levels are, healthcare professionals grade the condition as mild, moderate, severe, or very severe hypertriglyceridemia.

High lipid levels in the blood significantly increase the risk of pancreas inflammation (pancreatitis) and may contribute to the risk of cardiovascular disease. The goal of treatment is to reduce fat levels to at least mild hypertriglyceridemia (less than 200 mg/dL). 

Dietary changes and exercise are first-line treatments for high fat. Drugs called fibrates, fenofibrate, fenofibric acid, and gemfibrozil are first-line medications for high fat. These drugs rapidly reduce fat levels by as much as 50%. They also increase HDL cholesterol and reduce LDL cholesterol.

For hypertriglyceridemia, doctors start at the lowest dose and increase it as necessary to the highest dose. The doses will vary depending on which version of fenofibrate is used (see dosage table above). They are taken orally once daily. 

Fenofibrate dosage for children

Fenofibrate is not FDA-approved for use in children.

Fenofibrate dosage restrictions

Healthcare professionals may adjust the starting dose or avoid prescribing fenofibrate in people with kidney disease (renal impairment) or liver disease (hepatic impairment). Depending on their renal function, doctors may need to adjust doses for geriatric patients.

• Renally impaired patients:

  • Mild renal impairment (creatinine clearance 30–60 mL/min): Start at the lowest possible dose

  • Moderate to severe renal impairment (creatinine clearance <30 mL/min) or dialysis: Contraindicated

• Hepatically impaired patients: Contraindicated

Fenofibrate dosage for pets 

Veterinarians use fenofibrate and other fibrates to treat dogs with high triglycerides, but the use of fenofibrate in cats is not well-studied. Fenofibrate has the same safety profile and warnings for dogs as for people. Dosages are not standardized, so dogs may be prescribed the same doses as people. Veterinary formulations of fenofibrate come in the same dosage strengths as human versions.

How to take fenofibrate

The most important thing to know about fenofibrate is that there are several formulations that are not interchangeable. The doses vary, and each version has different rules about taking doses with food or taking missed doses. Most versions do not come with a Medication Guide or Patient Information sheet, so your best source of information is the pharmacist. 

The following tips are not a substitute for instructions or guidance provided by the prescriber or pharmacist:

• Take this medication as prescribed.

• Read the instruction sheet provided by the prescriber or pharmacist.

• Take only one dose orally daily.

• Different versions have different rules about taking the tablet or capsule with or without food. Ask the prescriber or pharmacist about these rules before taking fenofibrate.

• Take the following fenofibrate medications without regard to food:

  • 30 mg, 90 mg fenofibrate (Antara)

  • 40 mg, 120 mg fenofibrate (Fenoglide)

  • 48 mg, 145 mg fenofibrate (Tricor)

• Take the following fenofibrate medications with a meal:

  • 50 mg, 150 mg fenofibrate (Lipofen)

  • 54 mg, 160 mg fenofibrate

  • 67 mg, 134 mg, 200 mg fenofibrate

• Swallow the tablet or capsule whole. Do not open or chew the capsule. Do not chew, break, or crush the tablet.

• Store fenofibrate capsules at room temperature.

  • Protect Lipofen capsules from light and moisture.

• Store fenofibrate tablets at room temperature protected from moisture.

Fenofibrate dosage FAQs

What are the differences between fenofibrate formulations?

Fenofibrate formulations primarily differ in their bioavailability, that is, how much of the drug in the pill is absorbed into the bloodstream. The lowest dose products (30 mg, 90 mg) are formulated to have a high bioavailability. For fenofibrate medications with higher dosages, less of the drug gets into the system. However, every formulation of fenofibrate delivers the same amount of fenofibrate into the bloodstream. 

The bioavailability of different versions is affected by food. Some versions must be taken with meals, and some can be taken with or without meals. Some require high-fat meals, some require low-fat meals, and for others, it doesn’t matter. Ask the prescriber or pharmacist for advice.

How long does fenofibrate stay in your system?

Fenofibrate's half-life is 20 hours, meaning it takes four or five days to completely clear a dose from the body.

What happens if I miss a dose of fenofibrate?

Call or ask the prescriber what to do about a missed dose. For some versions of fenofibrate, you should never take a missed dose but instead take the next dose at its regular time. Other versions do not specify what to do about a missed dose.

How long can you take fenofibrate?

Fenofibrate is intended for long-term treatment. Although fenofibrate is used for months or years, the prescriber will need regular check-ups and blood tests to monitor for possible side effects. 

How do I stop taking fenofibrate?

Do not stop taking fenofibrate without consulting with the prescribing healthcare provider. Sudden discontinuation of fenofibrate does not cause withdrawal, but cholesterol and fat levels may increase.

There are good reasons to stop fenofibrate therapy. Doctors will stop fenofibrate if lab work shows it is not working after two months. People may experience allergic reactions, liver injury, muscle inflammation (myopathy), or severe muscle damage (rhabdomyolysis) and need to stop taking the medicine.

Fibrates are the first-line treatment for high triglycerides, but other treatment options include omega-3 fatty acids, niacin, and statins.

What interacts with fenofibrate?

To avoid possible drug interactions, tell the prescriber about all the prescription drugs, over-the-counter medications, and supplements being taken, particularly:

• Statins such as atorvastatin, simvastatin, rosuvastatin, or pravastatin

• Anticoagulants that block vitamin K, such as warfarin

• Drugs that suppress the immune system, particularly cyclosporine and tacrolimus

• Drugs similar to fenofibrate called fibric acid derivatives

• The gout treatment colchicine

If you are also taking high-cholesterol drugs called bile acid sequestrants, such as cholestyramine or colestipol, take the fenofibrate dose at least one hour before or four to six hours after taking the bile acid resin.

What are the possible side effects of fenofibrate?

The most common side effects of fenofibrate are headache, back pain, joint pain, diarrhea, constipation, abdominal pain, runny nose, sore throat, and flu-like symptoms. More severe adverse effects include abnormal liver function, gallstones (cholelithiasis), muscle injury (rhabdomyolysis), blood clots (thrombosis), heart rhythm abnormalities, heart attack, and inflamed pancreas (pancreatitis).

Sources

• A review of currently available fenofibrate and fenofibric acid formulations, Cardiology Research

• Antara fenofibrate capsule prescribing information, DailyMed (NIH National Library of Medicine)

• Fenofibrate, StatPearls

• Fenofibrate, VCA Animal Hospitals

• Fenofibrate capsule prescribing information, DailyMed (NIH National Library of Medicine)

• Fenofibrate tablet prescribing information, DailyMed (NIH National Library of Medicine)

• Fenoglide fenofibrate tablet prescribing information, DailyMed (NIH National Library of Medicine)

• Hyperlipidemia in dogs and cats, DVM 360

• Hypertriglyceridemia, StatPearls

• Lipofen fenofibrate capsule prescribing information, DailyMed (NIH National Library of Medicine)

• Tricor drug summary, Prescriber’s Digital Reference (PDR)

• Tricor fenofibrate tablet prescribing information, DailyMed (NIH National Library of Medicine)