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Fibrates (or fibric acid derivatives) are a type of cholesterol-reducing drug. These medications lower the levels of fats (lipids) in the blood, including cholesterol and triglycerides. Fibric acid mainly acts to lower triglycerides by reducing their production and increasing the rate at which existing triglycerides are removed from the bloodstream. Fibrates have been shown to reduce triglycerides by 35 to 50 percent in patients who have elevated triglyceride levels (hypertriglyceridemia), according to the National Institutes of Health (NIH).
Other types of cholesterol reducing drugs include statins, bile acid resins and nicotinic acid. All are commonly used to treat high cholesterol (hypercholesterolemia).
In addition to lowering triglycerides, fibrates can also modestly increase HDLs (“good”) cholesterol levels by 15 to 25 percent, according to the NIH. They are less effective at reducing LDL (“bad”) cholesterol levels. There are three types of fibrates currently available in the United States:
- Gemfibrozil (Lopid). Reduces triglycerides and has been shown to increase HDL levels by and average of 11 percent. It is the most commonly prescribed fibrate in the United States. It is usually taken twice a day, preferably 30 minutes before meals.
- Fenofibrate (Lifibra, Tricor, Antara, Lipofen, Triglide). Has been found in clinical studies to slow the progression of coronary artery disease in people with type 2 diabetes. This is often the preferred drug to be used in combination with statins because of a reduced risk of negative drug interaction. It is taken once a day, usually with a meal.
- Clofibrate (Abitrate, Atromid-S). Sometimes also used in the treatment of a rare disorder called diabetes insipidus (“water diabetes”), in which the kidneys produce an abnormally large amount of diluted urine. However, clofibrate is also associated with increased risk of certain cancers, so it is rarely, if ever, prescribed.
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