• Other cholesterol-reducing drugs. Taking more than one cholesterol reducer at a time may worsen side effects. Statins are of particular concern when taken in conjunction with fibrates such as gemfibrozil. The drug combination may increase the patient’s risk of developing a rare, but potentially fatal, reaction called rhabdomyolysis. Fenofibrate may also worsen some side effects, but is the preferred fibrate to combine with statins because of decreased risk of rhabdomyolysis. 

  • Anticoagulants. Medications that inhibit blood clot formation. Use with fibrates may increase the effects of anticoagulants and therefore increase the risk of bleeding. A physician may reduce the dose of anticoagulant when prescribing a fibrate.

  • Immunosuppressants (e.g., cyclosporine). Medications used to suppress the body’s immune system that are often prescribed following an organ transplant (e.g. heart transplant) to prevent the body from rejecting the donor organ. Taking certain fibrates (fenofibrate) with immunosuppressants may increase an individual’s risk of developing or worsening kidney problems.

  • Grapefruit juice. Grapefruit juice interferes with the liver’s ability to break down (metabolize) some medications. This, in turn, can cause a toxic buildup of the medication in the blood. While the buildup is less likely if the juice is ingested four or more hours prior to the medicine, patients taking fibrates are advised to refrain from drinking grapefruit juice. Patients may also be instructed to avoid eating grapefruit.