Fibrates - what is it? Composition, use, contraindications

As you know, vascular diseases are one of the most common pathologies in the world. Almost every elderly person suffers from hypertension and angina. Many have a history of severe illnesses, such as myocardial infarction and cerebral circulation. At present, it is scientifically proven that the pathologies of the vascular system are directly related to dyslipidemia. This condition implies a change in the content of cholesterol and fatty acids in the blood. To normalize the lipid balance, patients use fibrates and statins. These groups of drugs are necessary for all patients who have increased cholesterol in the blood, regardless of sex and age.

Fibrates - what is it and what are they used for?

It is known that the treatment of atherosclerosis is impossible without the use of statins. They are prescribed for all patients who are prone to obesity, ischemic heart disease, thrombosis. In addition to statins, there is another group of drugs - fibrates. Their mechanism of action is somewhat different. Therefore, these medicines are not prescribed by everyone. They are derivatives of fibroic acid. The main mechanism of their action is the correction of lipid metabolism in the body. Fibrates - what is it and what are they for? Thanks to the use of these drugs, there is a significant decrease in triglycerides in the blood. The main mechanism of the action of fibrates is that they activate the enzyme - lipoprotein lipase, thereby accelerating the exchange of fats. That is, they affect the biochemical processes that take place in the body. In addition to correcting dyslipidemia, fibrates also have other effects. Among them - the fight against free radicals, anti-inflammatory and tonic effect. They are also anticoagulants.

Indications for the use of fibrates

Due to the fact that these drugs have many positive effects, they have a wide range of applications. The main indication for their appointment is the metabolic syndrome. This condition is not an independent disease, but it is considered the main predisposing factor in the development of cardiovascular pathologies. Criteria for metabolic syndrome:

1. Abdominal obesity (increase in waist size from 90 cm and above).
2. Elevated cholesterol in the blood test.
3. Decrease in the number of high-density lipoproteins.
4. Increased levels of triglycerides and LDL.

In most cases, the metabolic syndrome is combined with type 2 diabetes mellitus, which is observed in the elderly. These factors predispose to the development of atherosclerosis, that is, the accumulation of lipids on the walls of the vascular bed. Fibrates - what is this and for what purpose they are appointed? In addition to the metabolic syndrome, indications for use are: hereditary forms of dyslipidemia and hypertriglyceridemia. They are also shown to patients with a history of diabetes mellitus and gout.

At what conditions are the fibrates contraindicated?

Despite the fact that fibrates have a number of advantages compared to other drugs to reduce cholesterol (statins), they can not be used by all patients. It should be remembered that these medicines affect the metabolism, therefore, under certain conditions, it is strictly forbidden to use them. Fibrates contraindications for use are as follows:

1. Pregnancy and the period of breastfeeding.
2. Diseases of the liver. This contraindication is due to the fact that this group of drugs affects the metabolism of fatty acids. With liver cirrhosis and alcoholic hepatosis, the work of this organ is significantly impaired. For this reason, fibrates can cause severe consequences in such patients, up to hepatic insufficiency.
3. Calculous cholecystitis. One of the effects of fibrates is an increase in lithogenicity, that is, the formation of gallstones.
4. Chronic renal failure. Fibrates increase the level of creatinine in the blood. Therefore, they can aggravate chronic renal failure.
5. Caution should be given to fibrates in elderly and senile patients. Also, their use is undesirable for people suffering from chronic alcoholism.

Side effects of fibrates

Fibrates - what is it and what side effects do they have? It should be noted that, unlike other medications, this group of drugs very rarely causes allergic reactions. Therefore, they can be prescribed to patients who have a history of hives, hay fever, etc. Nevertheless, the fibrates have a number of other side effects. The most common of these are: nausea and vomiting, flatulence, bloating. They can also affect the nervous system. In some cases, cause headaches, insomnia and a depressed condition. Side effects are also considered changes in the biochemical blood test: increased levels of creatinine, ALT, AST. In the absence of chronic kidney and liver diseases, this is not dangerous to the health of the patient.

What drugs belong to the group of fibrates?

To date, there are about 10 names of this group of drugs. Fibrates include medicines: Clofibrate, Bezafibrate, Gemfibrozil, and Fenofibrate. Each of these drugs is different in the number of side effects and dosage. Tablets "Clofibrate" have been known for many years and are rarely used at the moment. Despite their high effectiveness, they often cause side effects in the form of disruption of the digestive tract, muscle pain (myositis), and high lithogenicity. Less toxic is the drug "Bezafibrate". He is not inferior in efficiency and is quickly excreted from the body. Tablets "Gemfibrozil" is not recommended for use because of many side effects (but less than when using the drug "Clofibrate"). Also because of the need for prolonged use and large dosages. The most modern representative of this group is the drug "Fenofibrate". It has high efficiency and almost no side effects. In addition, he is prescribed to patients with gout, as he reduces the level of uric acid.

Fibrates: instructions for the use of these drugs

How often and in what dosages to apply these medications, depends on what kind of medication was prescribed by the attending physician. Most often they should be consumed about a month (or more) for 2-3 tablets a day. The main indication is a metabolic syndrome. This is the most commonly prescribed fibrate. Preparations must be combined with proper nutrition and administered under the control of the lipid spectrum. Tablets "Gemfibrozil" apply 1-2 times a day for 30 minutes before meals for several months. Their analogues are medicines "Gevilon" and "Normolit". The drug "Bezafibrate" is released in tablets of 200 mg and is taken 2 times a day for one month. Also there is its analogue - the drug "Retard", containing 400 mg of the active substance. The drug "Fenofibrate" has 2 forms of release: tablets and nanoparticles. They provide more effective absorption and bioavailability, are applied once a day (200 mg) for several months. His analogues are medicines "Traikor" and "Lipantil".

Fibrates: drug interactions

Before you start using this group of drugs, you need to consult a doctor and remind you what other medicines are being used. Fibrates can not be combined with nephro- and hepatotoxic agents. In particular, with the drug "Cyclosporin." The use of fibrates is undesirable for patients taking the anticoagulant Warfarin. Also, drugs of this group should not be combined with other dipolipidemic agents (statins). As this increases the likelihood of development of myositis.

Reviews of doctors and patients about fibrates

The majority of patients are satisfied with the use of fibrates, since they notice a decrease in the level of LDL, triglycerides and cholesterol. Doctors recommend these drugs to all patients with metabolic syndrome because of their high efficiency and wide spectrum of action. The only drawback is the contraindications to the use of fibrates, which are often found in elderly patients.