Managing Cholesterol: What Are Fibrates?

High levels of cholesterol and triglycerides in the blood can lead to hardening of the arteries (atherosclerosis), heart attack and stroke. Unfortunately, there are no warning signs for high cholesterol. A person needs to have a blood test to find out what their cholesterol levels are.

To find out about how simple it is to have your cholesterol levels checked, read my article on Cholesterol Screening.

Fibrates aren't usually prescribed on their own since their function is to lower triglyceride levels which elevates the levels of HDL cholesterol - the "good" kind. They don't lower LDL cholesterol - the "bad" kind. Fibrates work best when used along with statin drugs which lower LDL cholesterol.

How fibrates work

Triglycerides are a type of fat found in the blood. Your body converts calories that it can't use right away into triglycerides which are stored in fat cells. Hormones release them from the fat cells for energy between meals.

Whenever triglyceride levels increase, HDL cholesterol decreases. HDL cholesterol is needed to keep LDL cholesterol from sticking to artery walls, so a decrease in HDL levels spells trouble.

Fibrates work to slow the rate that triglycerides are produced and to speed up the rate that triglycerides are removed from the bloodstream.

By reducing triglyceride levels from 20% - 50%, fibrates effectively increase HDL levels by 10% - 20%. Fibrates don't directly affect LDL cholesterol levels.

Types of fibrates

There are three types of fibrates available in the US. The main type is Gemfibrozil and is the one most often prescribed by doctors when not used with a statin drug.

Fenofibrate has the additional benefit of slowing down coronary artery disease of people who have type 2 diabetes. This is the drug most often used with a statin because it has fewer risks of interacting negatively with other drugs.

Clofibrate is used sometimes when a patient is being treated for a rare disorder called diabetes insipidus, but since it's also associated with the risk of certain cancers, it's not prescribed very often.

Possible side effects

Most fibrates have a side effect of causing mild stomach upset, nausea and sometimes diarrhea. Fibrates can cause muscle pain and lead to muscle damage if taken with statin drugs. They can also increase the risk of gallstones since they cause the content of cholesterol in bile to increase. When fibrates are taken with statin drugs, such as Lipitor or Crestor, there is an increased risk of kidney failure that patients should be made aware of.

Since fibrates affect anti-coagulants, patients must always inform their doctor of other medications they're taking. Patients who take fibrates along with the blood thinner, warfarin, will probably need their dosage adjusted so the blood doesn't get too thin and cause excessive bleeding.

Sources:

Wikipedia

YourTotalHealth

MedicineNet.com