ciprofibrate: clinical use

Prescribing considerations

• Use only as an adjunct to appropriate dietary and other non-pharmacological measures.
• Exclude or correct secondary causes of dyslipidaemia, including hypothyroidism.
• Assess renal and hepatic function and factors increasing myopathy risk, including older age, alcohol misuse, hypoalbuminaemia and previous fibrate-associated muscle toxicity.
• Fibrates are generally not first-line treatment for newly diagnosed dyslipidaemia, except in severe hypertriglyceridaemia or when statins cannot be used.
• Reassess treatment if the lipid response is inadequate.

Contraindications and cautions

• Severe hepatic impairment
• Severe renal impairment
• Pregnancy or suspected pregnancy
• Breastfeeding
• Concurrent treatment with another fibrate
• Hypersensitivity to ciprofibrate or the product's excipients

Monitoring

• Lipid profile to confirm therapeutic response
• Renal function, particularly where impairment is present
• Periodic liver-function tests; discontinue for significant transaminase elevation or cholestatic injury
• Creatine kinase promptly if muscle symptoms occur; stop if myopathy or marked elevation is identified
• INR closely when used with an oral anticoagulant

Clinical pharmacology

Ciprofibrate is a PPAR-alpha-activating fibrate. It is readily absorbed, highly protein-bound and has a long terminal half-life. Urinary elimination and prolonged exposure in renal impairment contribute to its renal restrictions and interaction potential.

Formulation and product differences

• The selected product is a white to off-white, round oral tablet with a breakline and identifying embossing.
• It contains lactose monohydrate and is essentially sodium-free.
• It may be packaged in blister strips or amber glass bottles; not all pack sizes may be marketed.

Tablet

Route: Oral

Strengths: 100 mg