Fibric Acid Derivatives: Fibrates Side Effects and Mechanism of Action

Question: What are Fibric acid derivatives? Name some of these drugs. How do fibric acid derivatives lower cholesterol? Are there any problems with these drugs?

Fibrates Mechanism of Action

They are a class of drugs that interfere with the body’s ability to make cholesterol in the liver. They are also known as fibrates. They are cholesterol and triglyceride lowering drugs that have been around from nineteen sixties. They seemed to have fewer side effects than bile acid resins and nicotinic acid (the other two contenders at the time) and so were initially prescribed with enthutiasm.

But later they were found to have their own, very serious side effects and so now they are prescribed only for certain conditions.

Clofibrate and  Gemfibrozil Side Effects

Clofibrate (Atromid-S), gemifibrozil (Lopid), ciprofibrate (Modalim), fenofibrate (Lipantil Micro) and bezafibrate (Bezalid Mono) are some of the fibrates list that are available. They are known to work in the liver, but the way they work is not well understood. They increase the livers ability to break down VLDL cholesterol, which drops triglyceride levels. And they raise HDL cholesterol levels slightly.

It is true that these drugs showed reduction in the risk of fatal and non-fatal heart attacks in two large studies of people with no signs of heart attack.

However, according to one of the studies people who took clofibrate showed an increase in total deaths. In the other study, gemifibrozil did not cause an increase in deaths during the study. But a follow up of eight and half years of the people who took gemifibrozil during the study showed a twenty percent increased rate of death compared with the placebo group. The result of the finding’s led to a drop in the prescriptions of clofibrate and gemifibrozil.