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Fibrates are a class of drugs utilized in the management and treatment of dyslipidemia. This activity reviews the indications, action, and contraindications for fibrates as a valuable agent in managing serum cholesterol levels. This activity will highlight the mechanism of action, adverse event profile, and other key factors (e.g., monitoring, relevant interactions, etc.) pertinent for members of the healthcare team involved in the care of patients with atherogenic dyslipidemia and related conditions. Objectives: Identify the mechanism of action and administration of fibrates. Describe the adverse effects and contraindications of fibrates. Review the potential toxicity of fibrates. Outline interprofessional team strategies for improving care coordination and communication to advance fibrates and improve outcomes. Access free multiple choice questions on this topic.

There is no known antidote to fibrate toxicity. If possible, eliminate any unabsorbed drug via emesis or gastric lavage, maintaining the necessary common precautions for airway protection. If a patient happens to overdose on fibrates, do not consider hemodialysis as fibrates are highly plasma protein-bound drugs.

Managing appropriate drug use requires free-flowing and efficient communication between the entire interprofessional healthcare team, including clinicians, mid-level practitioners, nurses, and pharmacists. The same applies to the use of fibrates. Health professionals should bear in mind the adverse outcome of fibrates regarding liver function tests (LFTs) and ensure that there is regular testing, especially if the patient has pre-existing liver disease. Fibrates are also notorious for causing drug interactions, and health professionals should be thorough with the patient's medication history before prescribing them. If a patient is already on statins, monitor carefully for the development of myopathies, evaluate clotting studies for those on anticoagulants, etc. Most importantly, it is the responsibility of healthcare providers to counsel the patients about the adverse effects of this drug and ensure they report any new or untoward symptoms(such as muscle cramps, abdominal pain, indigestion, etc.) after initiating the drug. An interprofessional team effort is necessary to accomplish the above. The clinician will make the decision to initiate fibrate therapy based on the case facts before them. Still, they would do well to include a pharmacist who can review the patient's current medications to check for possible drug interactions and verify appropriate dosing. The pharmacist can also assist in choosing a specific fibrate depending on the patient's particular parameters. Nursing should be aware of the signs of the most common interactions and adverse effects; they can check on patient compliance and monitor for adverse events, alerting the prescriber when appropriate. In this way, fibrate therapy can achieve the best possible result with minimal chance of encountering adverse effects. [Level 5]