As you know, vascular diseases are one of the most common pathologies in the world. Almost every elderly person suffers from arterial hypertension and angina pectoris. Many have a history of severe illnesses, such as myocardial infarction and cerebrovascular accident. Currently, it is scientifically proven that the pathology of the vascular system is directly related to dyslipidemia. This condition implies a change in the content of cholesterol and fatty acids in the blood. To normalize lipid balance, patients use fibrates and statins. These groups of drugs are necessary for all patients who have found an increase in cholesterol in the blood, regardless of gender and age.
Fibrates - what is it and what are they used for
It is known that treatment of atherosclerosis is impossible without the use of statins. They are prescribed to all patients with a tendency to obesity, coronary heart disease, thrombosis. In addition to statins, there is another group of drugs - fibrates. Their mechanism of action is somewhat different. Therefore, such medications are not prescribed to 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 why are they needed? Thanks to the use of these drugs, a significant decrease in triglycerides in the blood is noted. The main mechanism of action of fibrates is that they activate the enzyme - lipoproteidlipase, thereby accelerating the metabolism of fats. That is, they affect the biochemical processes that occur 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 use is metabolic syndrome. This condition is not an independent disease, but is considered the main predisposing factor for the development of cardiovascular pathologies. Criteria for metabolic syndrome:
- Abdominal form of obesity (increase in waist size from 90 cm and above).
- Elevated cholesterol in a blood test.
- Decreased amount of high density lipoproteins.
- Increased triglycerides and LDL.
In most cases, metabolic syndrome is combined with type 2 diabetes, which is observed in older people. These factors predispose to the development of atherosclerosis, that is, the accumulation of lipids on the walls of the vascular bed. Fibrates - what is it and for what purpose are they prescribed? In addition to the metabolic syndrome, indications for use are: hereditary forms of dyslipidemia and hypertriglyceridemia. They are also indicated for patients with a history of diabetes mellitus and gout.
Under what conditions are fibrates contraindicated?
Although fibrates have several advantages over other cholesterol lowering drugs (statins), not all patients can use them. It should be remembered that these medicines affect the metabolism, therefore, in some conditions, it is strictly forbidden to use them. Fibrates contraindications for use have the following:
- Pregnancy and the period of breastfeeding.
- Liver disease. This contraindication is due to the fact that this group of drugs affects the metabolism of fatty acids. With cirrhosis of the liver and alcoholic hepatosis, the work of this organ is significantly impaired. For this reason, fibrates can cause serious consequences in such patients, up to liver failure.
- Calculous cholecystitis. One of the effects of fibrates is an increase in lithogenicity, that is, the formation of gallstones.
- Chronic renal failure. Fibrates increase creatinine levels in the blood. Therefore, they can aggravate chronic renal failure.
- With caution, fibrates should be prescribed to elderly 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 medicines, this group of drugs rarely causes allergic reactions. Therefore, they can be prescribed to patients with a history of urticaria, hay fever, etc. Nevertheless, 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, it causes headaches, insomnia and depression. Side effects are also considered changes in the biochemical analysis of blood: increased levels of creatinine, ALT, AST. In the absence of chronic kidney and liver diseases, this is not dangerous for the patient's health.
What drugs belong to the group of fibrates?
To date, there are about 10 names of this group of drugs. Fibrates include medications: Clofibrate, Bezafibrat, Gemfibrozil and Fenofibrat. Each of these drugs differs in the number of side effects and dosage. Clofibrate tablets have been known for many years and are currently rarely used. Despite their high efficacy, they often cause side effects in the form of disruption of the digestive tract, muscle pain (myositis), and are highly lithogenic. Less toxic is the drug "Bezafibrat." It is not inferior in efficiency and is more quickly excreted from the body. Gemfibrozil tablets are not recommended for use because of the many side effects (but less than with the use of the medication Clofibrat). Also due to the need for prolonged use and large dosages. The most modern representative of this group is the drug "Fenofibrate." It has high efficiency and practically does not cause side effects. In addition, it is prescribed for patients with gout, as it reduces uric acid levels.
Fibrates: instructions for the use of these drugs
How often and in what dosages to use these medications depends on which drug the attending physician prescribed. Most often, they need to be consumed for about a month (or more), 2-3 tablets per day. The main indication is metabolic syndrome. It is these patients who are most often prescribed fibrates. Drugs must be combined with proper nutrition and used under the control of the lipid spectrum. Gemfibrozil tablets are used 1-2 times a day 30 minutes before meals for several months. Their analogues are the medicines "Gavilon" and "Normolit". The drug "Bezafibrat" is available in tablets of 200 mg and is taken 2 times a day for one month. There is also its analogue - the medicine "Retard", containing 400 mg of active substance. The drug "Fenofibrate" has 2 forms of release: tablets and nanoparticles. They provide more effective absorption and bioavailability, are used 1 time per day (200 mg) for several months. Its analogues are the medicines "Tricor" and "Lipantil".
Fibrates: drug interactions
Before you start using drugs of this group, you need to consult a doctor and recall what other drugs are used. Fibrates cannot 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). Since this increases the likelihood of developing myositis.
Testimonials of doctors and patients about fibrates
Most patients benefit from the use of fibrates, since they note a decrease in LDL, triglycerides and cholesterol. Doctors recommend these drugs to all patients with metabolic syndrome because of their high effectiveness and wide spectrum of action. The only drawback is the contraindications to the use of fibrates, which are often found in elderly patients.