Dietary measures, including calorie restriction and reduced fat intake, remain the mainstay of management in prevention of
coronary heart disease (CHD). When this fails,
drug therapy should be considered.
Fibrates, a family of
lipid lowering drugs, decrease plasma
triglycerides and inhibit their synthesis. They are also reported to suppress
cholesterol production in the liver. A disadvantage of
fenofibrate is the poor solubility of the principal ingredient, with subsequent incomplete absorption after
oral administration. Micronized
fenofibrate, a new formulation chemically identical to the parent compound, has improved pharmacokinetic parameters which increase absorption, provide more stable plasma levels, and thus dosage can be decreased. The micronized formulation has been shown to be effective in reducing
LDL cholesterol and
triglycerides in patients with types IIa and IV
hyperlipidemia, with increasing responsiveness to
therapy in proportion to elevated baseline values of these parameters. This formulation has also been compared to
simvastatin, an
HMG-CoA reductase inhibitor. Results of a double-blind crossover study showed that both drugs reduced plasma
cholesterol levels by similar amounts, and both produced similar increases in
HDL cholesterol. The micronized formulation of
fenofibrate thus provides improved efficacy in the prevention of CHD. In comparison to the standard formulation, micronised
fenofibrate thus provides improved efficacy in the control of
dyslipidemia and the prevention of CHD.