When are Fibrates Appropriate?
Fibrates should be used in patients with certain lipid abnormalities, where lifestyle changes have failed to correct these abnormalities. In particular, they should be prescribed for: • Patients at high risk of CHD with a low HDL-C (< 1 mmol/l) and/or raised triglycerides. These patients may typically have Type 2 diabetes or features of the metabolic syndrome such as abdominal obesity. • In high-risk patients where combination therapy with statins is required to achieve total cholesterol (TC) and LDL-C targets - TC < 5.0 mmol/l and LDL-C < 3.0 mmol/l[7] - and when triglyceride levels remain > 2.3 mmol/l or HDL < 1.0 mmol/l. • Patients who have marked hypertriglyceridaemia (> 10 mmol/l). Use of fibrates is recommended in this situation to prevent development of pancreatitis. • Patients who are intolerant of statins.
