Bezafibrate 💊

⚠️ Key risk: Myotoxicity (rhabdomyolysis) if dose not reduced in renal failure. Always adjust by eGFR.

📖 About Bezafibrate

• Always check the BNF entry for up-to-date prescribing advice.
• Fibrate used for hyperlipidaemia, especially when statins are contraindicated or not tolerated.
• Particularly effective for hypertriglyceridaemia.

⚙️ Mode of Action

• PPAR-α agonist → increases lipoprotein lipase activity.
• ↓ Triglycerides, ↑ HDL cholesterol, modest ↓ in LDL cholesterol.
• Reduces VLDL production in the liver.

🎯 Indications & Doses

• Hyperlipidaemia (statin-intolerant): 200 mg PO every 8 h (TDS).
• Modified release: 400 mg PO once daily (OD).
• Severe hypertriglyceridaemia: as above.

💊 Dose Summary

⚠️ Dose Adjustments in Renal Impairment

• eGFR 40–60 → max 400 mg daily.
• eGFR 15–40 → 200 mg every 1–2 days.
• Contraindicated if eGFR < 15 mL/min/1.73m².

🚫 Contraindications

• Hypoalbuminaemia.
• Primary biliary cirrhosis or gall bladder disease.
• Nephrotic syndrome.
• Pregnancy & breastfeeding.

💥 Side Effects

• Common: GI disturbance, anorexia.
• Liver: cholestasis, raised LFTs.
• Muscle: myopathy, rhabdomyolysis (↑ risk with renal impairment or statins).

🔀 Interactions

• ↑ Risk of myopathy if combined with statins → monitor CK closely.
• Monitor LFTs and renal function during therapy.

📚 References

• BNF – Bezafibrate
• NICE Lipid Modification Guidelines