Fibrates are a class of drugs that activate a nuclear receptor called PPAR-alpha (peroxisome proliferator-activated receptor alpha). This activation alters the expression of genes involved in lipid metabolism, primarily leading to a significant reduction in blood triglyceride levels and a modest increase in HDL ('good') cholesterol. They are prescribed for specific types of dyslipidemia to manage cardiovascular risk, not as a general healthspan intervention.
Verdict
Effective for high triglycerides under medical guidance; not a healthspan intervention.
HEALTHSPAN IMPACT
High Value
RISK LEVEL
Moderate
EVIDENCE GRADE
A
MONTHLY COST
$10 - $50
Protocol
- Fenofibrate is typically prescribed at 48 to 145 mg once daily.
- Gemfibrozil is typically prescribed at 600 mg twice daily, 30 minutes before meals.
Flags
- Increased risk of myopathy (muscle pain) and rhabdomyolysis, especially when combined with statins.
- May cause elevation of liver enzymes (transaminases) and requires periodic monitoring.
- Can increase the risk of cholelithiasis (gallstones).
- Contraindicated in patients with severe renal or hepatic disease.
- Gemfibrozil has more significant drug-drug interactions than fenofibrate.