Audra Drug Interactions

Fenofibrate and other fibrates may enhance the effects of oral anticoagulants; the dose of anticoagulants should be reduced when treatment with a fibrate is started, and then adjusted gradually if necessary. Recommendations concerning the amount that the anticoagulant dose should be reduced by vary between the manufacturers of the differing fibrates and are sometimes not even specified; the manufacturers of fenofibrate suggest a reduction of up to 50% in the dosage of anticoagulant.
The mechanism of the interaction has not yet been determined. Fibrates have been reported to displace warfarin from protein binding sites but other mechanism are probably also involved. A number of other drugs may be displaced from plasma proteins by fibrates including tolbutamide and other sulfonylurea antidiabetics, phenytoin, and, in patients with hypoalbuminaemia, frusemide (furosemide). The interaction with antidiabetics is complex since fenofibrate has been shown to alter glucose tolerance in both diabetic and non-diabetic patients. The dosage of antidiabetic may need adjusting during concomitant fenofibrate therapy.