Fenolit Drug Interactions

Fenofibrate and other fibrates may enhance the effects of oral anticoagulants. The dose of the anticoagulant 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 the anticoagulant. The mechanism of the interaction has not yet been determined. Fibrates have been reported to displace warfarin from protein-binding sites but other mechanisms 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 hypoalbuminemia, furosemide. The interaction with antidiabetics is complex since fenofibrate has been shown to alter glucose tolerance in both diabetic and nondiabetic patients. The dosage of antidiabetics may need adjusting during concomitant fenofibrate therapy.