Cholesterol lowering with fibrate: The fibrates are cholesterol-lowering drugs that are primarily effective in lowering triglycerides and, to a lesser extent, in increasing HDL-cholesterol levels.

Gemfibrozil (brand name: LOPID), the fibrate most widely used in the United States, can be very effective for patients with high triglyceride levels. However, it is not very effective for lowering the LDL-cholesterol. As a result, it is used less often than other drugs in patients with heart disease for whom LDL-cholesterol lowering is the main goal of treatment.

Gemfibrozil therapy by itself is not recommended by the Food and Drug Administration for patients with heart disease. Fibrates are usually given in two daily doses 30 minutes before the morning and evening meals. The reductions in triglycerides generally are in the range of 20 to 50 percent with increases in HDL-cholesterol of 10 to 15 percent.

Fibrates are generally well tolerated by most patients. Gastrointestinal complaints are the most common side effect and fibrates appear to increase the likelihood of developing cholesterol gallstones . Fibrates can increase the effect of medications that thin the blood, and this should be monitored closely by your physician.

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