RESEARCH STARTER

Fibrate drugs (drug interactions)

Fibrate drugs are a class of medications primarily used to improve cholesterol levels and manage high triglycerides in the bloodstream. While they are effective in lowering lipid levels, it is crucial for users to be aware of potential drug interactions that could affect their health. Fibrates can interact with various substances, including B vitamins, blood-thinning supplements like warfarin, statins, and certain immunosuppressants, which may lead to harmful effects or reduced efficacy. For instance, combining fibrates with niacin, a form of vitamin B3, can increase the risk of muscle damage. Furthermore, their use alongside blood-thinning herbs such as garlic and ginkgo biloba might pose bleeding risks. Patients with pre-existing conditions, such as diabetes or liver issues, as well as those who are pregnant or breastfeeding, are generally advised against fibrate use. Given these considerations, it is vital for individuals taking fibrates to communicate with their healthcare providers about any other medications or supplements they are using, especially before surgical procedures. Understanding these interactions can help manage risks and enhance treatment outcomes.

Full Article

  • INTERACTIONS: B vitamins, blood-thinning supplements, statins, bile acid resins, immunosuppressant drugs, some diabetes medications, garlic, ginkgo biloba, red yeast rice, niacin (vitamin B3)
  • DRUGS IN THIS FAMILY: Clofibrate (Atromid-S; largely discontinued due to side effects), fenofibrate (Tricor, Lipofen, Antara, Fenoglide), gemfibrozil (Lopid)

DEFINITION: Drugs used to improve levels of cholesterol and related lipids found in the blood. Fibrates are particularly helpful for persons with high levels of triglycerides.

B Vitamins

Effect: Possible Helpful Interaction

Fibrate drugs are known to raise homocysteine levels in the blood. High levels of homocysteine have been associated with an increased risk of heart disease, although a direct connection has not been proven.

In a double-blind, placebo-controlled trial of twenty-nine men taking fenofibrate, the use of the B vitamins folate (650 micrograms [mcg]), vitamin B12 (50 mcg), and vitamin B6 (50 milligrams) once daily for six weeks restored homocysteine levels to nearly normal values.

Patients taking fibrate drugs are also advised to avoid niacin (vitamin B3) because it may cause muscle damage.

Blood-Thinning Supplements

Effect: Possible Harmful Interaction

Fibrate drugs are known to increase the blood-thinning effects of drugs in the warfarin (Coumadin) family. Certain herbs, such as garlic, danshen, devil’s claw, dong quai, papaya, and red clover, may thin the blood in a manner somewhat similar to warfarin. Although no such interactions have been reported, it is theoretically possible that the combined use of these herbs and fibrate drugs could pose a risk of bleeding problems. Garlic and ginkgo biloba should also be avoided for this reason. 

Fibrate drugs are also known to interact with certain statins, such as lovastatin and simvastatin. Immunosuppressants, such as ciclosporin or tacrolimus, should not be taken at the same time as fibrate drugs, as they may damage the kidneys. Further, women who are pregnant or breastfeeding and patients with diabetes and liver, gallbladder, and kidney conditions should not take fibrate drugs. Should a patient have surgery or dental work scheduled and be taking a fibrate drug, they should alert their medical provider. 


Bibliography

Dierkes, J., et al. "Vitamin Supplementation Can Markedly Reduce the Homocysteine Elevation Induced by Fenofibrate." Atherosclerosis, vol. 158, 2001, pp. 161-64, doi:10.1016/s0021-9150(00)00766-8. Accessed 18 Dec. 2025.

"Fibrates." Cleveland Clinic, 10 Feb. 2022, my.clevelandclinic.org/health/drugs/22385-fibrates. Accessed 18 Dec. 2025.

Singh, Gauri, and Ricardo Correa. "Fibrate Medications - StatPearls." NCBI, 1 May 2023, www.ncbi.nlm.nih.gov/books/NBK547756. Accessed 18 Dec. 2025.

Withe, Meara. "Fibrates for Cholesterol: Benefits and Side Effects." Medical News Today, 20 Nov. 2024, www.medicalnewstoday.com/articles/fibrates-for-cholesterol. Accessed 18 Dec. 2025.

Full Article

  • INTERACTIONS: B vitamins, blood-thinning supplements, statins, bile acid resins, immunosuppressant drugs, some diabetes medications, garlic, ginkgo biloba, red yeast rice, niacin (vitamin B3)
  • DRUGS IN THIS FAMILY: Clofibrate (Atromid-S; largely discontinued due to side effects), fenofibrate (Tricor, Lipofen, Antara, Fenoglide), gemfibrozil (Lopid)

DEFINITION: Drugs used to improve levels of cholesterol and related lipids found in the blood. Fibrates are particularly helpful for persons with high levels of triglycerides.

B Vitamins

Effect: Possible Helpful Interaction

Fibrate drugs are known to raise homocysteine levels in the blood. High levels of homocysteine have been associated with an increased risk of heart disease, although a direct connection has not been proven.

In a double-blind, placebo-controlled trial of twenty-nine men taking fenofibrate, the use of the B vitamins folate (650 micrograms [mcg]), vitamin B12 (50 mcg), and vitamin B6 (50 milligrams) once daily for six weeks restored homocysteine levels to nearly normal values.

Patients taking fibrate drugs are also advised to avoid niacin (vitamin B3) because it may cause muscle damage.

Blood-Thinning Supplements

Effect: Possible Harmful Interaction

Fibrate drugs are known to increase the blood-thinning effects of drugs in the warfarin (Coumadin) family. Certain herbs, such as garlic, danshen, devil’s claw, dong quai, papaya, and red clover, may thin the blood in a manner somewhat similar to warfarin. Although no such interactions have been reported, it is theoretically possible that the combined use of these herbs and fibrate drugs could pose a risk of bleeding problems. Garlic and ginkgo biloba should also be avoided for this reason. 

Fibrate drugs are also known to interact with certain statins, such as lovastatin and simvastatin. Immunosuppressants, such as ciclosporin or tacrolimus, should not be taken at the same time as fibrate drugs, as they may damage the kidneys. Further, women who are pregnant or breastfeeding and patients with diabetes and liver, gallbladder, and kidney conditions should not take fibrate drugs. Should a patient have surgery or dental work scheduled and be taking a fibrate drug, they should alert their medical provider. 


Bibliography

Dierkes, J., et al. "Vitamin Supplementation Can Markedly Reduce the Homocysteine Elevation Induced by Fenofibrate." Atherosclerosis, vol. 158, 2001, pp. 161-64, doi:10.1016/s0021-9150(00)00766-8. Accessed 18 Dec. 2025.

"Fibrates." Cleveland Clinic, 10 Feb. 2022, my.clevelandclinic.org/health/drugs/22385-fibrates. Accessed 18 Dec. 2025.

Singh, Gauri, and Ricardo Correa. "Fibrate Medications - StatPearls." NCBI, 1 May 2023, www.ncbi.nlm.nih.gov/books/NBK547756. Accessed 18 Dec. 2025.

Withe, Meara. "Fibrates for Cholesterol: Benefits and Side Effects." Medical News Today, 20 Nov. 2024, www.medicalnewstoday.com/articles/fibrates-for-cholesterol. Accessed 18 Dec. 2025.

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