Fenofibrate Capsules 160mg Taj Pharma

  1. Name of the medicinal product

Fenofibrate Capsules 160mg Taj Pharma
Fenofibrate Capsules 200mg Taj Pharma

  1. Qualitative and quantitative composition

a) Each hard-gelatin capsule contains:
Fenofibrate (Micronized)               160mg
Excipients                                        q.s.
Colour: Approved colours used in empty capsule shells.

b) Each hard-gelatin capsule contains:
Fenofibrate (Micronized)            200mg
Excipients                                     q.s.
Colour: Approved colours used in empty capsule shells.

For the full list of excipients, see section 6.1

  1. Pharmaceutical form

Hard-gelatin Capsule

  1. Clinical particulars

4.1 Therapeutic indications

Fenofibrate is indicated as an adjunct to diet and other non-pharmacological treatment (e.g. exercise, weight reduction) for the following:

– Treatment of severe hypertriglyceridaemia with or without low HDL cholesterol.

– Mixed hyperlipidaemia when a statin is contraindicated or not tolerated.

– Mixed hyperlipidaemia in patients at high cardiovascular risk in addition to a statin when triglycerides and HDL cholesterol are not adequately controlled.

4.2 Posology and method of administration

Dietary measures initiated before therapy should be continued. Response to therapy should be monitored by determination of serum lipid values. If an adequate response has not been achieved after several months (e.g. 3 months), complementary or different therapeutic measures should be considered.

Posology

Adults:

The recommended dose is 200 mg daily administered as one capsule of Fenofibrate 200 mg. The dose can be titrated up to 267 mg daily administered as one capsule of Fenofibrate 267 mg or 4 capsules of Fenofibrate 67 mg, if required. This maximum dose is not recommended in addition to a statin.

Special populations

Elderly patients (≥ 65 years old):

No dose adjustment is necessary. The usual dose is recommended, except for decreased renal function with estimated glomerular filtration rate < 60 mL/min/1.73 (see Patients with renal impairment).

Patients with renal impairment:

Fenofibrate should not be used if severe renal impairment, defined as eGFR <30 mL/min per 1.73 m2, is present. If eGFR is between 30 and 59 mL/min per 1.73 m2, the dose of fenofibrate should not exceed 100 mg standard or 67 mg micronized once daily. If, during follow-up, the eGFR decreases persistently to <30 mL/min per 1.73 m2, fenofibrate should be discontinued.

Hepatic impairment:

Fenofibrate 200 mg Capsules are not recommended for use in patients with hepatic impairment due to the lack of data.

Paediatric population:

The safety and efficacy of fenofibrate in children and adolescents younger than 18 years has not been established. No data are available. Therefore, the use of fenofibrate is not recommended in paediatric subjects under 18 years.

Method of administration

Capsules should be swallowed whole during a meal.

4.3 Contraindications

– Hypersensitivity to the active substance or to any of the excipients listed in section 6.1.

– Hepatic insufficiency (including biliary cirrhosis and unexplained persistent liver function abnormality)

– Known gallbladder disease

– Severe renal insufficiency (estimated glomerular filtration rate < 30 mL/min/1.73 m2)

– Chronic or acute pancreatitis with the exception of acute pancreatitis due to severe hypertriglyceridemia

– Known photoallergy or phototoxic reaction during treatment with fibrates or ketoprofen

4.4 Special warnings and precautions for use

Secondary causes of hyperlipidemia:

Secondary causes of hyperlipidemia, such as uncontrolled type 2 diabetes mellitus, hypothyroidism, nephrotic syndrome, dysproteinemia, obstructive liver disease, pharmacological treatment, alcoholism, should be adequately treated before fenofibrate therapy is considered.

Secondary cause of hypercholesterolemia related to pharmacological treatment can be seen with diuretics, β-blocking agents, estrogens, progestogens, combined oral contraceptives, immunosuppressive agents and protease inhibitors. In these cases it should be ascertained whether the hyperlipidaemia is of primary or secondary nature (possible elevation of lipid values caused by these therapeutic agents).

Liver function:

As with other lipid lowering agents, increases have been reported in transaminase levels in some patients. In the majority of cases these elevations were transient, minor and asymptomatic. It is recommended that transaminase levels are monitored every 3 months during the first 12 months of treatment and thereafter periodically. Attention should be paid to patients who develop increase in transaminase levels and therapy should be discontinued if AST (SGOT) and ALT (SGPT) levels increase to more than 3 times the upper limit of the normal range. When symptoms indicative of hepatitis occur (e.g. jaundice, pruritus), and diagnosis is confirmed by laboratory testing, fenofibrate therapy should be discontinued.

Pancreas:

Pancreatitis has been reported in patients taking fenofibrate (see sections 4.3 and 4.8). This occurrence may represent a failure of efficacy in patients with severe hypertriglyceridaemia, a direct drug effect, or a secondary phenomenon mediated through biliary tract stone or sludge formation, with obstruction of the common bile duct.

Muscle:

Muscle toxicity, including rare cases of rhabdomyolysis, with or without renal failure has been reported with administration of fibrates and other lipid-lowering agents. The incidence of this disorder increases in cases of hypoalbuminaemia and previous renal insufficiency. Patients with pre-disposing factors for myopathy and/or rhabdomyolysis, including age above 70 years, personal or familial history of hereditary muscular disorders, renal impairment, hypothyroidism and high alcohol intake, may be at an increased risk of developing rhabdomyolysis. For these patients, the putative benefits and risks of fenofibrate therapy should be carefully weighed up.

Muscle toxicity should be suspected in patients presenting diffuse myalgia, myositis, muscular cramps and weakness and/or marked increases in CPK (levels exceeding 5 times the normal range). In such cases treatment with fenofibrate should be stopped.

The risk of muscle toxicity may be increased if the drug is administered with another fibrate or an HMG-CoA reductase inhibitor, especially in cases of pre-existing muscular disease. Consequently, the co-prescription of fenofibrate with a HMG-CoA reductase inhibitor or another fibrate should be reserved to patients with severe combined dyslipidaemia and high cardiovascular risk without any history of muscular disease and a close monitoring of potential muscle toxicity.

Renal function:

Fenofibrate 200 mg is contraindicated in severe renal impairment (see section 4.3).

Fenofibrate 200 mg should be used with caution in patients with mild to moderate renal insufficiency. Dose should be adjusted in patients whose estimated glomerular filtration rate is 30 to 59 mL/min/1.73 m2 (see section 4.2).

Reversible elevations in serum creatinine have been reported in patients receiving fenofibrate monotherapy or co-administered with statins. Elevations in serum creatinine were generally stable over time with no evidence for continued increases in serum creatinine with long term therapy and tended to return to baseline following discontinuation of treatment.

During clinical trials, 10% of patients had a creatinine increase from baseline greater than 30 μmol/L with co-administered fenofibrate and simvastatin versus 4.4% with statin monotherapy. 0.3% of patients receiving co-administration had clinically relevant increases in creatinine to values > 200 μmol/L. Treatment should be interrupted when creatinine level is 50% above the upper limit of normal. It is recommended that creatinine is measured during the first three months after initiation of treatment and thereafter periodically (for dose recommendations, see section 4.2).

Excipients

This medicinal product contains lactose monohydrate. Patients with rare hereditary problems of galactose intolerance, total lactase deficiency or glucose-galactose malabsorption should not take this medicine.

This medicinal product also contains small amounts of sunset yellow (E 110) which is a colouring agent and may cause allergic reactions.

4.5 Interaction with other medicinal products and other forms of interaction

Oral Anti-coagulants

Fenofibrate enhances oral anti-coagulant effect and may increase risk of bleeding.

In patients receiving oral anti-coagulant therapy, the dose of anti-coagulant should be reduced by about one-third at the commencement of treatment and then gradually adjusted if necessary according to INR (International Normalised Ratio) monitoring.

Ciclosporin

Some severe cases of reversible renal function impairment have been reported during concomitant administration of fenofibrate and ciclosporin. The renal function of these patients must therefore be closely monitored and the treatment with fenofibrate stopped in the case of severe alteration of laboratory parameters.

HMG-CoA reductase inhibitors or Other Fibrates

The risk of serious muscle toxicity is increased if a fibrate is used concomitantly with HMG-CoA reductase inhibitors or other fibrates. Such combination therapy should be used with caution and patients monitored closely for signs of muscle toxicity (see section 4.4).

There is currently no evidence to suggest that fenofibrate affects the pharmacokinetics of simvastatin.

Glitazones

Some cases of reversible paradoxical reduction of HDL-cholesterol have been reported during concomitant administration of fenofibrate and glitazones. Therefore it is recommended to monitor HDL-cholesterol if one of these components is added to the other and stopping of either therapy if HDL-cholesterol is too low.

Cytochrome P450 enzymes

In vitro studies using human liver microsomes indicate that fenofibrate and fenofibric acid are not inhibitors of cytochrome (CYP) P450 isoforms CYP3A4, CYP2D6, CYP2E1, or CYP1A2. They are weak inhibitors of CYP2C19 and CYP2A6, and mild-to-moderate of CYP2C9 at therapeutic concentrations.

Patients co-administered fenofibrate and CYP2C19, CYP2A6, and especially CYP2C9 metabolised drugs with a narrow therapeutic index should be carefully monitored and, if necessary, dose adjustment of these drugs is recommended.

Other

In common with other fibrates, fenofibrate induces microsomal mixed-function oxidases involved in fatty acid metabolism in rodents and may interact with drugs metabolised by these enzymes.

4.6 Fertility, pregnancy and lactation

Pregnancy

There are no adequate data from the use of fenofibrate in pregnant women. Animal studies have not demonstrated any teratogenic effects. Embryotoxic effects have been shown at doses in the range of maternal toxicity (see section 5.3). The potential risk for humans is unknown.

Therefore, Fenofibrate 200 mg Capsules should only be used during pregnancy after a careful benefit/risk assessment.

Breast-feeding

It is unknown whether fenofibrate and/or its metabolites are excreted in human milk. A risk to the suckling child cannot be excluded. Therefore fenofibrate should not be used during breast-feeding.

Fertility

Reversible effects on fertility have been observed in animals (see section 5.3). There are no clinical data on fertility from the use of Fenofibrate 200 mg Capsules

4.7 Effects on ability to drive and use machines

Fenofibrate 200 mg Capsules have no or negligible influence on the ability to drive and use machines.

4.8 Undesirable effects

The most commonly reported ADRs during Fenofibrate therapy are digestive, gastric or intestinal disorders.

The following undesirable effects have been observed during placebo-controlled clinical trials (n=2344) with the below indicated frequencies:

System Organ Class Common

≥ 1/100 to < 1/10

Uncommon

≥ 1/1,000 to < 1/100

Rare

≥ 1/10,000 to < 1/1,000

Very rare

< 1/10,000 incl. isolated reports

Blood and lymphatic system disorders Haemoglobin decreased

White blood cell count decreased

Immune system disorders Hypersensitivity
Nervous system disorders Headache
Vascular disorders Thromboembolism (pulmonary embolism, deep vein thrombosis) *
Gastrointestinal disorders Gastrointestinal signs and symptoms (abdominal pain, nausea, vomiting, diarrhoea, flatulence) Pancreatitis*
Hepatobiliary disorders Transaminases increased (see section 4.4) Cholelithiasis (see section 4.4) Hepatitis
Skin and subcutaneous tissue disorders Cutaneous hypersensitivity (e.g. Rashes, pruritus, urticaria) Alopecia

Photosensitivity reactions

Musculoskeletal, connective tissue and bone disorders Muscle disorder (e.g. myalgia, myositis, muscular spasms and weakness)
Reproductive system and breast disorders Sexual dysfunction
Investigations Blood homocysteine level increased** Blood creatinine increased Blood urea increased

* In the FIELD-study, a randomized placebo-controlled trial performed in 9795 patients with type 2 diabetes mellitus, a statistically significant increase in pancreatitis cases was observed in patients receiving fenofibrate versus patients receiving placebo (0.8% versus 0.5%; p = 0.031). In the same study, a statistically significant increase was reported in the incidence of pulmonary embolism (0.7% in the placebo group versus 1.1% in the fenofibrate group; p = 0.022) and a statistically non-significant increase in deep vein thromboses (placebo: 1.0 % [48/4900 patients] versus fenofibrate 1.4% [67/4895 patients]; p = 0.074).

** In the FIELD study the average increase in blood homocysteine level in patients treated with fenofibrate was 6.5 µmol/L, and was reversible on discontinuation of fenofibrate treatment. The increased risk of venous thrombotic events may be related to the increased homocysteine level. The clinical significance of this is not clear.

In addition to those events reported during clinical trials, the following side effects have been reported spontaneously during postmarketing use of Fenofibrate. A precise frequency cannot be estimated from the available data and is therefore classified as “not known”.

Ear and labyrinth disorders: Vertigo

Respiratory, thoracic and mediastinal disorders: Interstitial lung disease

Musculoskeletal, connective tissue and bone disorders: Rhabdomyolysis

Hepatobiliary disorders: Jaundice, complications of cholelithiasis (e.g. cholecystitis, cholangitis, biliary colic)

Skin and Subcutaneous Tissue Disorders: severe cutaneous reactions (e.g. erythema multiforme, Stevens-Johnson syndrome, toxic epidermal necrolysis)

General disorders and administration site conditions: Fatigue

Reporting of suspected adverse reactions

Reporting suspected adverse reactions after authorisation of the medicinal product is important. It allows continued monitoring of the benefit/risk balance of the medicinal product.

4.9 Overdose

Only anecdotal cases of fenofibrate overdosage have been received. In the majority of cases no overdose symptoms were reported.

No specific antidote is known. If overdose is suspected, treat symptomatically and institute appropriate supportive measures as required. Fenofibrate cannot be eliminated by haemodialysis.

  1. Pharmacological properties

5.1 Pharmacodynamic properties

Pharmacotherapeutic group:

Serum Lipid Reducing Agents/Cholesterol and Triglyceride Reducers/Fibrates.

Fenofibrate 200 mg Capsules are a formulation containing 200 mg of micronized fenofibrate; the administration of this product results in effective plasma concentrations identical to those obtained with 3 capsules of 67 mg of micronized fenofibrate.

Mechanism of action:

Fenofibrate is a fibric acid derivative whose lipid modifying effects reported in humans are mediated via activation of Peroxisome Proliferator Activated Receptor type α (PPARα). Through activation of PPARα, fenofibrate increases lipolysis and elimination of atherogenic triglyceride rich particles from plasma by activating lipoprotein lipase and reducing production of Apoprotein C-III. Activation of PPARα also induces an increase in the synthesis of Apoproteins A-I and A-II.

Pharmacodynamic effects:.

Epidemiological studies have demonstrated a positive correlation between abnormally increased serum lipid levels and an increased risk of coronary heart disease. The control of such dyslipidaemia forms the rationale for treatment with Fenofibrate Micro 200. However the possible beneficial and adverse long term consequences of drugs used in the management of dyslipidaemia are still the subject of scientific discussion. Therefore the presumptive beneficial effect of Fenofibrate Micro 200 on cardiovascular morbidity and mortality is as yet unproven.

There is evidence that treatment with fibrates may reduce coronary heart disease events but they have not been shown to decrease all cause mortality in the primary or secondary prevention of cardiovascular disease.

Clinical efficacy and safety

The Action to Control Cardiovascular Risk in Diabetes (ACCORD) lipid trial was a randomized placebo-controlled study of 5518 patients with type 2 diabetes mellitus treated with fenofibrate in addition to simvastatin. Fenofibrate plus simvastatin therapy did not show any significant differences compared to simvastatin monotherapy in the composite primary outcome of non-fatal myocardial infarction, non-fatal stroke, and cardiovascular death (hazard ratio [HR] 0.92, 95% CI 0.79-1.08, p = 0.32; absolute risk reduction: 0.74%). In the pre-specified subgroup of dyslipidaemic patients, defined as those in the lowest tertile of HDL-C (≤34 mg/dl or 0.88 mmol/L) and highest tertile of TG (≥204 mg/dl or 2.3 mmol/L) at baseline, fenofibrate plus simvastatin therapy demonstrated a 31% relative reduction compared to simvastatin monotherapy for the composite primary outcome (hazard ratio [HR] 0.69, 95% CI 0.49-0.97, p = 0.03; absolute risk reduction: 4.95%). Another prespecified subgroup analysis identified a statistically significant treatment-by-gender interaction (p = 0.01) indicating a possible treatment benefit of combination therapy in men (p=0.037) but a potentially higher risk for the primary outcome in women treated with combination therapy compared to simvastatin monotherapy (p=0.069). This was not observed in the aforementioned subgroup of patients with dyslipidaemia but there was also no clear evidence of benefit in dyslipidaemic women treated with fenofibrate plus simvastatin, and a possible harmful effect in this subgroup could not be excluded.

Studies with fenofibrate on lipoprotein fractions show decreases in levels of LDL and VLDL cholesterol. HDL cholesterol levels are frequently increased. LDL and VLDL triglycerides are reduced. The overall effect is a decrease in the ratio of low and very low density lipoproteins to high density lipoproteins, which epidemiological studies have correlated with a decrease in atherogenic risk. Apolipoprotein-A and apolipoprotein-B levels are altered in parallel with HDL and LDL and VLDL levels respectively.

Extravascular deposits of cholesterol (tendinous and tuberous xanthoma) may be markedly reduced or even entirely eliminated during fenofibrate therapy.

Plasma uric acid levels are increased in approximately 20% of hyperlipidaemic patients, particularly in those with type IV disease.

Patients with raised levels of fibrinogen treated with fenofibrate have shown significant reductions in this parameter, as have those with raised levels of Lp(a). Other inflammatory markers such as C Reactive Protein are reduced with fenofibrate treatment.

The uricosuric effect of fenofibrate leading to reduction in uric acid levels of approximately 25% should be of additional benefit in those dyslipidaemic patients with hyperuricaemia.

Fenofibrate has been shown to possess an anti-aggregatory effect on platelets in animals and in a clinical study, which showed a reduction in platelet aggregation induced by ADP, arachidonic acid and epinephrine.

5.2 Pharmacokinetic properties

Absorption

Maximum plasma concentrations (Cmax) occur within 4 to 5 hours after oral administration. Plasma concentrations are stable during continuous treatment in any given individual.

The absorption of fenofibrate is increased when administered with food.

Distribution

Fenofibric acid is strongly bound to plasma albumin (more than 99%). It can displace antivitamin K compounds from the protein binding sites and may potentiate their anti-coagulant effect.

Metabolism and excretion

After oral administration, fenofibrate is rapidly hydrolised by esterases to the active metabolite fenofibric acid.

No unchanged fenofibrate can be detected in the plasma. Fenofibrate is not a substrate for CYP 3A4. No hepatic microsomal metabolism is involved.

The drug is excreted mainly in the urine; 70% in 24 hours and 88% in 6 days, at which time the total excretion in urine and faeces reaches 93%. Practically all the drug is eliminated within 6 days. Fenofibrate is mainly excreted as fenofibric acid and its derived glucuroconjugate.

In elderly patients, the fenofibric acid apparent total plasma clearance is not modified.

Kinetic studies following the administration of a single dose and continuous treatment have demonstrated that the drug does not accumulate.

Fenofibric acid is not eliminated during haemodialysis.

The plasma elimination half-life of fenofibric acid is approximately 20 hours.

5.3 Preclinical safety data

In a three-month oral nonclinical study in the rat species with fenofibric acid, the active metabolite of fenofibrate, toxicity for the skeletal muscles (particularly those rich in type I -slow oxidative- myofibres) and cardiac degeneration, anaemia and decreased body weight were seen. No skeletal toxicity was noted at doses up to 30 mg/kg (approximately 17-time the exposure at the human maximum recommended dose (MRHD). No signs of cardiomyotoxicity were noted at an exposure about 3 times the exposure at MRHD. Reversible ulcers and erosions in the gastro-intestinal tract occurred in dogs treated for 3 months. No gastro-intestinal lesions were noted in that study at an exposure approximately 5 times the exposure at the MRHD.

Studies on mutagenicity of fenofibrate have been negative.

In rats and mice, liver tumours have been found at high dosages, which are attributable to peroxisome proliferation. These changes are specific to small rodents and have not been observed in other animal species. This is of no relevance to therapeutic use in man.

Studies in mice, rats and rabbits did not reveal any teratogenic effect. Embryotoxic effects were observed at doses in the range of maternal toxicity. Prolongation of the gestation period and difficulties during delivery were observed at high doses.

Reversible hypospermia and testicular vacuolation and immaturity of the ovaries were observed in a repeat-dose toxicity study with fenofibric acid in young dogs. However no effects on fertility were detected in non-clinical reproductive toxicity studies conducted with fenofibrate.

  1. Pharmaceutical particulars

6.1 List of excipients

Sodium lauryl sulphate, Lactose, Pregelatinised starch, Crospovidone, Extragranular, Crospovidone

Pregelatinised starch, Talc, Colloidal anhydrous silica, Magnesium stearate, Gelatin, Titanium dioxide

Sunset yellow FCF, Shellac glaze, Iron oxide black, Propylene glycol.

6.2 Incompatibilities

Not applicable

6.3 Shelf life

3 years

6.4 Special precautions for storage

Store in the original package. Do not store above 25°C.

6.5 Nature and contents of container

Blister strip of clear transparent PVC film coated with PVdC on the inner side with a backing of aluminium foil

Pack size of: 7, 14, 28, 30, 50, 90, 100, and 500 capsules.

Not all pack sizes may be marketed.

6.6 Special precautions for disposal and other handling

No special requirements.

7. Manufactured In India By:
TAJ PHARMACEUTICALS LTD.
Mumbai, India
Unit No. 214.Old Bake House,
Maharashtra chambers of  Commerce Lane,
Fort, Mumbai – 400001
at:Gujarat, INDIA.
Customer Service and Product Inquiries:
1-800-TRY-FIRST (1-800-222-434 & 1-800-222-825)
Monday through Saturday 9:00 a.m. to 7:00 p.m. EST
E-mail: tajgroup@tajpharma.com

Fenofibrate Capsules 160mg/200 mg Taj Pharma
(Fenofibrate)

Package leaflet: Information for the patient

Read all of this leaflet carefully before you start taking this medicine because it contains important information for you.

  • Keep this leaflet. You may need to read it again.
  • If you have any further questions, ask your doctor, pharmacist or nurse.
  • This medicine has been prescribed for you only. Do not pass it on to others. It may harm them, even if their signs of illness are the same as yours.
  • If you get any side effects, talk to your doctor, pharmacist or nurse. This includes any possible side effects not listed in this leaflet. See section 4.

What is in this leaflet

  1. What Fenofibrate Capsules are and what they are used for
    2. What you need to know before you take Fenofibrate Capsules
    3. How to take Fenofibrate Capsules
    4. Possible side effects
    5. How to store Fenofibrate Capsules
    6. Contents of the pack and other information

 

  1. What Fenofibrate Capsules are and what they are used for

Fenofibrate Capsules belong to a group of medicines, commonly known as ‘fibrates’. These medicines are used to lower the level of fats (lipids) in the blood. For example the fats known as ‘triglycerides’.

Fenofibrate Capsules are used, alongside a low fat diet and other non-medical treatments such as exercise and weight loss, to lower levels of fats in the blood.

Fenofibrate Capsules can be used in addition to other medicines (called ‘statins’) in some circumstances when levels of fats in the blood are not controlled with a statin alone.

Fenofibrate Capsules can often also increase the amount of a ‘good’ type of cholesterol, called HDL or high density lipoprotein cholesterol.

It is always essential to continue a low-fat diet during treatment with Fenofibrate Capsules.

  1. What you need to know before you take Fenofibrate Capsules

Do not take Fenofibrate Capsules if:

  • You are allergic to fenofibrate, or any of the other ingredients of this medicine (listed in section 6). An allergic reaction can include rashes, hives, itching, swelling of face/lips/hands/feet or breathing difficulties
  • While taking other medicines, you have had an allergic reaction or skin damage from sunlight or UV light (these medicines include other fibrates and an anti-inflammatory drug called ‘ketoprofen’)
  • You have severe liver, kidney or gallbladder problems
  • You have pancreatitis (an inflamed pancreas which causes abdominal pain) which is not caused by high levels of fat in the blood

Do not take Fenofibrate Capsules if any of the above apply to you. If you are not sure, talk to your doctor or pharmacist before taking Fenofibrate Capsules.

Warnings and precautions

Talk to your doctor or pharmacist before taking Fenofibrate Capsules:

  • if you have any kidney problems (your doctor may need to start you on a lower dose)
  • if you have any liver problems. You may have an inflamed liver – signs include yellowing of the skin and whites of the eyes (jaundice) and an increase in liver enzymes (shown in blood tests)
  • if you have an under active thyroid gland (hypo-thyroidism)
  • if you have diabetes, especially Type 2 diabetes, that is not well controlled
  • if you have problems with certain proteins in your blood
  • if you have an alcohol problem
  • if you are taking other medicines
  • if you or your family have had muscle problems
  • if you are over 70 years of age

(Some of the above conditions can lead to high levels of lipids in your blood and need to be corrected before you start therapy with fenofibrate).

If any of the above apply to you (or you are not sure), talk to your doctor or pharmacist before taking Fenofibrate Capsules.

Your doctor might want to test your blood or urine to check if Fenofibrate Capsules are working properly and also if your kidneys, muscles and liver are working properly.

Effects on muscles:

Stop taking Fenofibrate Capsules and see a doctor straight away if you get unexplained cramps or painful, tender or weak muscles while taking this medicine.

  • This is because this medicine may cause muscle problems which may be serious.
  • These problems are rare but include muscle inflammation and breakdown which can cause kidney damage or even death.

Your doctor may do a blood test to check the condition of your muscles before and after starting treatment.

The risk of muscle breakdown is higher in some patients.

Tell your doctor if:

  • You are over 70 years old
  • You have kidney problems
  • You have thyroid problems
  • You or a close family member have a muscle problem which runs in the family
  • You drink large amounts of alcohol
  • You are taking medicines called statins to lower cholesterol (such as simvastatin, atorvastatin, pravastatin, rosuvastatin or fluvastatin)
  • You have ever had muscle problems during treatment with statins or fibrates (such as fenofibrate, bezafibrate or gemfibrozil)

If any of the above apply to you or (you are not sure) talk to your doctor before taking Fenofibrate Capsules.

Other medicines and Fenofibrate Capsules

Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines, including medicines obtained without a prescription.

In particular tell your doctor or pharmacist if you are taking any of the following medicines:

  • Anti-coagulants to thin your blood (such as warfarin)
  • Other medicines to control fat levels in the blood (such as statins or fibrates). Taking a statin at the same time as Fenofibrate Capsules may increase the risk of muscle problems.
  • A particular class of medicines to treat diabetes (such as rosiglitazone or pioglitazone)
  • Ciclosporin (used to supress your immune system)

If any of the above apply to you (or you are not sure) talk to your doctor or pharmacist before taking Fenofibrate Capsules.

Fenofibrate Capsules with food, drink and alcohol

It is important to take the capsule with food – it will not work as well if your stomach is empty.

You should avoid drinking alcohol with Fenofibrate Capsules as this increases the risk of muscle problems.

Pregnancy, breast-feeding and fertility

Do not take Fenofibrate Capsules and tell your doctor if you are pregnant, think you may be pregnant or are planning to have a baby.

Do not take Fenofibrate Capsules if you are breast-feeding or planning to breast-feed your baby.

Ask your doctor or pharmacist for advice before taking any medicine.

Driving and using machines

This medicine will not affect your ability to drive, use tools or use machines.

Fenofibrate Capsules contain lactose

This medicine contains lactose. If you have been told by your doctor that you have an intolerance to some sugars, contact your doctor before taking this medicinal product.

Fenofibrate Capsules contain sunset yellow (E110)

This medicine also contains sunset yellow (E110) which is found in the 200 mg capsules. This is a colouring agent and may cause an allergic reaction.

  1. How to take Fenofibrate Capsules

Always take this medicine exactly as your doctor or pharmacist has told you. Check with your doctor or pharmacist if you are not sure.

Your doctor will determine the appropriate strength for you, depending on your condition, your current treatment and your personal risk status.

  • Swallow the capsule whole with a glass of water.
  • Do not open or chew the capsule.
  • Take the capsule with food – it will not work as well if your stomach is empty.

The recommended dose for adults is one capsule of Fenofibrate 200 mg a day, taken at mealtimes. However your doctor may want you to take one capsule of Fenofibrate 267 mg a day (higher dose).

Use in children and adolescents

The use of Fenofibrate Capsules are not recommended in children under the age of 18.

People with kidney problems

If you have kidney problems, your doctor may tell you to take a lower dose. Ask your doctor or pharmacist about this.

If you take more Fenofibrate Capsules than you should

If you take more Fenofibrate Capsules than you should, contact your doctor or go to the nearest hospital casualty department immediately. Take this leaflet or some capsules with you so your doctor will know what you have taken.

If you forget to take Fenofibrate Capsules

  • If you forget a dose, take the next dose with your next meal
  • Then take your next capsule at the normal time
  • Do not take a double dose to make up for a forgotten dose

If you are worried about this talk to your doctor.

If you stop taking Fenofibrate Capsules

Do not stop taking this medicine unless your doctor tells you to, or the capsules make you feel unwell. This is because abnormal levels of fats in the blood need treating for a long period of time. Remember that as well as taking Fenofibrate Capsules it is also important that you:

  • Have a low-fat diet
  • Take regular exercise

If you have any further questions on the use of this medicine, ask your doctor or pharmacist.

  1. Possible side effects

Like all medicines, this medicine can cause side effects, although not everybody gets them.

Serious side effects:

Stop taking Fenofibrate Capsules and see a doctor immediately or go to the casualty department at your nearest hospital if you notice any of the following serious side effects – you may need urgent medical treatment:

  • Allergic reaction – the signs may include swelling of the face/lips/tongue or throat which may cause difficulty in breathing.
  • Cramps or painful, tender or weak muscles – these may be signs of muscle inflammation or breakdown which can cause kidney damage or even death
  • Stomach pain – this may be a sign that your pancreas is inflamed (pancreatitis)
  • Chest pain and feeling breathless – these may be signs of a blood clot in the lung (pulmonary embolism)
  • Pain, redness or swelling in your leg– these may be signs of a blood clot in the leg (deep vein thrombosis)
  • Yellowing of the skin and whites of the eyes (jaundice), or an increase in liver enzymes – these may be signs of an inflamed liver (hepatitis)

Stop taking Fenofibrate Capsules and see a doctor straight away if you notice any of the side effects above

Other side effects

Common: may affect up to 1 in 10 people

  • Diarrhoea
  • Stomach pain
  • Wind (flatulence)
  • Feeling sick (nausea)
  • Being sick (vomiting)
  • Raised levels of liver enzymes in the blood – shown in tests
  • Increase in homocysteine (too much of this amino acid in the blood has been associated with a higher risk of coronary heart disease, stroke and peripheral vascular disease, although a causal link has not been established)

Uncommon: may affect up to 1 in 100 people

  • Headache
  • Gallstones
  • Reduced sex drive
  • Rash, itching or red patches on the skin
  • Increase in ‘creatinine’ produced by the kidneys – shown in tests
  • Pancreatitis (inflammation of the pancreas leading to abdominal pain)
  • Thromboembolism: pulmonary embolism (blood clot in the lung causing chest pain and breathlessness); deep vein thrombosis (blood clot in the leg causing pain, redness or swelling)
  • Muscle pain, muscle inflammation, muscle cramps and weakness

Rare: may affect up to 1 in 10,000 people

  • Hair loss
  • Increase in ‘urea’ produced by the kidneys – shown in tests
  • Increased sensitivity of your skin to sunlight, sun lamps and sunbeds
  • Drop in haemoglobin (that carries oxygen in the blood) and white blood cells – shown in tests
  • Hepatitis (inflammation of the liver), symptoms of which may be mild jaundice (yellowing of the skin and whites of the eyes), stomach pain and itching
  • Hypersensitivity (allergic reaction) – signs may include swelling of the face/lips/tongue or throat which may cause difficulty in breathing.

Not known: frequency cannot be estimated from the available data

  • Severe form of skin rash with reddening, peeling and swelling of the skin that resembles severe burns
  • Long-term lung problems
  • Muscle breakdown
  • Complications with gallbladder stones
  • Jaundice
  • Feeling exhausted (fatigue)
  • Feeling dizzy (vertigo)

If you get any unusual breathing discomfort, tell your doctor straight away.

If you get any side effects, talk to your doctor, pharmacist or nurse. This includes any side effects not listed in this leaflet.

Reporting of side effects

If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet.

  1. How to store Fenofibrate Capsules

Keep this medicine out of the sight and reach of children.

Do not use this medicine after the expiry date which is stated on the carton and blister after EXP. The expiry date refers to the last day of that month.

Do not store above 25ºC. Store in the original package.

Do not throw away any medicines via wastewater or household waste. Ask your pharmacist how to throw away medicines you no longer use. These measures will help protect the environment.

  1. Contents of the pack and other information

What Fenofibrate Capsules contain

a) Each hard-gelatin capsule contains:
Fenofibrate (Micronized)               160mg
Excipients                                        q.s.
Colour: Approved colours used in empty capsule shells.

b) Each hard-gelatin capsule contains:
Fenofibrate (Micronized)            200mg
Excipients                                     q.s.
Colour: Approved colours used in empty capsule shells.

What Fenofibrate Capsules look like and contents of the pack

Blister strip of clear transparent PVC film coated with PVdC on the inner side with a backing of aluminium foil

Pack size of 7, 14, 28, 30, 50, 90, 100, and 500 capsules.

Not all pack sizes may be marketed.

7. Manufactured In India By:
TAJ PHARMACEUTICALS LTD.
Mumbai, India
Unit No. 214.Old Bake House,
Maharashtra chambers of  Commerce Lane,
Fort, Mumbai – 400001
at:Gujarat, INDIA.
Customer Service and Product Inquiries:
1-800-TRY-FIRST (1-800-222-434 & 1-800-222-825)
Monday through Saturday 9:00 a.m. to 7:00 p.m. EST
E-mail: tajgroup@tajpharma.com

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Taj Generics (Taj Pharma) provides a wide range of products to the Indian market, including an extensive range of generics and specialty products; Our products cover a vast array of therapeutic categories, and we offer an extensive range of dosage forms and delivery systems including oral solids, controlled-release, steriles, injectables, topicals, liquids, transdermals, semi-solids and high-potency products. Our Generics portfolio offers over 1500 products in the major therapeutic areas of gastro-intestinal, cardiovascular, pain management, oncology, anti-infectives, paediatrics and dermatology.