Head-to-head clinical analysis & difference comparison: details on mechanism of action, dosing, half-life, interactions, and maternal-fetal safety.
ATROMID-S vs LIPIDIL
Clinician-reviewed, head-to-head comparison of mechanism, dosing, pharmacokinetics, and safety profiles.
Last clinically reviewed: July 2026 · OpiCalc Medical Review Team
Inhibits hepatic triglyceride synthesis and increases lipoprotein lipase activity, leading to reduced VLDL and triglycerides.
LIPIDIL (fenofibrate) is a fibric acid derivative that activates peroxisome proliferator-activated receptor-alpha (PPAR-alpha), leading to increased lipolysis and clearance of triglyceride-rich particles, and increased synthesis of apolipoproteins A-I and A-II.
Type III hyperlipoproteinemia,Hypertriglyceridemia (Fredrickson types IV and V) not responsive to diet
Primary hypercholesterolemia or mixed dyslipidemia (as adjunct to diet),Severe hypertriglyceridemia,Prevention of pancreatitis in patients with hypertriglyceridemia
500 mg to 1 g orally twice daily. Maximum dose 2 g/day.
130 mg orally once daily.
Terminal elimination half-life is 6-8 hours in patients with normal renal function; may be prolonged to 12-24 hours in renal impairment.
Terminal elimination half-life of fenofibric acid is approximately 20 hours (range 15-25 hours). This supports once-daily dosing; steady-state is achieved after ~5 days.
Hepatic via glucuronidation and oxidation; major metabolite is clofibric acid.
Fenofibrate is metabolized primarily by glucuronidation; fenofibric acid is further metabolized via reduction to benzhydrol metabolite. Minor involvement of CYP450 enzymes, predominantly CYP3A4.
Primarily renal excretion as glucuronide conjugates; approximately 60-70% of the dose is excreted in urine, 20-30% in feces via biliary elimination.
Primarily renal excretion of glucuronide conjugates; approximately 70% of a single oral dose is recovered in urine (mostly as fenofibric acid glucuronide), and about 6% is excreted in feces.
>95% bound to plasma proteins, primarily albumin.
Fenofibric acid is highly bound to plasma proteins, primarily albumin, with >99% binding.
0.11-0.14 L/kg; low Vd indicates limited extravascular distribution, consistent with high protein binding.
Apparent volume of distribution (Vd/F) is approximately 0.9 L/kg, indicating distribution into total body water.
Oral: approximately 60-70% due to first-pass metabolism; administered as clofibrate (prodrug) which is hydrolyzed to active clofibric acid.
Absolute bioavailability of fenofibrate (prodrug) is not determined; fenofibrate is rapidly converted to fenofibric acid with a relative bioavailability of approximately 81-96% compared to the micronized formulation when taken with food. Absorption is enhanced when taken with meals.
GFR 30-59 m L/min: 500 mg twice daily. GFR 15-29 m L/min: 250 mg twice daily. GFR <15 m L/min: avoid use.
GFR 30-89 m L/min: 130 mg once daily; GFR <30 m L/min: contraindicated.
Child-Pugh Class B or C: avoid use or reduce dose by at least 50%; not recommended in severe hepatic impairment.
Child-Pugh class A: 130 mg once daily; Child-Pugh class B or C: contraindicated.
Not recommended; safety and efficacy not established in pediatric patients.
Not recommended for use in pediatric patients.
Start at lower end of dosing range (500 mg twice daily). Monitor renal function; adjust dose based on GFR.
No dose adjustment required, but monitor renal function due to age-related decline.
None
There is no FDA black box warning for LIPIDIL.
Hepatotoxicity,Cholelithiasis,Renal impairment dose adjustment,Rhabdomyolysis risk with statins,Malignancy risk (hepatic, GI)
Hepatotoxicity: elevated liver enzymes reported; monitor liver function,Myopathy/rhabdomyolysis: increased risk when combined with statins or in renal impairment,Renal impairment: dose adjustment required; avoid in severe renal impairment,Cholelithiasis: increased bile cholesterol saturation may lead to gallstones, Pancreatitis: despite triglyceride reduction, pancreatitis can occur
Hypersensitivity to clofibrate,Active liver disease,Severe renal dysfunction,Primary biliary cirrhosis,Pregnancy
Severe renal impairment (e GFR < 30 m L/min),Active liver disease including primary biliary cirrhosis,Pre-existing gallbladder disease,Hypersensitivity to fenofibrate or any component,Nursing mothers (due to potential for tumorigenicity in animal studies)
High-fat meals may reduce absorption; consistent timing of administration with food is recommended. Grapefruit juice may increase drug levels; avoid excessive intake. Alcohol may exacerbate hepatotoxicity.
Take with food to enhance absorption. Avoid high-fat meals that may exacerbate hypertriglyceridemia. Grapefruit juice has minimal interaction but caution is advised with statin combinations. Alcohol should be limited or avoided due to potential for elevated triglycerides and hepatotoxicity.
FDA Pregnancy Category C. First trimester: Potential for teratogenicity based on animal studies showing skeletal and visceral anomalies. Human data limited; use only if benefit outweighs risk. Second and third trimesters: May cause fetal harm due to placental transfer and potential for reduced fetal growth.
Lipidil (fenofibrate) is contraindicated in pregnancy. Animal studies show fetal toxicity at high doses. Human data are insufficient, but risk cannot be excluded. First trimester: possible embryotoxicity; second and third trimesters: potential for fetal harm due to interference with lipid metabolism.
Excreted into breast milk in low amounts; M/P ratio not established. Due to potential for serious adverse effects in infants, a decision should be made to discontinue nursing or discontinue the drug, taking into account the importance of the drug to the mother.
Contraindicated during breastfeeding. Fenofibrate is excreted in breast milk in animal studies; M/P ratio unknown in humans. Potential for serious adverse effects in breastfed infants, including interference with fatty acid metabolism.
No specific dosing adjustments recommended due to lack of data. However, pharmacokinetic changes in pregnancy (increased volume of distribution, altered metabolism) may necessitate careful monitoring and empiric dose adjustments based on clinical response and adverse effects.
Lipidil is contraindicated in pregnancy; no dose adjustment recommended. Therapy should be discontinued upon conception or if pregnancy is planned. There are no established dose adjustments for pregnant women due to lack of safety data.
ATROMID-S (clofibrate) is a fibric acid derivative primarily indicated for hyperlipidemia but its use is now limited due to increased non-cardiovascular mortality and cholelithiasis risk. Monitor liver function and prothrombin time (potentiates warfarin). Not first-line; consider statins or fibrates like fenofibrate.
Lipidil (fenofibrate) is a PPARα agonist used primarily for severe hypertriglyceridemia and mixed dyslipidemia. Monitor renal function at baseline and periodically; reduce dose in CKD (e GFR <60 m L/min). Avoid in severe hepatic impairment or gallbladder disease. Combines with statins but increases risk of myopathy; monitor for muscle symptoms. May raise serum creatinine and homocysteine levels. Tablet should be swallowed whole; do not crush or chew.
Take with meals to reduce gastrointestinal upset.,Report unexplained muscle pain, tenderness, or weakness; may indicate myopathy.,Avoid alcohol as it may increase liver enzyme elevations.,Notify your doctor if you develop gallstones symptoms (e.g., right upper abdominal pain, nausea).,Use effective contraception as clofibrate may cause fetal harm.
Take with food to improve absorption and reduce stomach upset.,Avoid alcohol as it can worsen triglyceride levels and liver effects.,Report unexplained muscle pain, tenderness, or weakness immediately.,Inform your doctor if you have kidney or liver disease, or gallbladder problems.,This medication may increase the effects of blood thinners (warfarin); monitor INR closely.,Do not take if you are pregnant or breastfeeding without consulting your doctor.
No interactions on record
No interactions on record
Explore head-to-head clinical comparisons of other medications in the same therapeutic classes.
Common clinical questions about ATROMID-S vs LIPIDIL, answered by our medical review team.
ATROMID-S is a Antilipemic Agent that works by Inhibits hepatic triglyceride synthesis and increases lipoprotein lipase activity, leading to reduced VLDL and triglycerides.. LIPIDIL is a Fibrate Antilipemic that works by LIPIDIL (fenofibrate) is a fibric acid derivative that activates peroxisome proliferator-activated receptor-alpha (PPAR-alpha), leading to increased lipolysis and clearance of triglyceride-rich particles, and increased synthesis of apolipoproteins A-I and A-II.. They differ in pharmacokinetic profiles, FDA-approved indications, and side effect profiles.
Potency comparisons between ATROMID-S and LIPIDIL depend on the specific clinical indication. These are agents from distinct pharmacological classes and are not directly interchangeable by dose. A physician or clinical pharmacist should guide any therapeutic switching decisions.
The standard adult dose of ATROMID-S is: 500 mg to 1 g orally twice daily. Maximum dose 2 g/day.. The standard adult dose of LIPIDIL is: 130 mg orally once daily.. Dosing should always be individualized based on indication, renal and hepatic function, age, and other patient factors.
No direct drug-drug interaction has been formally documented between ATROMID-S and LIPIDIL in current clinical databases. However, individual patient risk factors including other medications, organ function, and comorbidities should always be evaluated by a qualified healthcare provider.
The maternal-fetal safety profiles differ. ATROMID-S is classified as Category C. FDA Pregnancy Category C. First trimester: Potential for teratogenicity based on animal studies showing skeletal and visceral anomalies. Human data limited; use only if benefit out. LIPIDIL is classified as Category C. Lipidil (fenofibrate) is contraindicated in pregnancy. Animal studies show fetal toxicity at high doses. Human data are insufficient, but risk cannot be excluded. First trimester: . Always consult a maternal-fetal medicine specialist before taking either drug during pregnancy or lactation.