Head-to-head clinical analysis & difference comparison: details on mechanism of action, dosing, half-life, interactions, and maternal-fetal safety.
ATROMID-S vs LIPOFEN
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.
Lipofen (fenofibrate) is a peroxisome proliferator-activated receptor alpha (PPARα) agonist. It activates PPARα, which increases lipolysis and elimination of triglyceride-rich particles from plasma by stimulating lipoprotein lipase activity and reducing apolipoprotein C-III production. This leads to decreased triglyceride levels and increased HDL cholesterol.
Type III hyperlipoproteinemia,Hypertriglyceridemia (Fredrickson types IV and V) not responsive to diet
Adjunct to diet for treatment of hypertriglyceridemia (Fredrickson types IV and V hyperlipidemia),Adjunct to diet for treatment of primary hypercholesterolemia or mixed dyslipidemia (Fredrickson types IIa and IIb) when statins are contraindicated or not tolerated
500 mg to 1 g orally twice daily. Maximum dose 2 g/day.
For hypertriglyceridemia: 67-134 mg (as fenofibric acid) orally three times daily with meals. Maximum dose 200 mg/day.
Terminal elimination half-life is 6-8 hours in patients with normal renal function; may be prolonged to 12-24 hours in renal impairment.
5-7 hours (prolonged in renal impairment; may exceed 24 hours in severe CKD).
Hepatic via glucuronidation and oxidation; major metabolite is clofibric acid.
Primarily metabolized by glucuronidation via UDP-glucuronosyltransferases (UGT1A1, UGT1A3, UGT2B7) to fenofibric acid, the active metabolite. Minor CYP450 involvement (CYP3A4, CYP2C8, CYP2C19). Renal elimination of conjugates and unchanged drug.
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 (90% as unchanged drug), with <5% fecal.
>95% bound to plasma proteins, primarily albumin.
>99% bound to albumin.
0.11-0.14 L/kg; low Vd indicates limited extravascular distribution, consistent with high protein binding.
Approximately 0.5 L/kg (low, indicating minimal tissue distribution).
Oral: approximately 60-70% due to first-pass metabolism; administered as clofibrate (prodrug) which is hydrolyzed to active clofibric acid.
Oral: 30% (first-pass effect; absorption increased with food).
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 30-59 m L/min: reduce dose by 50% (e.g., 67 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: no dose adjustment. Child-Pugh Class B or C: contraindicated due to risk of hepatotoxicity.
Not recommended; safety and efficacy not established in pediatric patients.
Not recommended in children <18 years; safety and efficacy not established.
Start at lower end of dosing range (500 mg twice daily). Monitor renal function; adjust dose based on GFR.
Start at lower end of dosing range; monitor renal function and adjust accordingly.
None
None.
Hepatotoxicity,Cholelithiasis,Renal impairment dose adjustment,Rhabdomyolysis risk with statins,Malignancy risk (hepatic, GI)
Hepatotoxicity: Elevations of serum transaminases; monitor liver function. Discontinue if ALT > 3x ULN.,Cholelithiasis: Increases cholesterol excretion into bile, risk of gallstones.,Pancreatitis: Has been reported, especially during initiation or dose escalation.,Myopathy/Rhabdomyolysis: Risk increased when co-administered with statins.,Renal impairment: Dose adjustment required. Use with caution in patients with serum creatinine > 2.0 mg/d L.,Venothromboembolic disease: Increased risk of pulmonary embolism and deep vein thrombosis in some trials.
Hypersensitivity to clofibrate,Active liver disease,Severe renal dysfunction,Primary biliary cirrhosis,Pregnancy
Severe renal impairment (e GFR < 30 m L/min/1.73 m²),Active liver disease including primary biliary cirrhosis and unexplained persistent liver function abnormalities,Pre-existing gallbladder disease,Known hypersensitivity to fenofibrate or any formulation components,Nursing mothers
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 bioavailability. Avoid high-fat meals immediately before dosing as they may delay absorption. Grapefruit juice has no significant interaction. Alcohol should be limited or avoided due to potential for increased triglyceride levels and hepatotoxicity. No specific restriction on caffeine. Ensure adequate hydration to prevent renal complications.
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.
LIPOFEN (fenofibrate) is classified as FDA Pregnancy Category C. Animal studies have shown embryotoxicity and teratogenicity at high doses, but no adequate human studies exist. First trimester: potential risk of congenital anomalies cannot be ruled out. Second and third trimesters: may cause fetal skeletal abnormalities and growth retardation; risk of neonatal complications if used near term. Contraindicated in pregnancy unless clearly needed.
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.
Fenofibrate is excreted in breast milk in rats; no human data. M/P ratio unknown. Due to potential for adverse effects in nursing infants, avoid use during breastfeeding or discontinue nursing.
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.
No specific dose adjustments are recommended due to lack of pharmacokinetic data in pregnancy. However, use is generally avoided; if deemed necessary, use lowest effective dose and monitor maternal and fetal status closely.
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.
LIPOFEN (fenofibrate) is a PPAR-alpha agonist that reduces triglycerides and increases HDL-C. Monitor renal function before initiation and periodically; dose adjustment required if e GFR <60 m L/min/1.73m2. Avoid use in severe renal impairment (e GFR <30). May increase serum creatinine transiently. Increases risk of cholelithiasis due to cholesterol supersaturation. Concomitant statin therapy increases risk of myopathy; monitor for muscle symptoms. Use with caution in patients with hepatic impairment; contraindicated in active liver disease. May potentiate effect of oral anticoagulants; monitor INR.
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 meals to improve absorption. Do not break, crush, or chew capsules.,Avoid alcohol consumption as it can increase triglyceride levels and risk of liver damage.,Report unexplained muscle pain, tenderness, or weakness, especially if accompanied by fever or malaise.,Notify your doctor if you develop abdominal pain, nausea, or jaundice (yellowing of skin/eyes).,Maintain a low-fat diet and exercise regularly to maximize lipid-lowering benefits.,Do not take supplements containing red yeast rice or niacin without consulting your physician.
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 LIPOFEN, 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.. LIPOFEN is a Fibrate Antilipemic that works by Lipofen (fenofibrate) is a peroxisome proliferator-activated receptor alpha (PPARα) agonist. It activates PPARα, which increases lipolysis and elimination of triglyceride-rich particles from plasma by stimulating lipoprotein lipase activity and reducing apolipoprotein C-III production. This leads to decreased triglyceride levels and increased HDL cholesterol.. They differ in pharmacokinetic profiles, FDA-approved indications, and side effect profiles.
Potency comparisons between ATROMID-S and LIPOFEN 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 LIPOFEN is: For hypertriglyceridemia: 67-134 mg (as fenofibric acid) orally three times daily with meals. Maximum dose 200 mg/day.. 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 LIPOFEN 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. LIPOFEN is classified as Category C. LIPOFEN (fenofibrate) is classified as FDA Pregnancy Category C. Animal studies have shown embryotoxicity and teratogenicity at high doses, but no adequate human studies exist. Fir. Always consult a maternal-fetal medicine specialist before taking either drug during pregnancy or lactation.