Head-to-head clinical analysis & difference comparison: details on mechanism of action, dosing, half-life, interactions, and maternal-fetal safety.
FENOFIBRIC ACID vs TRIGLIDE
Clinician-reviewed, head-to-head comparison of mechanism, dosing, pharmacokinetics, and safety profiles.
Last clinically reviewed: July 2026 · OpiCalc Medical Review Team
Fenofibric acid is a peroxisome proliferator-activated receptor alpha (PPARα) agonist that increases lipolysis and clearance of triglyceride-rich lipoproteins and reduces apolipoprotein C-III production, leading to decreased triglycerides and increased HDL cholesterol.
TRIGLIDE (fenofibrate) is a peroxisome proliferator-activated receptor alpha (PPARα) activator. It increases lipolysis and elimination of triglyceride-rich particles from plasma by activating lipoprotein lipase and reducing production of apolipoprotein C-III.
Adjunct to diet for treatment of severe hypertriglyceridemia (Fredrickson types IV and V hyperlipidemia),Adjunct to diet for reduction of LDL-C, total-C, triglycerides, and Apo B in primary hypercholesterolemia or mixed dyslipidemia (Fredrickson types IIa and IIb)
Adjunctive therapy to diet for severe hypertriglyceridemia (Fredrickson types IV and V),Primary hypercholesterolemia or mixed dyslipidemia (Fredrickson types IIa and IIb)
135 mg orally once daily
Initial dose: 60 mg (1 tablet) twice daily, gradually increased over 3-7 days to maintenance dose of 120 mg twice daily.
Terminal elimination half-life is approximately 20 hours (range 15-25 h) for fenofibric acid, supporting once-daily dosing. In renal impairment, half-life may be prolonged.
22-35 hours; prolonged in renal impairment (up to 50 hours).
Primarily hepatic via glucuronidation; minor CYP3A4 involvement. Excreted as glucuronide conjugates in urine and feces.
Fenofibrate is a prodrug that is rapidly hydrolyzed by esterases to the active metabolite fenofibric acid. Fenofibric acid is conjugated with glucuronic acid and excreted in urine. Major CYP450 involvement is minimal; however, fenofibric acid is a substrate of CYP3A4 and to some extent CYP2C8.
Primarily renal as unchanged drug and glucuronide conjugate (approximately 60-70% of dose); remainder eliminated via biliary/fecal routes (~25%).
Primarily renal (70% as unchanged drug), 20% fecal, <10% biliary.
Highly bound to serum albumin (approximately 99%).
>99% to albumin.
Approximately 0.4 L/kg (range 0.2-0.6 L/kg), indicating distribution mainly in extracellular fluid.
0.11-0.16 L/kg; indicates limited extravascular distribution.
Oral bioavailability of fenofibric acid is approximately 100% when administered as the choline salt; the capsule formulation has high bioavailability relative to tablet. Food may reduce rate but not extent of absorption.
60-70% (oral).
If e GFR 30-59 m L/min: reduce dose to 45 mg orally once daily. If e GFR <30 m L/min: contraindicated.
No specific dose adjustment for GFR >10 m L/min; avoid use in patients with GFR <10 m L/min or on dialysis.
Contraindicated in Child-Pugh class B or C; no dose adjustment defined for Child-Pugh A (use with caution).
Contraindicated in Child-Pugh class B and C; use with caution in Child-Pugh class A with dose reduction (e.g., 60 mg twice daily) and monitor closely.
Not approved for use in pediatric patients.
Not approved for pediatric patients; safety and efficacy not established.
No specific dose adjustment required; consider renal function and potential for decreased renal clearance in elderly.
Use lowest effective dose; monitor for cardiac and electrolyte disturbances; start at 60 mg twice daily and titrate slowly.
None
None
Hepatotoxicity: elevation of serum transaminases; contraindicated in active liver disease.,Myopathy/rhabdomyolysis risk, especially with statins or in patients with renal impairment, hypothyroidism, or alcohol abuse.,Cholelithiasis: risk of gallstones due to increased cholesterol excretion into bile.,Pancreatitis: reported in hypertriglyceridemia patients.,Renal impairment: dose adjustment required; avoid in severe renal disease.,Venothromboembolic events: increased risk in clinical trials.
Hepatotoxicity: elevations in serum transaminases, rare reports of hepatitis and cirrhosis; monitor hepatic function,Cholelithiasis: increased cholesterol excretion into bile, risk of gallstone formation,Rhabdomyolysis: increased risk in patients with renal impairment, hypothyroidism, or those taking statins or other fibrates,Pancreatitis: observed in patients with severe hypertriglyceridemia,Renal impairment: contraindicated in severe renal disease; dose adjustment needed in mild-to-moderate impairment
Active liver disease including primary biliary cirrhosis and unexplained persistent liver function abnormalities.,Known gallbladder disease (cholelithiasis).,Severe renal impairment (e GFR <30 m L/min/1.73 m²).,Hypersensitivity to fenofibrate or fenofibric acid.
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,Known gallbladder disease,Hypersensitivity to fenofibrate or any component of the formulation,Nursing mothers (due to potential for tumorigenicity in animal studies)
Take with food to enhance absorption and reduce gastrointestinal intolerance. Avoid high-fat meals as they may exacerbate hypertriglyceridemia and reduce drug efficacy.
Take with food to enhance bioavailability. Avoid high-fat meals that may exacerbate hypertriglyceridemia. Limit alcohol intake as it can increase triglyceride levels and hepatotoxicity risk. Grapefruit juice has no significant interaction with fenofibrate.
Pregnancy Category C. First trimester: Data insufficient to assess risk; animal studies show embryotoxicity and teratogenicity at high doses. Second/third trimesters: Avoid use due to potential fetal harm; no well-controlled human studies.
TRIGLIDE (fenofibrate) is contraindicated in pregnancy due to potential fetal harm. First trimester: no adequate human data; animal studies show embryotoxicity and delayed ossification at doses below human exposure. Second and third trimesters: risk of fetal skeletal abnormalities and growth retardation; use only if maternal benefit outweighs risk.
Excreted in breast milk in rats; human data unknown. Use caution, especially in preterm or jaundiced infants. M/P ratio not established.
Fenofibrate is excreted in rat milk; no human data. M/P ratio unknown. Breastfeeding is contraindicated due to potential lipid metabolism disruption in infant and lack of safety data.
Avoid use during pregnancy; no established safe dose. Pharmacokinetic changes (increased volume of distribution, clearance) may reduce efficacy; dose adjustments not recommended due to potential fetal risk.
No dose adjustment guidelines due to contraindication. Pharmacokinetics in pregnancy not studied; no recommended dose changes.
Fenofibric acid is a PPARα agonist that reduces triglycerides by 30-50% and increases HDL; monitor renal function as dose adjustment required for Cr Cl 30-59 m L/min; contraindicated in severe renal impairment (Cr Cl <30 m L/min) and active liver disease; may increase serum creatinine; use with caution in patients with gallbladder disease; can potentiate warfarin effect (monitor INR).
TRIGLIDE (fenofibrate) is a fibric acid derivative used as adjunctive therapy to diet for severe hypertriglyceridemia (≥500 mg/d L) to reduce risk of pancreatitis. Monitor renal function before initiation; dose adjustment required if e GFR 30-59 m L/min (starting dose: 48 mg/day). Avoid use if e GFR <30 m L/min or active liver disease. Coadministration with statins increases risk of myopathy/rhabdomyolysis; discontinue if unexplained muscle pain or weakness occurs.
Take with food to reduce GI side effects.,Report unexplained muscle pain, tenderness, or weakness, especially if accompanied by fever or malaise.,Avoid alcohol as it can increase triglyceride levels and worsen liver effects.,This medication is not a substitute for diet and exercise; continue lifestyle modifications.,Notify your doctor if you develop abdominal pain (possible gallstones).
Take with meals to improve absorption and reduce gastrointestinal side effects.,Report unexplained muscle pain, tenderness, or weakness immediately, especially if also taking a statin.,Avoid alcohol consumption as it can worsen triglyceride levels and liver function.,You may need regular blood tests to monitor kidney function, liver enzymes, and lipid levels.,Do not take if you have severe kidney disease or active liver disease.
"Fenofibric acid, a peroxisome proliferator-activated receptor alpha (PPARα) agonist, may reduce the therapeutic efficacy of ursodeoxycholic acid (UDCA) by increasing the biliary excretion of cholesterol and altering bile acid composition, thereby counteracting the beneficial effects of UDCA in dissolving cholesterol gallstones and improving cholestatic liver diseases. This interaction can lead to reduced clinical response, including incomplete stone dissolution or worsening of liver function tests in conditions such as primary biliary cholangitis."
"Glisoxepide may increase the hypoglycemic activities of Fenofibric acid."
"Colchicine may increase the myopathic rhabdomyolysis activities of Fenofibric acid."
No interactions on record
Explore head-to-head clinical comparisons of other medications in the same therapeutic classes.
Common clinical questions about FENOFIBRIC ACID vs TRIGLIDE, answered by our medical review team.
FENOFIBRIC ACID is a Antilipemic that works by Fenofibric acid is a peroxisome proliferator-activated receptor alpha (PPARα) agonist that increases lipolysis and clearance of triglyceride-rich lipoproteins and reduces apolipoprotein C-III production, leading to decreased triglycerides and increased HDL cholesterol.. TRIGLIDE is a Fibrate Antilipemic that works by TRIGLIDE (fenofibrate) is a peroxisome proliferator-activated receptor alpha (PPARα) activator. It increases lipolysis and elimination of triglyceride-rich particles from plasma by activating lipoprotein lipase and reducing production of apolipoprotein C-III.. They differ in pharmacokinetic profiles, FDA-approved indications, and side effect profiles.
Potency comparisons between FENOFIBRIC ACID and TRIGLIDE 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 FENOFIBRIC ACID is: 135 mg orally once daily. The standard adult dose of TRIGLIDE is: Initial dose: 60 mg (1 tablet) twice daily, gradually increased over 3-7 days to maintenance dose of 120 mg twice 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 FENOFIBRIC ACID and TRIGLIDE 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. FENOFIBRIC ACID is classified as Category C. Pregnancy Category C. First trimester: Data insufficient to assess risk; animal studies show embryotoxicity and teratogenicity at high doses. Second/third trimesters: Avoid use due. TRIGLIDE is classified as Category C. TRIGLIDE (fenofibrate) is contraindicated in pregnancy due to potential fetal harm. First trimester: no adequate human data; animal studies show embryotoxicity and delayed ossifica. Always consult a maternal-fetal medicine specialist before taking either drug during pregnancy or lactation.