Head-to-head clinical analysis & difference comparison: details on mechanism of action, dosing, half-life, interactions, and maternal-fetal safety.
TRICOR (MICRONIZED) vs FENOFIBRIC ACID
Clinician-reviewed, head-to-head comparison of mechanism, dosing, pharmacokinetics, and safety profiles.
Last clinically reviewed: July 2026 · OpiCalc Medical Review Team
Tricor (micronized fenofibrate) is a peroxisome proliferator-activated receptor alpha (PPARα) agonist that increases lipolysis and elimination of triglyceride-rich particles from plasma by activating lipoprotein lipase and reducing production of apolipoprotein C-III.
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.
Adjunctive therapy to diet for adult patients with primary hypercholesterolemia or mixed dyslipidemia (Fredrickson types IIa and IIb),Adjunctive therapy to diet for adult patients with severe hypertriglyceridemia (Fredrickson types IV and V),Fenofibrate is indicated as an adjunct to diet to reduce elevated LDL-C, total-C, triglycerides, and Apo B, and to increase HDL-C in patients with primary hypercholesterolemia or mixed dyslipidemia,Reduction of triglycerides in patients with hypertriglyceridemia (types IV and V hyperlipidemia)
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)
Initial 48 mg (1 tablet) orally once daily with meals. May increase to 96 mg (2 tablets) once daily with meals. Maximum dose 96 mg/day.
135 mg orally once daily
Terminal elimination half-life is approximately 20 hours (range 15-25 hours) in patients with normal renal function. Half-life is prolonged in renal impairment, requiring dose adjustment when e GFR < 30 m L/min/1.73 m².
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.
Fenofibrate is a prodrug that is rapidly hydrolyzed by esterases to the active metabolite, fenofibric acid. Fenofibric acid is further metabolized by glucuronidation and excreted in urine. Major metabolic pathways involve hepatic glucuronidation via UGT1A1 and UGT1A3, with minor CYP-mediated metabolism (CYP3A4, CYP2C9).
Primarily hepatic via glucuronidation; minor CYP3A4 involvement. Excreted as glucuronide conjugates in urine and feces.
Primarily renal excretion of glucuronide conjugate, accounting for approximately 60-70% of elimination; fecal excretion accounts for about 25%. Minimal unchanged drug in urine.
Primarily renal as unchanged drug and glucuronide conjugate (approximately 60-70% of dose); remainder eliminated via biliary/fecal routes (~25%).
Highly protein-bound (>99%), primarily to albumin.
Highly bound to serum albumin (approximately 99%).
Apparent volume of distribution is approximately 0.5 L/kg (range 0.2-0.9 L/kg). This moderate Vd indicates limited extravascular distribution, primarily intravascular and interstitial fluid spaces.
Approximately 0.4 L/kg (range 0.2-0.6 L/kg), indicating distribution mainly in extracellular fluid.
Oral bioavailability is approximately 66% (range 50-90%) after administration of micronized fenofibrate capsules taken with food. Absorption is enhanced by food; bioavailability is reduced when taken on an empty stomach.
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.
Contraindicated in severe renal impairment (e GFR <30 m L/min/1.73 m²). For mild to moderate impairment (e GFR 30-80 m L/min/1.73 m²), reduce dose to 48 mg once daily. Not to exceed 48 mg/day.
If e GFR 30-59 m L/min: reduce dose to 45 mg orally once daily. If e GFR <30 m L/min: contraindicated.
Contraindicated in active liver disease or unexplained persistent liver function abnormalities. For Child-Pugh class A or B, avoid use due to potential risk; no specific dose adjustment recommendations, but cautious use only if benefit outweighs risk. Contraindicated in Child-Pugh class C.
Contraindicated in Child-Pugh class B or C; no dose adjustment defined for Child-Pugh A (use with caution).
Safety and effectiveness in pediatric patients have not been established; use not recommended in children.
Not approved for use in pediatric patients.
Select dose cautiously starting at the lower end of dosing range (48 mg once daily) due to possible decreased renal function and increased risk of adverse effects. Monitor renal function and adjust accordingly.
No specific dose adjustment required; consider renal function and potential for decreased renal clearance in elderly.
There is no FDA black box warning for Tricor (micronized fenofibrate).
None
Hepatotoxicity: elevations of serum transaminases; monitor liver function tests,Cholelithiasis: fenofibrate may increase cholesterol excretion into bile, leading to gallstones,Pancreatitis: risk may be increased, especially in patients with severe hypertriglyceridemia,Myopathy/rhabdomyolysis: risk increased when used with HMG-Co A reductase inhibitors (statins) or other fibrates,Renal impairment: dose adjustment required; contraindicated in severe renal impairment (e GFR <30 m L/min/1.73 m²)
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.
Severe renal impairment (e GFR <30 m L/min/1.73 m²) or end-stage renal disease,Active liver disease, including primary biliary cirrhosis and unexplained persistent liver function abnormalities,Pre-existing gallbladder disease,Known hypersensitivity to fenofibrate or any component of the formulation,Breastfeeding (due to potential for serious adverse reactions in nursing infants)
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.
Take with food to enhance absorption. Avoid grapefruit juice. Limit alcohol intake. Maintain a low-fat diet as part of triglyceride management.
Take with food to enhance absorption and reduce gastrointestinal intolerance. Avoid high-fat meals as they may exacerbate hypertriglyceridemia and reduce drug efficacy.
FDA Pregnancy Category C. First trimester: No adequate human studies; animal studies show fetal skeletal variations at high doses. Second and third trimesters: Avoid due to potential fetal harm and insufficient data. Use only if benefit outweighs risk.
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.
No data on milk concentration or M/P ratio. Not recommended due to potential for adverse effects in nursing infant; alternatives should be considered.
Excreted in breast milk in rats; human data unknown. Use caution, especially in preterm or jaundiced infants. M/P ratio not established.
No established dosing adjustments. Pharmacokinetics may be altered due to increased plasma volume and renal clearance; monitor efficacy and safety. Consider therapy discontinuation.
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.
Monitor renal function before and during therapy; reduce dose in e GFR 30-59 m L/min; contraindicated in severe renal impairment (e GFR <30 m L/min). May increase serum creatinine and transaminases. Avoid in active liver disease or unexplained persistent transaminase elevation. Risk of myopathy increases when coadministered with statins, especially in renal impairment. Can be used in combination with statins but monitor for muscle symptoms. Dose adjustment not required in mild to moderate hepatic impairment but use with caution.
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).
Take with food to improve absorption and reduce GI side effects.,Swallow capsules whole; do not crush, chew, or open.,Avoid consuming grapefruit juice as it may increase drug levels.,Report unexplained muscle pain, tenderness, or weakness, especially if accompanied by fever or malaise.,May cause gallstones; report right upper abdominal pain, nausea, or vomiting.,Avoid alcohol as it may increase triglyceride levels and liver effects.,This medication is not a substitute for a healthy diet and exercise; continue lifestyle modifications.,Inform your doctor if you have kidney or liver disease, diabetes, or if you are pregnant or breastfeeding.
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).
No interactions on record
"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."
Explore head-to-head clinical comparisons of other medications in the same therapeutic classes.
Common clinical questions about TRICOR (MICRONIZED) vs FENOFIBRIC ACID, answered by our medical review team.
TRICOR (MICRONIZED) is a Fibrate Antilipemic that works by Tricor (micronized fenofibrate) is a peroxisome proliferator-activated receptor alpha (PPARα) agonist that increases lipolysis and elimination of triglyceride-rich particles from plasma by activating lipoprotein lipase and reducing production of apolipoprotein C-III.. 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.. They differ in pharmacokinetic profiles, FDA-approved indications, and side effect profiles.
Potency comparisons between TRICOR (MICRONIZED) and FENOFIBRIC ACID 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 TRICOR (MICRONIZED) is: Initial 48 mg (1 tablet) orally once daily with meals. May increase to 96 mg (2 tablets) once daily with meals. Maximum dose 96 mg/day.. The standard adult dose of FENOFIBRIC ACID is: 135 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 TRICOR (MICRONIZED) and FENOFIBRIC ACID 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. TRICOR (MICRONIZED) is classified as Category C. FDA Pregnancy Category C. First trimester: No adequate human studies; animal studies show fetal skeletal variations at high doses. Second and third trimesters: Avoid due to potenti. 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. Always consult a maternal-fetal medicine specialist before taking either drug during pregnancy or lactation.