Head-to-head clinical analysis & difference comparison: details on mechanism of action, dosing, half-life, interactions, and maternal-fetal safety.
TRIGLIDE vs ATROMID-S
Clinician-reviewed, head-to-head comparison of mechanism, dosing, pharmacokinetics, and safety profiles.
Last clinically reviewed: July 2026 · OpiCalc Medical Review Team
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.
Inhibits hepatic triglyceride synthesis and increases lipoprotein lipase activity, leading to reduced VLDL and triglycerides.
Adjunctive therapy to diet for severe hypertriglyceridemia (Fredrickson types IV and V),Primary hypercholesterolemia or mixed dyslipidemia (Fredrickson types IIa and IIb)
Type III hyperlipoproteinemia,Hypertriglyceridemia (Fredrickson types IV and V) not responsive to diet
Initial dose: 60 mg (1 tablet) twice daily, gradually increased over 3-7 days to maintenance dose of 120 mg twice daily.
500 mg to 1 g orally twice daily. Maximum dose 2 g/day.
22-35 hours; prolonged in renal impairment (up to 50 hours).
Terminal elimination half-life is 6-8 hours in patients with normal renal function; may be prolonged to 12-24 hours in renal impairment.
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.
Hepatic via glucuronidation and oxidation; major metabolite is clofibric acid.
Primarily renal (70% as unchanged drug), 20% fecal, <10% biliary.
Primarily renal excretion as glucuronide conjugates; approximately 60-70% of the dose is excreted in urine, 20-30% in feces via biliary elimination.
>99% to albumin.
>95% bound to plasma proteins, primarily albumin.
0.11-0.16 L/kg; indicates limited extravascular distribution.
0.11-0.14 L/kg; low Vd indicates limited extravascular distribution, consistent with high protein binding.
60-70% (oral).
Oral: approximately 60-70% due to first-pass metabolism; administered as clofibrate (prodrug) which is hydrolyzed to active clofibric acid.
No specific dose adjustment for GFR >10 m L/min; avoid use in patients with GFR <10 m L/min or on dialysis.
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.
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.
Child-Pugh Class B or C: avoid use or reduce dose by at least 50%; not recommended in severe hepatic impairment.
Not approved for pediatric patients; safety and efficacy not established.
Not recommended; safety and efficacy not established in pediatric patients.
Use lowest effective dose; monitor for cardiac and electrolyte disturbances; start at 60 mg twice daily and titrate slowly.
Start at lower end of dosing range (500 mg twice daily). Monitor renal function; adjust dose based on GFR.
None
None
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
Hepatotoxicity,Cholelithiasis,Renal impairment dose adjustment,Rhabdomyolysis risk with statins,Malignancy risk (hepatic, GI)
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)
Hypersensitivity to clofibrate,Active liver disease,Severe renal dysfunction,Primary biliary cirrhosis,Pregnancy
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.
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.
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.
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.
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.
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.
No dose adjustment guidelines due to contraindication. Pharmacokinetics in pregnancy not studied; no recommended dose changes.
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.
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.
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.
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.
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.
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 TRIGLIDE vs ATROMID-S, answered by our medical review team.
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.. ATROMID-S is a Antilipemic Agent that works by Inhibits hepatic triglyceride synthesis and increases lipoprotein lipase activity, leading to reduced VLDL and triglycerides.. They differ in pharmacokinetic profiles, FDA-approved indications, and side effect profiles.
Potency comparisons between TRIGLIDE and ATROMID-S 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 TRIGLIDE is: Initial dose: 60 mg (1 tablet) twice daily, gradually increased over 3-7 days to maintenance dose of 120 mg twice daily.. The standard adult dose of ATROMID-S is: 500 mg to 1 g orally twice daily. Maximum dose 2 g/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 TRIGLIDE and ATROMID-S 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. 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. 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. Always consult a maternal-fetal medicine specialist before taking either drug during pregnancy or lactation.