Fenofibrate- Oral anticoagulants-

It increase clotting time and causes bleeding complications. Concomittant administration needs frequent prothrombin time determination

Resins- it impede the absorption the absorption of fenofibrate

Atorvastatin- The risk of myopasthy during treatment with other drugs of this class is increased with concurrent administration.of cyclosporine, fibric acid derivatives, niacin ( nicotinic acid ) eryrthromycin, azole antifungals

Antacids, colestitpol, when coadministred with atorvastatin decreases the plasma concentration of atorvastatin

Co-administration of atorvastain with digoxin, eryhrthromycin,

oral contraceptivs increases the plasma concentration of digoxin, eryhtromycin and oral contraceptives

Mixed dyslipidermia

Fenofibrate- Abnormal liver function tests ,abdominal pain, back pain, respiratory disorder, rhinitis, increase in SGOT, SGPT and creatinine phosphoinase

Atorvastatin- Constipation, flatulence, dyspepsia, abdominal pain, headache, nausea, myalgia, asthenia, diarrhoea, insomnia

Fenofibrate-

Hypersentivity, hepatic and renal dysfunction,unexplained persistent liver function abnormality and primary billiary cirrhosis.

Patients with preexisting gall bladder disease and in lactating mothers.

Atorvastatin-

Active liver disease or unexplained persistent elevation of serum transaminases. Hypersensitivity to any component of this mnedication

Pregnancy and lactation Women of child bearing potential unless on an effective contraceptive and highly unlikely to conceive

Approved by (DCI) Drug Controller  GENERAL -  India  For Marketing                                                                                   (Ref- IDMA Publication)

Indication-

Mixed dyslipidermia

Dosage-

1 tab daily

Pharmacology

Fenofibrate-  reduces plasma total cholestrerol (TC) LDL- C , triglyceride TG ans very low density liopoprotein cholesterol (HDL-C), and apolipoprotein (Apo) AL and ApoAII levels in patients with dyslipedemia.

The lipid modifying effects of fenofubrate are mediated via the activation of the peroxisome proliferator- activated receptors ( PPARs )

Atorvastatin- inhibits hydroxymethylglutaryl coenzyme A HMG-CoA reductase in vivo and in vitro and impedes the formation of mevalonic acid which is the rate limiting step in the biosynthesis of cholesterol.

The reduction in intracellular cholesterol increases the number of LDL receptors, thus increasing the clearance of LDL-C from plasma.

Pharmacokinetics

The result of the study showed that atorvastatin fenofibrate combination reduced total cholesterol by 37%, LDL cholestrol by 46%.

The study concluded that atorvastain-fenofibrate combination has a highly beneficial efect on all lipid parameters and plasma fibronogen in patients with type 2 diabetes and combined hyperlipidermia

Use contraindicated observe caution