Clofibrine acid derivatives and analogs

Pharmacology and toxicology

Clofibrate is a lipid reducer that acts on the triglycerides and, to a limited extent, on cholesterol It is used for primary hyperlipidemia. Clofibrate has been withdrawn from the market in some countries because of serious side effects. In animal studies, clofibrate was identified in fetal tissue and was capable of inducing fetal hepatic enzymes. Because of the reduced glucuronide conjugation of clofibrate in the fetus, it is possible that fetal accumulation of the drug could occur with treatment towards the end of prcgnancy.

The analog products bezafibrate, etofibrate, fenofibrate, ciprofi-brate, and gemfibrozil can be evaluated pharmacologically and tox-icologically in the similar manner as Clofibrate.

Experience with Clofibrate - and primarily with the other ingredients - is very limited and insufficient for risk assessment, but no reports linking the use of Clofibrate with congenital defects have been located.

Recommendation. Clofibrate, like bezafibrate, etofibrate, fenofibrate, and gemfibrozil, should not be prescribed during pregnancy. Inadvertent treatment with these lipid reducers during pregnancy does not necessitate either termination of pregnancy or invasive diagnostic procedures.

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