Ciprofibrate

CLINICAL USE

Hyperlipidaemia

DOSE IN NORMAL RENAL FUNCTION

100 mg daily

PHARMACOKINETICS

Molecular weight :289.2

%Protein binding :95–99

%Excreted unchanged in urine : 20–25

Volume of distribution (L/kg) :12 litres

half-life – normal/ESRD (hrs) :38–86/171.9

DOSE IN RENAL IMPAIRMENT

GFR (mL/MIN)

20 to 50 : Dose as in normal renal function

10 to 20 : 100 mg every 48 hours

<10 : Avoid. See ‘Other Information’

DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

CAPD :Not dialysed. Avoid

HD :Not dialysed. Avoid

HDF/high flux :Unknown dialysability. Avoid

CAV/VVHD :Unknown dialysability. Dose as in GFR 10 to 20 mL/min

IMPORTANT DRUG INTERACTIONS

Potentially hazardous interactions with other drugsAntibacterials: increased risk of myopathy with daptomycin – try to avoid concomitant useAnticoagulants: enhances effect of coumarins and phenindione. Dose of anticoagulant should be reduced by up to 50% and readjusted by monitoring INRAntidiabetics: may improve glucose tolerance and have an additive effect with insulin or sulphonylureasLipid-regulating drugs: increased risk of myopathy in combination with statins (do not exceed 10 mg of simvastatin1) and ezetimibe – avoid concomitant use with ezetimibe

ADMINISTRATION

Reconstition

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Route

Oral

Rate of Administration

–

Comments

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OTHER INFORMATION

Increased risk of rhabdomyolysis in doses of 200 mg or greaterApproximately 30–75% of a single dose administered to volunteers was excreted in the urine in 72 hours, either as unchanged ciprofibrate (20–25% of the total excreted) or as a conjugate. Subjects with moderate renal impairment excreted on average 7% of a single dose as unchanged ciprofibrate over 96 hours, compared with 6.9% in normal subjects. In subjects with severe insufficiency this was reduced to 4.7%

See how to identify renal failure stages according to GFR calculation

See how to diagnose irreversible renal disease

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