Understanding Cholesterol

The ups and downs of cholesterol management can seem confusing. There are different types of cholesterol to learn about, different goal numbers to reach, and many other variables that can affect managing your cholesterol.

The basics are:

LDL-C (low-density lipoprotein cholesterol) is the “bad” cholesterol
HDL-C (high-density lipoprotein cholesterol) is the “good” cholesterol
Triglycerides make up the largest proportion of fats (lipids) in the diet and in the blood

If your triglycerides and your LDL “bad” cholesterol are high, but your HDL “good” cholesterol is low, your doctor may prescribe treatment to control your cholesterol in addition to
diet and exercise.

Cholesterol

Cholesterol, a waxy, fat-like substance made in the liver, is found in every cell of the body. Cholesterol is needed to produce cell membranes and certain hormones. Because the body makes enough cholesterol to do these things, it’s not necessary to have extra cholesterol in your diet. But cholesterol is in many foods, such as egg yolk, meat, chicken, fish, and dairy products containing “saturated fats.” Excessive intake of saturated fats, which stay solid at room temperature, may further increase your risks of cardiovascular disease. Read about the different types of cholesterol.

Lipoproteins

Fatty cholesterol is not water soluble and does not travel very easily through blood, which is mostly water. In order to make moving through the blood easier, cholesterol travels in little
packages called lipoproteins. The two types of lipoproteins are HDL and LDL:

High-density lipoprotein cholesterol — HDL-C — is the “good” cholesterol. A high level of HDL-C is desirable and may decrease heart attack and stroke risk, while a low level may increase these risks.
Low-density lipoprotein cholesterol — LDL-C — is the “bad” cholesterol. A high LDL-C level can cause cholesterol to build up on the artery walls, increasing the risk for heart attack.

Triglycerides

Triglycerides are the most common form of fat in the body. They are stored in fat cells to be used as energy. They too are made by the body and found in many foods. Elevated levels of triglycerides are also linked to developing heart disease. Learn more about triglycerides.

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Important Safety Information

ANTARA® (fenofibrate) capsules is contraindicated in patients with hypersensitivity to fenofibrate, in patients with hepatic or severe renal dysfunction including primary biliary cirrhosis, in patients with unexplained persistent liver function abnormality, and in patients with preexisting gallbladder disease.
Fenofibrate has been associated with increases in serum transaminases. Regular periodic monitoring of liver function should be performed, for duration of therapy, and therapy discontinued if enzyme levels persist above 3 times the normal limit.
There are no adequate and well-controlled studies in pregnant women. Fenofibrate should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.
Improving glycemic control in diabetic patients showing fasting chylomicronemia will usually reduce fasting triglycerides and eliminate chylomicronemia thereby obviating the need for pharmacologic intervention. Markedly elevated levels of serum triglycerides (eg, >2000 mg/dL) may increase the risk of developing pancreatitis. ANTARA therapy on reducing this risk has not been studied.
Fenofibrate may increase cholesterol excretion into the bile, leading to cholelithiasis. If cholelithiasis is suspected, ANTARA therapy should be discontinued.
The combined use of ANTARA and HMG-CoA reductase inhibitors should be avoided unless the benefit of further alterations in lipid levels is likely to outweigh the increased risk. The combined use of fibric acid derivatives and HMG-CoA reductase inhibitors has been associated with rhabdomyolysis, markedly elevated creatine kinase levels, and myoglobinuria, leading to acute renal failure.
The use of fibrates alone including ANTARA, may occasionally be associated with myositis, myopathy, or rhabdomyolysis. Patients complaining of muscle pain, tenderness, or weakness should have prompt medical evaluation for myopathy. Discontinue ANTARA if myopathy or myositis is suspected or diagnosed.
The effect of ANTARA on coronary heart disease morbidity and mortality and noncardiovascular mortality has not been established.
Patients treated with other fibrate drugs experienced an increase in noncardiovascular and cardiovascular morbidity and mortality compared with placebo-treated patients.
Other precautions include pancreatitis, hypersensitivity reactions, and hematologic changes. Refer to full Prescribing Information for a complete list of precautions.
Caution should be exercised when coumarin anticoagulants are given in conjunction with ANTARA. The dosage of the anticoagulants should be reduced to maintain the prothrombin time/INR at the desired level to prevent bleeding complications. Frequent prothrombin time/INR determinations are advisable until it has been definitely determined that the prothrombin time/INR has stabilized.
Since bile acid sequestrants may bind other drugs given concurrently, patients should take ANTARA at least 1 hour before or 4–6 hours after a bile acid binding resin to avoid impeding its absorption.
Cyclosporine can produce nephrotoxicity with decreases in creatinine clearance and rises in serum creatinine. Because renal excretion is the primary elimination route of fibrate drugs including ANTARA, there is a risk that an interaction will lead to deterioration. The benefits and risks of using ANTARA with immunosuppressants and other potentially nephrotoxic agents should be carefully considered, and lowest effective dose employed.
Fenofibric acid is known to be substantially excreted by the kidney, and the risk of adverse reactions to this drug may be greater in patients with impaired renal function. Because elderly patients are more likely to have decreased renal function, care should be taken in dose selection.
The most common (≥2% reported in clinical trials) side effects are: abnormal liver function test, including increased AST; increased ALT; CPK increase; respiratory disorder; abdominal pain; back pain; headache; diarrhea; nausea; rhinitis; asthenia; flu syndrome and constipation.

Please see full Prescribing Information.

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