Not FDA approved

GOOGLE OVERVIEW

• Lipid Lowering: Bezafibrate effectively lowers high levels of triglycerides (up to 50%) and low-density lipoprotein (LDL) cholesterol ("bad" cholesterol) (up to 20%), while simultaneously increasing high-density lipoprotein (HDL) cholesterol("good" cholesterol) (up to 20%).
• Hyperlipidaemia and Hypertriglyceridemia: It's specifically used to treat hyperlipidaemia, particularly when associated with high triglyceride levels. In patients with hypertriglyceridemia and coronary artery disease, bezafibrate has been associated with a significant long-term reduction in mortality.
• PPAR Agonism: Bezafibrate acts as an agonist for peroxisome proliferator-activated receptors (PPARs), particularly PPAR-α. This mechanism involves:
  • Reducing the liver's secretion of very low-density lipoprotein (VLDL).
  • Increasing the activity of triglyceride lipases, which break down triglyceride-rich lipoproteins.
  • Reducing cholesterol biosynthesis and stimulating LDL-receptor mediated lipoprotein catabolism. 

• Gastrointestinal Issues: Common side effects include nausea, stomach pain, gas, and stomach upset. These are often mild and may improve with time.
• Muscle Problems: Muscle aches, pain, cramps, or weakness (myopathy) can occur. In rare instances, this can escalate to a serious condition called rhabdomyolysis, which involves rapid muscle tissue breakdown and potential kidney damage.
• Liver Function: Bezafibrate can affect liver function, potentially causing elevated liver enzymes. Regular monitoring of liver function tests is important.
• Other potential side effects: Allergic reactions (rash, hives, itching, swelling), headaches, dizziness, skin redness, and problems with renal (kidney) function. 

• Bezafibrate is typically administered as an oral medication.
• Standard dosage often involves 200 mg three times daily, or a sustained-release preparation of 400 mg once daily.
• It should be taken with or after meals.
• The sustained-release tablets should be swallowed whole and not chewed, crushed, or broken.
• Dosage adjustments may be necessary for individuals with impaired renal (kidney) function. 

• Statins: Caution is advised when combining bezafibrate with statins, particularly in patients predisposed to muscle disease, due to an increased risk of muscle-related side effects.
• Warfarin: Bezafibrate may enhance the anticoagulant effect of warfarin, potentially increasing the risk of bleeding.
• Other Medications: Bezafibrate can interact with a variety of other medications, including:
  • Medications that increase the risk or severity of myopathy or rhabdomyolysis.
  • Medications that affect blood sugar levels (sulfonylureas).
  • Certain medications that can decrease bezafibrate's metabolism or excretion.
• Contraindications: Bezafibrate is not recommended for individuals with primary biliary cirrhosis, pre-existing gallbladder disease, or Type I hyperlipoproteinemia. It is also contraindicated in pregnant or breastfeeding women. 

• Mitochondrial Function: Bezafibrate has shown promise in preclinical studies and is being investigated for its potential role in improving mitochondrial function in conditions such as mitochondrial myopathy.
• X-Linked Adrenoleukodystrophy (X-ALD): Clinical trials are exploring bezafibrate's ability to reduce very long chain fatty acids (VLCFA) in patients with X-ALD.
• Diabetes and Metabolic Syndrome: Compared to other fibrates, bezafibrate has shown positive effects on glucose metabolism and insulin resistance, potentially reducing the incidence of type 2 diabetes.