Last update Sept. 22, 2017

Clofibrate

Very High Risk

Very unsafe. Contraindicated. Use of an alternative or cessation of breastfeeding. Read the Comment.

Clofibrate, like other fibrates, decreases elevated blood lipids (triglycerides and cholesterol) by increasing the activity of lipases that catabolize triglyceride-rich lipoproteins and slightly decreasing cholesterol biosynthesis (Miller 1998).
In general, fibrates have a discrete effect on the increase of high density lipoprotein (HDL) concentration and the reduction of low density lipoprotein (LDL).

Since the last update we have not found published data in relation to breastfeeding.

Its high binding to plasma proteins makes it unlikely it will pass into breast milk.

Cholesterol levels in milk are very stable even in hypercholesterolemic women and are not severely affected by diet or nutritional status of the mother, suggesting that 3 is synthesized, at least in part, in the mammary gland (Lawrence 2016, p 289-90).
It is not probable therefore, but it is not known if the fibrates are able to alter the lipid composition of the milk.

Infants need to ingest large amounts of cholesterol, as it is critical to the proper development of the nervous system, cell membranes and is a precursor of several hormones and vitamins.

Suspending the pharmacological treatment of hyperlipidemia during breastfeeding is not likely to alter the long-term outcome of the disease, especially when breastfeeding can be considered therapeutic (Lawrence 2016, p.393).

It is advisable to follow a lipid-lowering diet.

In case of administering a fibrate during breastfeeding it is advisable to choose those with a shorter half-life: Bezafibrate, Gemfibrozil.

Due to increased mortality and other serious complications in patients treated with Clofibrate (Oliver 2012, WHO 1984), in most countries the product has been withdrawn from sale or restrictions have been imposed on its approved use.

It was suggested as treatment for neonatal hyperbilirubinemia (Xiong 2012, Bourget 1995).

Alternatives

  • Bezafibrate (Possibly safe. Probably compatible. Mild risk possible. Follow up recommended. Read the Comment.)
  • Colesevelam Hydrochloride ( Safe. Compatible. Minimal risk for breastfeeding and infant.)
  • Colestipol ( Safe. Compatible. Minimal risk for breastfeeding and infant.)
  • Colestyramine ( Safe. Compatible. Minimal risk for breastfeeding and infant.)
  • Gemfibrozil (Possibly safe. Probably compatible. Mild risk possible. Follow up recommended. Read the Comment.)

Suggestions made at e-lactancia are done by APILAM team of health professionals, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it. The pharmaceutical industry contraindicates breastfeeding, mistakenly and without scientific reasons, in most of the drug data sheets.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

Your contribution is essential for this service to continue to exist. We need the generosity of people like you who believe in the benefits of breastfeeding.

Thank you for helping to protect and promote breastfeeding.

José María Paricio, founder of e-lactancia.

Other names

Clofibrate is also known as


Clofibrate in other languages or writings:

Group

Clofibrate belongs to this group or family:

Tradenames

Main tradenames from several countries containing Clofibrate in its composition:

Pharmacokinetics

Variable Value Unit
Oral Bioavail. 100 %
Molecular weight 243 daltons
Protein Binding 95 - 97 %
Tmax 6 hours
14 - 35 hours

References

  1. Lawrence RA, Lawrence RM. Breastfeeding. A guide for the medical profession. Eighth Edition. Philadelphia: Elsevier; 2016
  2. Xiong T, Chen D, Duan Z, Qu Y, Mu D. Clofibrate for unconjugated hyperbilirubinemia in neonates: a systematic review. Indian Pediatr. 2012 Abstract
  3. Oliver M. The clofibrate saga: a retrospective commentary. Br J Clin Pharmacol. 2012 Abstract
  4. Miller DB, Spence JD. Clinical pharmacokinetics of fibric acid derivatives (fibrates). Clin Pharmacokinet. 1998 Abstract
  5. Bourget P, Broise I, Quinquis-Desmaris V, Gabilan JC. [Pharmacokinetics of clofibrate in jaundiced newborn infants at term]. Arch Pediatr. 1995 Abstract
  6. [No authors listed] WHO cooperative trial on primary prevention of ischaemic heart disease with clofibrate to lower serum cholesterol: final mortality follow-up. Report of the Committee of Principal Investigators. Lancet. 1984 Abstract

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