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Fenofibrate, 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 (AEMPS 2017, BGP 2015, 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.
Until there is more data in relation to breastfeeding, it is prudent to avoid using it, at least while breastfeeding exclusively.
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.