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The main connection between fenofibrate and atorvastatin is that they are both used to treat hypercholesterolemia, otherwise known as high cholesterol. They differ in their mechanism of action and potential side effects and may affect the different types of cholesterol to different degrees. The choice of which drug to use, between fenofibrate and atorvastatin, will be made by the treating doctor, taking a number of factors into consideration, especially each patient's lipid profile.
High cholesterol is an increasing problem worldwide and, if left untreated, can result in serious conditions such as heart attack and stroke. Cholesterol is a vital building block in the body and can be divided into three main types called triglycerides, high density lipoprotein (HDL) and low density lipoprotein (LDL). The HDL is commonly referred to as "good cholesterol" and LDL as "bad cholesterol." If the levels of LDL and/or triglycerides are too high, it may cause blockage of the blood vessels. High cholesterol may be caused by genetics but is mainly be attributed to lifestyle choices.
Diagnosis of high cholesterol will be done by doing a lipid profile, which is a simple blood test. Depending on the results, the treating doctor may recommend lifestyle changes alone, or a combination of lifestyle changes with drug treatment from one of the classes of cholesterol-lowering drugs, such as a fibrate like fenofibrate and atorvastatin, which is a statin. Lifestyle changes which will help to lower cholesterol levels include weight loss, exercise, changing from a high fat diet to a more healthy one, limiting alcohol and quitting smoking.
While both fenofibrate and atorvastatin are used to treat high cholesterol, they work in different ways. Fenofibrate works by increasing the activity of lipoprotein lipase in the muscles and fat tissue. Lipoprotein lipase is an enzyme involved in breaking down LDL and triglycerides, so by stimulating it, fenofibrate lowers the levels of LDL and triglycerides. It may also increase the amount of the "good cholesterol," HDL.
Atorvastatin belongs to the group of drugs called HMG-CoA Reductase inhibitors, or statins. It works in the liver by blocking this enzyme, which is involved in the production of LDL, thus lowering the amount made and increasing the removal of LDL from the blood. It may also have a small effect in lowering triglycerides and increasing HDL levels.
As with any medication, both fenofibrate and atorvastatin may cause adverse side effects, interact with other medications and be contraindicated in people with some underlying conditions. The prescribing doctor will take the lipid profile of each patient and their clinical history into consideration when deciding which of the fibrates or statins to use. Lifestyle changes are always recommended in combination with drug therapy.