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When your doctor orders a blood test to check your blood cholesterol levels, you receive a report that tells you about your "bad" cholesterol (LDL), "good" cholesterol (HDL), and triglycerides. Understanding what those numbers mean is the first step to reducing your risk for heart disease. To evaluate your overall risk for heart disease, your doctor will look at these numbers as well as risk factors, such as high blood pressure, smoking, age, and family history.
Total (serum) blood cholesterol
Triglycerides
"Bad" (LDL) cholesterol
"Good" (HDL) cholesterol
Total (serum) blood cholesterol
| Desirable | less than 200 mg/dL |
| Borderline high | 200 to 239 mg/dL |
| High | 240 mg/dL and above |
Total, or serum, blood cholesterol is the most common measurement of blood cholesterol. It is measured in milligrams per deciliter (mg/dL). Combined with other risk factors, total cholesterol numbers can help your doctor estimate your overall risk for heart disease.
Triglycerides
| Normal | less than 150 mg/dL |
| Borderline high | 150 to 199 mg/dL |
| High | 200 to 499 mg/dL |
| Very high | 500 mg/dL and above |
Triglycerides are another important form of fat in the blood. People with high triglycerides often have high total (serum) cholesterol, high LDL-C, and low HDL-C. If you have high triglycerides, your doctor will ask you to follow a heart-healthy diet and exercise regimen. Medication can help reduce these levels if diet and exercise alone aren't enough to reach your personal goal.
"Bad" (LDL) cholesterol
| Optimal | Less than 100 mg/dL |
| Near or above optimal | 100 to 129 mg/dL |
| Borderline high | 130 to 159 mg/dL |
| High | 160 to 189 mg/dL |
| Very high | 190 mg/dL and above |
Too much LDL cholesterol in your blood can block your arteries and contribute to heart disease. It's important to keep this kind of cholesterol low. LDL-C goals are different depending on how many other risk factors for heart disease you have. Your doctor can determine what your personal goal should be.
"Good" (HDL) cholesterol
| Low | Less than 40 mg/dL (for men) Less than 50 mg/dL (for women) |
| High | 60 mg/dL and above |
Low HDL cholesterol is a risk factor for heart disease. Keeping an HDL-C of 60 mg/dL or above may help reduce your risk.
Indications
Lipofen® is indicated as adjunctive therapy to diet to reduce elevated LDL-C, total-C, triglycerides (TG), and Apo B, and to increase
HDL-C in adult patients with primary hypercholesterolemia or mixed dyslipidemia (Fredrickson Types IIa and IIb).
Lipid-altering agents should be used in addition to a diet restricted in saturated fat and cholesterol when response to diet and non-pharmacological intervention alone has been inadequate.
Lipofen® is also indicated as adjunctive therapy to diet for treatment of adult patients with hypertriglyceridemia (Fredrickson Types IV and V hyperlipidemia). Improving glycemic control in diabetic patients showing fasting chylomicronemia will usually reduce fasting triglycerides and eliminate chylomicronemia thereby obviating the need for pharmacologic intervention.
Important Safety Information
The effect of Lipofen® therapy on reducing the risk of pancreatitis in patients with elevated serum TG has not been adequately studied.
Drug therapy is not indicated for patients with Type I hyperlipoproteinemia.
The use of drugs should be considered only when reasonable attempts have been made to obtain satisfactory results with non-drug methods. If the decision is made to use drugs, the patient should be instructed that this does not reduce the importance of adhering to diet.
Lipofen® is contraindicated in patients with hypersensitivity to fenofibrate, hepatitis or severe renal dysfunction, including primary biliary cirrhosis, unexplained persistent liver function abnormality, and preexisting gallbladder disease.
Fenofibrate at doses equivalent to 100 mg to 150 mg Lipofen® per day has been associated with increases in serum transaminases. Regular periodic monitoring of liver functions, including serum ALT (SGPT) should be performed for the duration of therapy with Lipofen®, and therapy discontinued if enzyme levels persist >3 times the normal limit.
Fenofibrate may increase cholesterol excretion into the bile, leading to cholelithiasis. If cholelithiasis is confirmed, therapy with Lipofen® should be discontinued.
Caution should be exercised when anticoagulants are given in conjunction with Lipofen® because of a potential increase in coumarin-type anticoagulant effects. To prevent bleeding complications, frequent prothrombin time/INR determinations and appropriate dosage adjustments are advisable.
The combined use of Lipofen® and HMG-CoA reductase inhibitors should be avoided unless the benefit of further alterations in lipid levels is likely to outweigh the increased risk of this drug combination.
The effect of fenofibrate on coronary heart disease morbidity and mortality and non-cardiovascular mortality has not been established.
Lipofen® may occasionally be associated with myopathy or rhabdomyolysis, usually in patients with impaired renal function. Patients should be advised to report promptly unexplained muscle pain, tenderness or weakness. Lipofen® should be discontinued if markedly elevated CPK levels occur or myopathy is diagnosed.
Other precautions include pancreatitis, hypersensitivity reactions, and hematologic changes.
In clinical trials, the most common adverse events were abnormal liver function tests, respiratory disorder, abdominal pain, back pain, and headache.
Reference: 1. American Heart Association Web site. Cholesterol levels. Available at: http://www.americanheart.org/presenter.jhtml?identifier=4500.
Accessed September 24, 2008.
