CHOLIB FILM-COATED TABLET 145MG/20MG

Fenofibrate
Simvastatin

Source of information: Drugbank (External Link). Last updated on: 3rd July 18
*Trade Name used in the content below may not be the same as the HSA-registered product.

Active Ingredient / Synonyms

2-(4-(4-Chlorobenzoyl)phenoxy)-2-methylpropanoic acid 1-methylethyl ester | Fenofibrato | Fenofibratum | Finofibrate | FNF | Isopropyl (4'-(p-chlorobenzoyl)-2-phenoxy-2-methyl)propionate | Isopropyl 2-(4-(4-chlorobenzoyl)phenoxy)-2-methylpropionate | Procetofen | Fenofibrate |

Description

Fenofibrate is a prodrug of fenofibric acid, an antilipemic agent which reduces both cholesterol and triglycerides in the blood.

Indication

For use as adjunctive therapy to diet to reduce elevated LDL-C, Total-C,Triglycerides and Apo B, and to increase HDL-C in adult patients with primary hypercholesterolemia or mixed dyslipidemia (Fredrickson Types IIa and IIb)

Mechanism of Action

Fenofibrate exerts its therapeutic effects through activation of peroxisome proliferator activated receptor a (PPARa). This increases lipolysis and elimination of triglyceride-rich particles from plasma by activating lipoprotein lipase and reducing production of apoprotein C-III. The resulting fall in triglycerides produces an alteration in the size and composition of LDL from small, dense particles, to large buoyant particles. These larger particles have a greater affinity for cholesterol receptors and are catabolized rapidly.

Pharmacodynamics

Fenofibrate is a lipid regulating agent indicated as adjunctive therapy to diet to reduce elevated LDL-C, Total-C,Triglycerides and Apo B, and to increase HDL-C in adult patients with primary hypercholesterolemia or mixed dyslipidemia (Fredrickson Types IIa and IIb). Fenofibrate is also indicated as adjunctive therapy to diet for treatment of adult patients with hypertriglyceridemia (Fredrickson Types IV and V hyperlipidemia). Fenofibric acid, the active metabolite of Fenofibrate, produces reductions in total cholesterol, LDL cholesterol, apolipoprotein B, total triglycerides and triglyceride rich lipoprotein (VLDL) in treated patients. In addition, treatment with fenofibrate results in increases in high density lipoprotein (HDL) and apoproteins apoAI and apoAII.

Pharmacokinetics

Absorption:

Fenofibrate is well absorbed from the gastrointestinal tract. After absorption, fenofibrate is mainly excreted in the urine in the form of metabolites, primarily fenofibric acid and fenofibric acid glucuronide

Distribution:

In healthy adults, the volume of distribution is 30 L. The volume of distribution is 95 L in individuals with moderate renal impairment and creatinine clearance of 50 to 90 mL/min [FDA Label].

Metabolism:

Not Available

Elimination:

Fenofibric acid is primarily conjugated with glucuronic acid and then excreted in urine. Following oral administration in healthy volunteers, approximately 60% of a single dose of radiolabelled fenofibrate appeared in urine, primarily as fenofibric acid and its glucuronate conjugate and 25% was excreted in the feces.

Half-life

20 hours

Clearance

* 1.2 L/h [Eldery]

Toxicity

LD50=1600 mg/kg (Oral, in mice); Investigated as a teratogen and reproductive hazard.

Source of information: Drugbank (External Link). Last updated on: 3rd July 18
*Trade Name used in the content below may not be the same as the HSA-registered product.

Active Ingredient / Synonyms

2,2-Dimethylbutyric acid, 8-ester with (4R,6R)-6-(2-((1S,2S,6R,8S,8ar)-1,2,6,7,8,8a-hexahydro-8-hydroxy-2,6-dimethyl-1-naphthyl)ethyl)tetrahydro-4-hydroxy-2H-pyran-2-one | Simvastatin | Simvastatina | Simvastatine | Simvastatinum | Synvinolin | Simvastatin |

Description

Simvastatin is a lipid-lowering agent that is derived synthetically from the fermentation of Aspergillus terreus. It is a potent competitive inhibitor of 3-hydroxy-3-methylglutaryl coenzyme A reductase (hydroxymethylglutaryl COA reductases), which is the rate-limiting enzyme in cholesterol biosynthesis. It may also interfere with steroid hormone production. Due to the induction of hepatic LDL receptors, it increases breakdown of LDL cholesterol. [PubChem]

Indication

For the treatment of hypercholesterolemia and for the reduction in the risk of cardiac heart disease mortality and cardiovascular events. It can also be used in adolescent patients for the treatment of heterozygous familial hypercholesterolemia.

Mechanism of Action

Simvastatin is a prodrug in which the 6-membered lactone ring of simvastatin is hydrolyzed in vivo to generate the beta,delta-dihydroxy acid, an active metabolite structurally similar to HMG-CoA (hydroxymethylglutaryl CoA). Once hydrolyzed, simvastatin competes with HMG-CoA for HMG-CoA reductase, a hepatic microsomal enzyme. Interference with the activity of this enzyme reduces the quantity of mevalonic acid, a precursor of cholesterol.

Pharmacodynamics

Simvastatin, the methylated form of lovastatin, is an oral antilipemic agent which inhibits HMG-CoA reductase. Simvastatin is used in the treatment of primary hypercholesterolemia and is effective in reducing total and LDL-cholesterol as well as plasma triglycerides and apolipoprotein B.

Pharmacokinetics

Absorption:

Absorption of simvastatin, estimated relative to an intravenous reference dose, in each of two animal species tested, averaged about 85% of an oral dose. In animal studies, after oral dosing, simvastatin achieved substantially higher concentrations in the liver than in non-target tissues. However, because simvastatin undergoes extensive first-pass metabolism, the availability of the drug in the systemic is low. Peak plasma concentration occurs 1.3 - 2.4 hours after administration.

Distribution:

Simvastatin can cross the blood-brain-barrier.

Metabolism:

Hepatic, simvastatin is a substrate for CYP3A4. The major active metabolites of simvastatin are β-hydroxyacid metabolite and its 6'-hydroxy, 6'-hydroxymethyl, and 6'-exomethylene derivatives

Elimination:

Following an oral dose of 14C-labeled simvastatin in man, 13% of the dose was excreted in urine and 60% in feces.

Half-life

3 hours

Clearance

Not Available

Toxicity

The most common adverse reactions that lead to discontinuation of therapy include gastrointestinal disorders (0.5%), myalgia (0.1%), and arthralgia (0.1%).

References

  1. Health Science Authority of Singapore - Reclassified POM
  2. Drugbank

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Approval Information

CHOLIB FILM-COATED TABLET 145MG/20MG was registered with Health Science Authority of Singapore by ABBOTT LABORATORIES (SINGAPORE ) PTE LTD. It is marketed with the registration number of SIN15664P with effective from 2019-04-09.

This product contains 145mg of Fenofibrate, and20mg of Simvastatin in the form of TABLET, FILM COATED.

The medicine was manufactured by Fournier Laboratories Ireland Limited in IRELAND, andMylan Laboratoires SAS (Primary & Secondary) in FRANCE

It is a Presciption Only Medicine which can only be obtained from a doctor or a dentist, or from a pharmacist with a prescription from a Singapore-registered doctor or dentist.

Anatomical Therapeutic Chemical (ATC) Classification

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41APO-PROPRANOLOL TABLET 40mgPropranololPOMPHARMAFORTE SINGAPORE PTE LTDActive
42APO-DIAZEPAM TABLET 2mgDiazepamPOMPHARMAFORTE SINGAPORE PTE LTDActive
44APO-DIAZEPAM TABLET 5mgDiazepamPOMPHARMAFORTE SINGAPORE PTE LTDActive
45APO-DIAZEPAM TABLET 10mgDiazepamPOMPHARMAFORTE SINGAPORE PTE LTDActive
46APO-PROPRANOLOL TABLET 10mgPropranololPOMPHARMAFORTE SINGAPORE PTE LTDActive
55APO-ISDN TABLET 10mgIsosorbide DinitratePOMPHARMAFORTE SINGAPORE PTE LTDActive
63DIAPO TABLET 10mgDiazepamPOMBEACONS PHARMACEUTICALS PTE LTDActive
64FURMIDE TABLET 40mgFurosemidePOMBEACONS PHARMACEUTICALS PTE LTDActive

Products Containing as Mixture Ingredient

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4DIPHENHYDRAMINE EXPECTORANTAmmonium Chloride|Diphenhydramine|Sodium CitrateP OnlyDRUG HOUSES OF AUSTRALIA PTE LTDActive
5DIPHENHYDRAMINE EXPECTORANT PAED.Ammonium Chloride|Diphenhydramine|Sodium CitrateP OnlyDRUG HOUSES OF AUSTRALIA PTE LTDActive
400FAKTU SUPPOSITORYCinchocaine|PolicresulenP OnlyTAKEDA PHARMACEUTICALS (ASIA PACIFIC) PTE LTDActive
407TRIMAXAZOLE TABLETSulfamethoxazole|TrimethoprimPOMBEACONS PHARMACEUTICALS PTE LTDActive
435APO-SULFATRIM TABLETSulfamethoxazole|TrimethoprimPOMPHARMAFORTE SINGAPORE PTE LTDActive
508APO-SULFATRIM PEDIATRIC TABLETSulfamethoxazole|TrimethoprimPOMPHARMAFORTE SINGAPORE PTE LTDActive
526B.S. SUSPENSIONSulfamethoxazole|TrimethoprimPOMAPEX PHARMA MARKETING PTE LTDActive
583CO-TRIMEXAZOLE SUSPENSIONSulfamethoxazole|TrimethoprimPOMBEACONS PHARMACEUTICALS PTE LTDActive
676BANEOCIN OINTMENTBacitracin|NeomycinPOMNOVARTIS (SINGAPORE) PTE LTDActive
678BANEOCIN POWDERBacitracin|NeomycinPOMNOVARTIS (SINGAPORE) PTE LTDActive