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Choline fenofibrate is the choline salt of fenofibric acid, which is the active metabolite of the prodrug fenofibrate. It functions as an agonist of the peroxisome proliferator-activated receptor alpha (PPARα), a nuclear receptor that regulates lipid metabolism. Activation of PPARα leads to increased lipolysis and elimination of triglyceride-rich particles from plasma by activating lipoprotein lipase and reducing the production of apoprotein C-III. Additionally, it enhances the synthesis of apoproteins A-I and A-II, resulting in increased levels of high-density lipoprotein (HDL) cholesterol. Choline fenofibrate is indicated as an adjunct to diet for the treatment of severe hypertriglyceridemia and for the management of primary hypercholesterolemia or mixed dyslipidemia to reduce elevated LDL-C, Total-C, Triglycerides, and Apo B, while increasing HDL-C.
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