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Fenofibrate + omega-3-acid ethyl esters is a combination therapy used to manage dyslipidemia and severe hypertriglyceridemia. Fenofibrate is a fibrate that acts as an agonist of peroxisome proliferator activated receptor alpha (PPARα), leading to increased lipolysis and enhanced clearance of triglyceride-rich particles by activating lipoprotein lipase and reducing apoprotein C-III. This results in decreased levels of total cholesterol and triglycerides while increasing HDL cholesterol[5][1]. Omega-3-acid ethyl esters are composed primarily of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). They lower very high triglyceride levels by inhibiting hepatic synthesis of triglycerides through multiple mechanisms including inhibition of acyl-CoA:1,2-diacylglycerol acyltransferase and increased beta-oxidation[6][2]. The combination targets different pathways in lipid metabolism for additive or synergistic effects on lowering blood lipid levels. Both agents are indicated as adjuncts to diet for the treatment of severe hypertriglyceridemia.
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