Issues for surgery
Potential increase in serum triglycerides if omitted.
Risk of myopathy and rhabdomyolysis if continued (see Further information).
Advice in the perioperative period
Elective and emergency Surgery
Continue.
Surgery for gallbladder disease
Bezafibrate is contraindicated in gallbladder disease. Consider asking patient’s General Practitioner (GP) or surgeon to review bezafibrate if patient is awaiting surgery for gallbladder disease – see product literature for further information.
Post-operative advice
Restart post-operatively as soon as next dose is due.
Monitor renal function – treatment interruption or dose reduction may be necessary if renal function is impaired (see Further information).
Interactions with common anaesthetic agents
None.
Interactions with other common medicines used in the perioperative period
None.
Further information
Renal function and skeletal muscle effects
A concern with perioperative fibrate therapy is the risk of fibrate-induced myopathy and rhabdomyolysis. Perioperatively, factors increasing the risk of fibrate-induced myopathy include impairment of renal function after major surgery. Monitor renal function and adjust fibrate dose or interrupt treatment according to recommendations in product literature. Monitor the patient for signs and symptoms of skeletal muscle effects such as muscle pain, cramps or weakness. If symptoms occur or creatinine kinase (CK) level found to be raised, bezafibrate should be stopped.
References
Joint Formulary Committee. British National Formulary (online) London: BMJ Group and Pharmaceutical Press. http://www.medicinescomplete.com [Accessed on 4th January 2024]
Bezafibrate. In: Brayfield A (Ed), Martindale: The Complete Drug Reference. London: The Royal Pharmaceutical Society of Great Britain. http://www.medicinescomplete.com [Accessed 4th January 2024]
Summary of Product Characteristics – Fibrazate® (bezafibrate) XL 400 mg Modified Release Tablets. Sandoz Limited. Accessed via www.medicines.org.uk 04/01/2024 [date of revision of the text September 2021]
Baxter K, Preston CL (eds), Stockley’s Drug Interactions (online) London: Pharmaceutical Press. http://www.medicinescomplete.com [Accessed on 4th January 2024]