Can I take Fenofibrate while planning for pregnancy?

Question

Hello doctor,

I am 35 and have very high triglycerides. I am planning to get pregnant, and I am currently taking Fenofibrate, but I have read that it is not safe during pregnancy. Can I switch to a safer medicine, or do I need to stop it completely? Can high triglycerides by themselves affect the baby or lead to complications like preeclampsia? Should I see a lipid specialist before trying to get pregnant?

Kindly help.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

During pregnancy, triglyceride levels naturally go up. But if they are already very high before getting pregnant, they can rise even more during pregnancy. This can lead to serious problems like pancreatitis, large babies, thickened blood (hyperviscosity syndrome), poor growth of the baby in the womb (intrauterine growth restriction), and preeclampsia.

Managing high triglycerides during pregnancy requires a team approach. This usually includes an obstetrician who understands lipid problems, a cardiologist, a dietitian, and an endocrinologist.

The main treatment steps include lifestyle changes such as daily walking or exercise, losing weight, quitting smoking, and avoiding alcohol. Diet changes are also important, such as eating more fruits and vegetables, avoiding greasy or oily foods, using vegetable oils, reducing sugar and refined carbohydrates, and increasing fiber intake. Omega-3 fatty acids are also used, as they are considered safe during pregnancy.

There is limited data on using fibrates during pregnancy, and they are usually avoided. However, in severe cases of high triglycerides, they might be used with caution after the first trimester if the benefits outweigh the risks.

Some hospitals use insulin infusions off and on to treat extremely high triglyceride levels, especially when levels go above 1000 mg/dL (milligrams per deciliter). If other treatments do not work, plasmapheresis (a procedure to filter the blood) may be used to help lower triglycerides.

I hope you are satisfied with my answer. For further queries, you can consult me at iCliniq.

Thank you.