Clofibrate and Furosemide Injection: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Furosemide Injection
Clofibrate
No brand names on record
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
What happens
Muscle pain and stiffness, accentuation of diuretic effects, and elevations in serum transaminases and creatine phosphokinase
Interaction Deep Dive
The concurrent administration of furosemide and clofibrate has resulted in muscular pain and stiffness, general malaise, pronounced diuresis, and elevated levels of serum transaminases and creatine phosphokinase. These are more prominent in patients with nephrotic syndrome, hypoalbuminemia, and hyperlipoproteinemia1. Similar muscular effects have also been reported with clofibrate monotherapy 2. The proposed mechanism for the furosemide-clofibrate interaction involves competition for protein binding sites, especially in the presence of hypoalbuminemia, which results in higher free levels of each drug 3.
Why it happens (mechanism)
Competition for plasma albumin binding sites
Literature reports
1 report — tap to read
a) One study described five patients on maintenance diuretic therapy who experienced muscular pain, stiffness, and malaise when given clofibrate. All of the patients had hyperlipoproteinemia secondary to nephrotic syndrome. It was discovered that a higher proportion of clofibrate was not bound, possibly because low serum albumin reduces the number of binding sites for the drug. The increased proportion of clofibrate that was unbound may be responsible for its toxic effects. Furosemide is also bound to albumin, thereby creating a competitive environment for binding sites. Three of the patients experienced pronounced diuresis, which could be attributed to clofibrate displacing some of the bound furosemide. This sudden diuresis could also contribute to muscular cramping by causing increased urinary losses of potassium and sodium. Additionally, the half-life of clofibrate was increased from 12 hours to over 36 hours in most of these cases, which could also potentiate its toxic effects 1.
Common questions
Can I take Clofibrate and Furosemide Injection together?
Muscle pain and stiffness, accentuation of diuretic effects, and elevations in serum transaminases and creatine phosphokinase Always confirm with your pharmacist or prescriber before making any change.
How serious is the Clofibrate and Furosemide Injection interaction?
It is rated moderate. Can be significant — usually manageable with monitoring.
How quickly could this interaction happen?
The documented onset is "delayed". Effects tend to build up gradually over days to weeks.
How strong is the evidence for this interaction?
The evidence is graded "probable". Good supporting evidence, though not definitively proven.
Questions for your pharmacist
- Does my dose of Clofibrate or Furosemide Injection need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there anything you'd monitor while I'm on both?
References (3)
- Bridgman JF, Rosen SM, & Thorp JM: Complications during clofibrate treatment of nephrotic-syndrome hyperlipoproteinaemia. Lancet 1972; 2:506-509.
- Langer T & Levy RI: Acute muscular syndrome associated with administration of clofibrate. N Engl J Med 1968; 279:856-858. DOI
- Prandota J & Pruitt AW: Furosemide binding to human albumin and plasma of nephrotic children. Clin Pharmacol Ther 1975; 17:159-166. PubMed
Keep reading about Furosemide Injection
Keep reading about Clofibrate
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