Fibrate-statin combinations with reduced fed-fasted effects

Abstract

This invention discloses an orally administered pharmaceutical composition for the treatment of elevated levels of cholesterol and related conditions comprising a statin and fenofibrate in the form of microparticles of solid fenofibrate that are stabilized by phospholipid as a surface active substance, wherein a therapeutically effective amount of the composition provides the statin and a quantity of fenofibrate to a fasted human patient that is greater than 80% of the quantity of fenofibrate provided by the same amount of the composition when administered to the same patient who has been fed a high fat meal.

1 . A dosage form of a pharmaceutical composition comprising a combination of a statin and microparticles of fenofibrate that are stabilized by a phospholipid surface active substance, wherein the dosage form provides to a patient in need of treatment by the statin and fenofibrate a therapeutically effective dose of the statin and a therapeutically effective quantity of fenofibrate active species to said patient when fasted that is at least 80% of the quantity of fenofibrate active species provided by said amount to said patient when fed a meal containing fat.  
     
     
         2 . A dosage form of a pharmaceutical composition comprising a combination of a statin and microparticles of fenofibrate that are stabilized by a phospholipid surface active substance, wherein the dosage form provides to a human patient in need of treatment by the statin and fenofibrate a therapeutically effective dose of the statin and a therapeutically effective quantity of fenofibrate active species to said patient when fasted that is greater than 80% of the quantity of fenofibrate active species provided by said amount to said patient when fed at least 1000 calories 50% of which are from fat.  
     
     
         3 . An oral dosage form of a pharmaceutical composition comprising a combination of a statin and microparticles of fenofibrate that are stabilized by a phospholipid surface active substance, wherein the dosage form provides to a human patient in need of treatment by the statin and fenofibrate a therapeutically effective dose of the statin and a therapeutically effective quantity of fenofibrate active species into the blood of said patient when fasted that is between 85% and 115% of the quantity of fenofibrate active species provided by said amount into the blood of said patient when fed at least 1000 calories 50% of which are from fat.  
     
     
         4 . An oral dosage form of a pharmaceutical composition comprising a combination of a statin and microparticles of fenofibrate that are stabilized by a phospholipid surface active substance, wherein the dosage form provides to a human patient in need of treatment by the statin and fenofibrate a therapeutically effective dose of the statin and a therapeutically effective quantity of fenofibrate active species to said patient when fasted that is at least 85% of the AUC quantity of fenofibrate active species provided by said amount to said patient when fed at least 1000 calories 50% of which are from fat.  
     
     
         5 . The dosage form of  claim 1  wherein the microparticles have been prepared in the presence of the phospholipid surface active substance.  
     
     
         6 . The dosage form of  claim 1  where the statin is water-soluble.  
     
     
         7 . The dosage form of  claim 1  where the statin is water insoluble or poorly water-soluble.  
     
     
         8 . The dosage form of  claim 7  where the statin is in the form of a microparticle or is a constituent of a microparticle.  
     
     
         9 . The dosage form of any of  claim 1  where the statin is in the form of a microparticle that is stabilized by one or more surface active substance or is a constituent of a microparticle that is stabilized by one or more surface active substance.  
     
     
         10 . The dosage form of  claim 9  where the surface active substance comprises a phospholipid.  
     
     
         11 . The dosage form of any of  claim 1  where the statin is selected from the group consisting of lovastatin, pravastatin, simvastatin, atorvastatin, rosuvastatin, fluvastatin, itavastatin, and cerivastatin.  
     
     
         12 . The dosage form of  claim 1  where the statin is lovastatin.  
     
     
         13 . The dosage form of  claim 12  where the lovastatin is present in the range of 2 mg to 50 mg.  
     
     
         14 . The dosage form of  claim 1  where the statin is pravastatin.  
     
     
         15 . The dosage form of  claim 14  where the pravastatin is present in the range of 2 mg to 50 mg.  
     
     
         16 . The dosage form of  claim 1  where the statin is simvastatin.  
     
     
         17 . The dosage form of  claim 16  where the simvastatin is present in the range of 2 mg to 100 mg.  
     
     
         18 . The dosage form of  claim 1  where the statin is atorvastatin.  
     
     
         19 . The dosage form of  claim 18  where the atorvastatin is present in the range of 2 mg to 100 mg.  
     
     
         20 . The dosage form of  claim 1  where the statin is rosuvastatin.  
     
     
         21 . The dosage form of  claim 20  where the rosuvastatin is present in the range of 2 mg to 100 mg.  
     
     
         22 . The dosage form of  claim 1  where the statin is fluvastatin.  
     
     
         23 . The dosage form of  claim 22  where the fluvastatin is present in the range of 2 mg to 50 mg.  
     
     
         24 . The dosage form of  claim 1  where the statin is itavastatin.  
     
     
         25 . The dosage form of  claim 24  where the itavastatin is present in the range of 0.2 mg to 100 mg.  
     
     
         26 . The dosage form of  claim 1  where the statin is cerivastatin.  
     
     
         27 . The dosage form of  claim 26  where the cerivastatin is present in the range of 0.05 mg to 2 mg.  
     
     
         28 . The dosage form of  claim 1  where the fenofibrate is a solid.  
     
     
         29 . The dosage form of  claim 1  where the fenofibrate is crystalline.  
     
     
         30 . The dosage form of  claim 1  where the microparticles have a volume weighted mean size smaller than 5 micrometers.  
     
     
         31 . The dosage form of  claim 1  where the microparticles have a volume weighted mean size smaller than 4 micrometers.  
     
     
         32 . The dosage form of  claim 1  where the microparticles have a volume weighted mean size smaller than 3 micrometers.  
     
     
         33 . The dosage form of  claim 1  where the microparticles have a volume weighted mean size smaller than 2 micrometers.  
     
     
         34 . The dosage form of  claim 1  where the microparticles have a volume weighted mean size smaller than 1 micrometers.  
     
     
         35 . The dosage form of  claim 1  where the microparticles have a volume weighted mean size smaller than 0.5 micrometers.  
     
     
         36 . The dosage form of  claim 1  where the microparticles have been prepared by a process selected from the group consisting of homogenization, microfluidization, hot melt microfluidization, and sonication.  
     
     
         37 . The dosage form of  claim 1  where the microparticles have been prepared by a process selected from the group consisting of a milling process, a precipitation process, an emulsification process, a solvent evaporation spray process, a particle preparation process that utilizes a liquefied gas, and a particle preparation process that utilizes a supercritical fluid.  
     
     
         38 . The dosage form of  claim 1  that contains a weight of fenofibrate in the range from 40 mg to 300 mg.  
     
     
         39 . The dosage form of  claim 1  that contains a weight of fenofibrate selected from the group consisting of 40 mg, 50 mg, 51 mg, 52 mg, 53 mg, 54 mg, 67 mg, 100 mg, 102 mg, 103 mg, 104 mg, 134 mg, 150 mg, 153 mg, 156 mg, 159,mg, 160 mg, 200 mg, 213 mg, 250 mg, and 300 mg of fenofibrate.  
     
     
         40 . The dosage form of  claim 1  further comprising one or more pharmaceutically acceptable excipient.  
     
     
         41 . The dosage form of  claim 1  further comprising one or more excipients selected from the group consisting of monosaccharides, disaccharides, trisaccharides, sucrose, raffinose, lactose, mannitol, sorbitol, trehalose, glycerol, dextrose, fructose, pentoses, hexoses, xylitol, and mixtures thereof.  
     
     
         42 . The dosage form of  claim 1  wherein the phospholipid surface active substance comprises a mixture of phospholipids.  
     
     
         43 . The dosage form of  claim 1  wherein the phospholipid surface active substance is selected from the group consisting of saturated phospholipids, unsaturated phospholipids, naturally derived phospholipids, synthetic phospholipids, and semisynthetic phospholipids.  
     
     
         44 . The dosage form of  claim 1  wherein the phospholipid surface active substance is selected from the group consisting of Lipoid E80, Lipoid EPC, Lipoid SPC, DMPG, Phospholipon 100H, a hydrogenated soybean phosphatidylcholine, Phospholipon 90H, Lipoid SPC-3, egg phospholipid, purified egg phopholipid, and mixtures thereof.  
     
     
         45 . The dosage form of  claim 1  that comprises a capsule.  
     
     
         46 . The dosage form of  claim 1  that comprises a tablet.  
     
     
         47 . The dosage form of  claim 1  that comprises a powder dispersible in water or a beverage.  
     
     
         48 . The dosage form of  claim 1  further comprising a bulking agent.  
     
     
         49 . A process for preparing a dosage form of  claim 1  comprising the steps of: 
 (a) mixing at high shear an admixture of fenofibrate and a phospholipid substance in an aqueous carrier in the absence of an organic solvent within a first temperature range at or above the melting point of fenofibrate to form a heated suspension wherein fenofibrate is molten;  
 (b) homogenizing said heated suspension in a first pressure range and within said first temperature range to form a heated homogenate containing fenofibrate;  
 (c) cooling said heated homogenate to a second temperature range below the melting temperature of fenofibrate to form a transiently stable cooled homogenate containing fenofibrate;  
 (d) applying a particle stabilizing energetic process to said cooled homogenate within a second temperature range below the melting temperature of fenofibrate and in a second pressure range to form a cooled dispersion of small particles containing fenofibrate, and  
 (e) drying said cooled dispersion to form dried small particles containing fenofibrate.  
 
     
     
         50 . The process of  claim 49  further comprising the step of adding a statin in any of steps (a) through (d).  
     
     
         51 . The process of  claim 50  where the statin is water-soluble.  
     
     
         52 . The process of  claim 50  where the statin is water insoluble or poorly water-soluble.  
     
     
         53 . The process of  claim 50  further comprising the addition of one or more bulking agents in any of steps (a) through (d).  
     
     
         54 . The process of  claim 53  where the bulking agent is selected from the group consisting of a monosaccharide, a disaccharide, a trisaccharide, sucrose, raffinose, lactose, mannitol, sorbitol, trehalose, glycerol, dextrose, fructose, a sugar, a pentose, a hexose, xylitol, and mixtures thereof.  
     
     
         55 . The process of  claim 53  wherein the bulking agent is selected from the group consisting of trehalose, sucrose, raffinose, sorbitol and mixtures thereof.  
     
     
         56 . The dosage form of  claim 1  prepared by a process comprising blending dried small particles containing fenofibrate stabilized by a phospholipid surface active substance with a statin.  
     
     
         57 . The dosage form of  claim 1  further comprising one or more pharmaceutically acceptable excipients.  
     
     
         58 . The process of  claim 49  where the phospholipid substance is selected from the group consisting of Lipoid E80, Lipoid EPC, Lipoid SPC, DMPG, Phospholipon 100H, Lipoid SPC-3, egg phospholipid, purified egg phospholipid, and mixtures thereof.  
     
     
         59 . The process of  claim 49  where the phospholipid substance is Lipoid E80.  
     
     
         60 . The process of  claim 49  wherein the first temperature range is from the melting point of fenofibrate to 20° C. above the melting point of fenofibrate.  
     
     
         61 . The process of  claim 49  wherein the second temperature range is from 4° C. to 40° C. and fenofibrate is not molten.  
     
     
         62 . The process of claim 49 wherein the aqueous carrier is selected from the group consisting of water, sterile water, water for injection, and phosphate buffered water having a pH from 4 to 10.  
     
     
         63 . The process of  claim 49  wherein the aqueous carrier is phosphate buffered water having a pH from 7 to 9.  
     
     
         64 . The process of  claim 49  wherein the first pressure range is from 2,000 to 30,000 psi.  
     
     
         65 . The process of  claim 49  wherein the second pressure range is 18,000 to 5,000 psi.  
     
     
         66 . The process of claims  49  wherein the small particles have size in the range from 0.05 to 2 micrometers.  
     
     
         67 . A method of treatment of dyslipidemia and dyslipoproteinemia in a patient comprising the administration to said patient of a dosage form of a pharmaceutical composition comprising a combination of a statin and microparticles of fenofibrate that are stabilized by a phospholipid surface active substance, wherein the dosage form provides to a patient in need of treatment by the statin and fenofibrate a therapeutically effective dose of the statin and a therapeutically effective quantity of fenofibrate active species to said patient when fasted that is at least 80% of the quantity of fenofibrate active species provided by said amount to said patient when fed a meal containing fat.  
     
     
         68 . A method of treatment of dyslipidemia and dyslipoproteinemia in a patient comprising the administration to said patient of a dosage form of a pharmaceutical composition comprising a combination of a statin and microparticles of fenofibrate that are stabilized by a phospholipid surface active substance, wherein the dosage form provides to a human patient in need of treatment by the statin and fenofibrate a therapeutically effective dose of the statin and a therapeutically effective quantity of fenofibrate active species to said patient when fasted that is greater than 80% of the quantity of fenofibrate active species provided by said amount to said patient when fed at least 1000 calories 50% of which are from fat.  
     
     
         69 . A method of treatment of dyslipidemia and dyslipoproteinemia in a patient comprising the administration to said patient of an oral dosage form of a pharmaceutical composition comprising a combination of a statin and microparticles of fenofibrate that are stabilized by a phospholipid surface active substance, wherein the dosage form provides to a human patient in need of treatment by the statin and fenofibrate a therapeutically effective dose of the statin and a therapeutically effective quantity of fenofibrate active species into the blood of said patient when fasted that is between 85% and l 15% of the quantity of fenofibrate active species provided by said amount into the blood of said patient when fed at least 1000 calories 50% of which are from fat.  
     
     
         70 . A method of treatment of dyslipidemia and dyslipoproteinemia in a patient comprising the administration to said patient of an oral dosage form of a pharmaceutical composition comprising a combination of a statin and microparticles of fenofibrate that are stabilized by a phospholipid surface active substance, wherein the dosage form provides to a human patient in need of treatment by the statin and fenofibrate a therapeutically effective dose of the statin and a therapeutically effective quantity of fenofibrate active species to said patient when fasted that is at least 85% of the AUC quantity of fenofibrate active species provided by said amount to said patient when fed at least 1000 calories 50% of which are from fat.  
     
     
         71 . The method of treatment of  claim 67  where the administration is one a day.  
     
     
         72 . The method of treatment of  claim 67  where the administration is twice a day.  
     
     
         73 . The method of treatment of  claim 67  where the administration is three to five times a day.  
     
     
         74 . The method of treatment of  claim 67  where the dyslipidemia comprises hypercholesterolemia, hyperlipidemia, hypertrigylceridaemia or combinations thereof.  
     
     
         75 . The tablet of  claim 46  selected from the group consisting of a film-coated tablet, a moisture resistant tablet, and a tablet coated with a pharmaceutically acceptable polymer.  
     
     
         76 . A capsule or tablet dosage form for oral administration comprising a pharmaceutically effective amount of a composition containing a statin and small particles of a fibrate stabilized by a phospholipid stabilizing agent, a sugar, and optionally a carbohydrate-derived alcohol wherein said amount of said dosage form provides a therapeutically effective dose of the statin and a therapeutically effective level of fibrate active species into the blood of a patient in a fasted state that differs by less than 20% of the level of said fibrate active species that said patient receives in a fed state.  
     
     
         77 . A dosage form of a pharmaceutical composition comprising a combination of a statin, a carbohydrate bulking agent, and microparticles of fenofibrate that are stabilized by a phospholipid surface active substance, wherein the dosage form provides to a patient in need of treatment by the statin and fenofibrate a therapeutically effective dose of the statin and a therapeutically effective quantity of fenofibrate active species to said patient when fasted that is at least 80% of the quantity of fenofibrate active species provided by said amount to said patient when fed a meal containing fat.  
     
     
         78 . A dosage form of a pharmaceutical composition comprising a combination of a statin, a carbohydrate bulking agent, and microparticles of fenofibrate that are stabilized by a phospholipid surface active substance, wherein the dosage form provides to a human patient in need of treatment by the statin and fenofibrate a therapeutically effective dose of the statin and a therapeutically effective quantity of fenofibrate active species to said patient when fasted that is greater than 80% of the quantity of fenofibrate active species provided by said amount to said patient when fed at least 1000 calories 50% of which are from fat.  
     
     
         79 . An oral dosage form of a pharmaceutical composition comprising a combination of a statin, a carbohydrate bulking agent, and microparticles of fenofibrate that are stabilized by a phospholipid surface active substance, wherein the dosage form provides to a human patient in need of treatment by the statin and fenofibrate a therapeutically effective dose of the statin and a therapeutically effective quantity of fenofibrate active species into the blood of said patient when fasted that is between 85% and 115% of the quantity of fenofibrate active species provided by said amount into the blood of said patient when fed at least 1000 calories 50% of which are from fat.  
     
     
         80 . An oral dosage form of a pharmaceutical composition comprising a combination of a statin, a carbohydrate bulking agent, and microparticles of fenofibrate that are stabilized by a phospholipid surface active substance, wherein the dosage form provides to a human patient in need of treatment by the statin and fenofibrate a therapeutically effective dose of the statin and a therapeutically effective quantity of fenofibrate active species to said patient when fasted that is at least 85% of the AUC quantity of fenofibrate active species provided by said amount to said patient when fed at least 1000 calories 50% of which are from fat.  
     
     
         81 . The dosage form of  claim 77  wherein the microparticles have been prepared in the presence of the phospholipid surface active substance.  
     
     
         82 . The dosage form of  claim 77  where the statin is water-soluble.  
     
     
         83 . The dosage form of  claim 77  where the statin is water insoluble or poorly water-soluble.  
     
     
         84 . The dosage form of  claim 83  where the statin is in the form of a microparticle or is a constituent of a microparticle.  
     
     
         85 . The dosage form of  claim 77  where the statin is in the form of a microparticle that is stabilized by one or more surface active substance or is a constituent of a microparticle that is stabilized by one or more surface active substance.  
     
     
         86 . The dosage form of  claim 85  where the surface active substance comprises a phospholipid.  
     
     
         87 . The dosage form of  claim 77  where the statin is selected from the group consisting of lovastatin, pravastatin, simvastatin, atorvastatin, rosuvastatin, fluvastatin, itavastatin, and cerivastatin.  
     
     
         88 . The dosage form of  claim 77  where the statin is lovastatin.  
     
     
         89 . The dosage form of  claim 88  where the lovastatin is present in the range of 2 mg to 50 mg.  
     
     
         90 . The dosage form of  claim 77  where the statin is pravastatin.  
     
     
         91 . The dosage form of  claim 90  where the pravastatin is present in the range of 2 mg to 50 mg.  
     
     
         92 . The dosage form of  claim 77  where the statin is simvastatin.  
     
     
         93 . The dosage form of  claim 92  where the simvastatin is present in the range of 2 mg to 100 mg.  
     
     
         94 . The dosage form of  claim 77  where the statin is atorvastatin.  
     
     
         95 . The dosage form of  claim 94  where the atorvastatin is present in the range of 2 mg to 100 mg.  
     
     
         96 . The dosage form of  claim 77  where the statin is rosuvastatin.  
     
     
         97 . The dosage form of  claim 96  where the rosuvastatin is present in the range of 2 mg to 100 mg.  
     
     
         98 . The dosage form of  claim 77  where the statin is fluvastatin.  
     
     
         99 . The dosage form of  claim 98  where the fluvastatin is present in the range of 2 mg to 50 mg.  
     
     
         100 . The dosage form of  claim 77  where the statin is itavastatin.  
     
     
         101 . The dosage form of  claim 100  where the itavastatin is present in the range of 0.2 mg to 100 mg.  
     
     
         102 . The dosage form of  claim 77  where the statin is cerivastatin.  
     
     
         103 . The dosage form of  claim 102  where the cerivastatin is present in the range of 0.05 mg to 2 mg.  
     
     
         104 . The dosage form of  claim 77  where the fenofibrate is a solid.  
     
     
         105 . The dosage form of  claim 77  where the fenofibrate is crystalline.  
     
     
         106 . The dosage form of  claim 77  where the microparticles have a volume weighted mean size smaller than 5 micrometers.  
     
     
         107 . The dosage form of  claim 77  where the microparticles have a volume weighted mean size smaller than 4 micrometers.  
     
     
         108 . The dosage form of  claim 77  where the microparticles have a volume weighted mean size smaller than 3 micrometers.  
     
     
         109 . The dosage form of  claim 77  where the microparticles have a volume weighted mean size smaller than 2 micrometers.  
     
     
         110 . The dosage form of  claim 77  where the microparticles have a volume weighted mean size smaller than 1 micrometers.  
     
     
         111 . The dosage form of  claim 77  where the microparticles have a volume weighted mean size smaller than 0.5 micrometers.  
     
     
         112 . The dosage form of  claim 77  where the microparticles have been prepared by a process selected from the group consisting of homogenization, microfluidization, hot melt microfluidization, and sonication.  
     
     
         113 . The dosage form of  claim 77  where the microparticles have been prepared by a process selected from the group consisting of a milling process, a precipitation process, an emulsification process, a solvent evaporation spray process, a particle preparation process that utilizes a liquefied gas, and a particle preparation process that utilizes a supercritical fluid.  
     
     
         114 . The dosage form of  claim 77  that contains a weight of fenofibrate in the range from 40 mg to 300 mg.  
     
     
         115 . The dosage form of  claim 77  that contains a weight of fenofibrate selected from the group consisting of 40 mg, 50 mg, 51 mg, 52 mg, 53 mg, 54 mg, 67 mg, 100 mg, 102 mg, 103 mg, 104 mg, 134 mg, 150 mg, 153 mg, 156 mg, 159 mg, 160 mg, 200 mg, 213 mg, 250 mg, and 300 mg of fenofibrate.  
     
     
         116 . The dosage form of  claim 77  further comprising one or more pharmaceutically acceptable excipient.  
     
     
         117 . The dosage form of  claim 77  where the carbohydrate is a sugar.  
     
     
         118 . The dosage form of  claim 77  where the carbohydrate is selected from the group consisting of monosaccharides, disaccharides, trisaccharides, sucrose, raffinose, lactose, mannitol, sorbitol, trehalose, glycerol, dextrose, fructose, pentoses, hexoses, xylitol, and mixtures thereof.  
     
     
         119 . The dosage form of  claim 77  wherein the phospholipid surface active substance comprises a mixture of phospholipids.  
     
     
         120 . The dosage form of  claim 77  wherein the phospholipid surface active substance is selected from the group consisting of saturated phospholipids, unsaturated phospholipids, naturally derived phospholipids, synthetic phospholipids, and semisynthetic phospholipids.  
     
     
         121 . The dosage form of  claim 77  wherein the phospholipid surface active substance is selected from the group consisting of Lipoid E80, Lipoid EPC, Lipoid SPC, DMPG, Phospholipon 100H, a hydrogenated soybean phosphatidylcholine, Phospholipon 90H, Lipoid SPC-3, egg phospholipid, purified egg phopholipid, and mixtures thereof.  
     
     
         122 . The dosage form of  claim 77  that comprises a capsule.  
     
     
         123 . The dosage form of  claim 77  that comprises a tablet.  
     
     
         124 . The dosage form of  claim 77  that comprises a powder dispersible in water or a beverage.  
     
     
         125 . A process for preparing a dosage form of  claim 77  comprising the steps of: 
 (a) mixing at high shear an admixture of fenofibrate and a phospholipid substance in an aqueous carrier in the absence of an organic solvent within a first temperature range at or above the melting point of fenofibrate to form a heated suspension wherein fenofibrate is molten;  
 (b) homogenizing said heated suspension in a first pressure range and within said first temperature range to form a heated homogenate containing fenofibrate;  
 (c) cooling said heated homogenate to a second temperature range below the melting temperature of fenofibrate to form a transiently stable cooled homogenate containing fenofibrate;  
 (d) applying a particle stabilizing energetic process to said cooled homogenate within a second temperature range below the melting temperature of fenofibrate and in a second pressure range to form a cooled dispersion of small particles containing fenofibrate, and  
 (e) drying said cooled dispersion to form dried small particles containing fenofibrate, wherein the process further comprises the addition of a carbohydrate bulking agent at any of the steps (a) through (e) and wherein the process further comprises the addition of a statin in any of steps (a) through (e).  
 
     
     
         126 . The process of  claim 125  where the statin is water-soluble.  
     
     
         127 . The process of  claim 125  where the statin is water insoluble or poorly water-soluble.  
     
     
         128 . The process of  claim 125  further comprising the addition of another bulking agent in any of steps (a) through (e).  
     
     
         129 . The process of  claim 125  where the carbohydrate is a sugar.  
     
     
         130 . The process of  claim 125  where the carbohydrate is selected from the group consisting of a monosaccharide, a disaccharide, a trisaccharide, sucrose, raffinose, lactose, mannitol, sorbitol, trehalose, glycerol, dextrose, fructose, a sugar, a pentose, a hexose, xylitol, and mixtures thereof.  
     
     
         131 . The process of  claim 125  wherein the bulking agent is selected from the group consisting of trehalose, sucrose, raffinose, sorbitol and mixtures thereof.  
     
     
         132 . The dosage form of  claim 77  prepared by a process comprising blending dried small particles containing fenofibrate stabilized by a phospholipid surface active substance with a statin.  
     
     
         133 . The dosage form of  claim 77  further comprising one or more pharmaceutically acceptable excipients.  
     
     
         134 . The process of  claim 125  where the phospholipid substance is selected from the group consisting of Lipoid ESO, Lipoid EPC, Lipoid SPC, DMPG, Phospholipon 100H, Lipoid SPC-3, egg phospholipid, purified egg phospholipid, and mixtures thereof.  
     
     
         135 . The process of  claim 125  where the phospholipid substance is Lipoid E80.  
     
     
         136 . The process of  claim 125  wherein the first temperature range is from the melting point of fenofibrate to 20° C. above the melting point of fenofibrate.  
     
     
         137 . The process of  claim 125  wherein the second temperature range is from 4° C. to 40° C. and fenofibrate is not molten.  
     
     
         138 . The process of  claim 125  wherein the aqueous carrier is selected from the group consisting of water, sterile water, water for injection, and phosphate buffered water having a pH from 4 to 10.  
     
     
         139 . The process of  claim 125  wherein the aqueous carrier is phosphate buffered water having a pH from 7 to 9.  
     
     
         140 . The process of  claim 125  wherein the first pressure range is from 2,000 to 30,000 psi.  
     
     
         141 . The process of  claim 125  wherein the second pressure range is 18,000 to 5,000 psi.  
     
     
         142 . The process of claims  125  wherein the small particles have size in the range from 0.05 to 2 micrometers.  
     
     
         143 . A method of treatment of dyslipidemia and dyslipoproteinemia in a patient comprising the administration to said patient of a dosage form of a pharmaceutical composition comprising a combination of a statin, a carbohydrate bulking agent, and microparticles of fenofibrate that are stabilized by a phospholipid surface active substance, wherein the dosage form provides to a patient in need of treatment by the statin and fenofibrate a therapeutically effective dose of the statin and a therapeutically effective quantity of fenofibrate active species to said patient when fasted that is at least 80% of the quantity of fenofibrate active species provided by said amount to said patient when fed a meal containing fat.  
     
     
         144 . A method of treatment of dyslipidemia and dyslipoproteinemia in a patient comprising the administration to said patient of a dosage form of a pharmaceutical composition comprising a combination of a statin, a carbohydrate bulking agent, and microparticles of fenofibrate that are stabilized by a phospholipid surface active substance, wherein the dosage form provides to a human patient in need of treatment by the statin and fenofibrate a therapeutically effective dose of the statin and a therapeutically effective quantity of fenofibrate active species to said patient when fasted that is greater than 80% of the quantity of fenofibrate active species provided by said amount to said patient when fed at least 1000 calories 50% of which are from fat.  
     
     
         145 . A method of treatment of dyslipidemia and dyslipoproteinemia in a patient comprising the administration to said patient of an oral dosage form of a pharmaceutical composition comprising a combination of a statin, a carbohydrate bulking agent, and microparticles of fenofibrate that are stabilized by a phospholipid surface active substance, wherein the dosage form provides to a human patient in need of treatment by the statin and fenofibrate a therapeutically effective dose of the statin and a therapeutically effective quantity of fenofibrate active species into the blood of said patient when fasted that is between 85% and 115% of the quantity of fenofibrate active species provided by said amount into the blood of said patient when fed at least 1000 calories 50% of which are from fat.  
     
     
         146 . A method of treatment of dyslipidemia and dyslipoproteinemia in a patient comprising the administration to said patient of an oral dosage form of a pharmaceutical composition comprising a combination of a statin, a carbohydrate bulking agent, and microparticles of fenofibrate that are stabilized by a phospholipid surface active substance, wherein the dosage form provides to a human patient in need of treatment by the statin and fenofibrate a therapeutically effective dose of the statin and a therapeutically effective quantity of fenofibrate active species to said patient when fasted that is at least 85% of the AUC quantity of fenofibrate active species provided by said amount to said patient when fed at least 1000 calories 50% of which are from fat.  
     
     
         147 . The method of treatment of  claim 143  where the administration is one a day.  
     
     
         148 . The method of treatment of  claim 143  where the administration is twice a day.  
     
     
         149 . The method of treatment of  claim 143  where the administration is three to five times a day.  
     
     
         150 . The method of treatment of  claim 143  where the dyslipidemia comprises hypercholesterolemia, hyperlipidemia, hypertrigylceridaemia or combinations thereof.  
     
     
         151 . The tablet of  claim 123  selected from the group consisting of a film-coated tablet, a moisture resistant tablet, and a tablet coated with a pharmaceutically acceptable polymer.  
     
     
         152 . The process of  claim 49  where the cooled dispersion is dried by spray drying or by lyophilization.