Gemfibrozil Brand Name– Lopid
What is Gemfibrozil
Gemfibrozil is a fibric acid antilipemic agent similar to clofibrate, but possesses biologic actions distinct from those of clofibrate.
Gemfibrozil effectively lowers serum triglycerides and also produces favorable changes in lipoproteins, but the HMG-CoA reductase inhibitors are more effective in hyperlipoproteinemia.
Gemfibrozil is indicated as second-line therapy for type IIb hypercholesterolemia (elevated cholesterol, triglycerides, LDL, VLDL), recommended only in patients with low HDL (< 35 mg/dL) and without evidence of coronary artery disease.
The Helsinki Heart Study, published in 1987, found gemfibrozil effective in reducing the risk of coronary heart disease in men.
Combination therapy with HMG-CoA reductase inhibitors and gemfibrozil has been associated with a significantly enhanced risk of myopathy and rhabdomyolysis.
Gemfibrozil was approved by the FDA in 1981.
Indications
- hyperlipoproteinemia
- hypertriglyceridemia
For use as an adjunct to diet for the treatment of hyperlipoproteinemia and hypertriglyceridemia
for hypertriglyceridemia including Type IV (elevated triglycerides, VLDL) and Type V (elevated triglycerides, chylomicrons, VLDL) in patients who have significant risk of coronary artery disease or pancreatitis, and have not responded to diet
NOTE: Gemfibrozil is not indicated for patients with Type I (rare) hyperlipoproteinemia who have elevated chylomicrons, triglycerides, but who have normal VLDL concentrations. Inspection of plasma refrigerated for 14 hours is helpful in distinguishing Types I (rare), IV, and V (rare) hyperlipoproteinemia.
Side Effects
- abdominal pain
- alopecia
- anaphylactic shock
- anemia
- angioedema
- arthralgia
- atrial fibrillation
- blurred vision
- cataracts
- cholecystitis
- cholelithiasis
- cholestasis
- colitis
- confusion
- constipation
- depression
- diarrhea
- dizziness
- dyspepsia
- elevated hepatic enzymes
- eosinophilia
- exfoliative dermatitis
- fatigue
- headache
- hepatoma
- hyperbilirubinemia
- impotence (erectile dysfunction)
- infection
- intracranial bleeding
- jaundice
- laryngeal edema
- leukopenia
- libido decrease
- lupus-like symptoms
- myalgia
- myasthenia
- myopathy
- nausea
- neuritis
- pancreatitis
- paresthesias
- photosensitivity
- pruritus
- rash
- retinal edema
- rhabdomyolysis
- syncope
- synovitis
- thrombocytopenia
- urticaria
- vasculitis
- vomiting
- weight loss
Monitoring Parameters
- creatine phosphokinase (CPK)
- LFTs
- serum bilirubin (total and direct)
- serum cholesterol profile
- serum triglycerides
Contraindications
- biliary cirrhosis
- breast-feeding
- children
- cholelithiasis
- gallbladder disease
- hepatic disease
- infants
- neonates
- pregnancy
- renal disease
- renal failure
- renal impairment
Gemfibrozil is contraindicated in patients with a hypersensitivity to gemfibrozil.
Interactions
- Acarbose
- Albiglutide
- Aliskiren; Valsartan
- Alogliptin; Metformin
- Alogliptin; Pioglitazone
- Alpha-glucosidase Inhibitors
- Amlodipine; Atorvastatin
- Amlodipine; Hydrochlorothiazide, HCTZ; Olmesartan
- Amlodipine; Hydrochlorothiazide, HCTZ; Valsartan
- Amlodipine; Olmesartan
- Amlodipine; Valsartan
- Apalutamide
- Apixaban
- Aspirin, ASA; Pravastatin
- Atorvastatin
- Atorvastatin; Ezetimibe
- Belinostat
- Bempedoic Acid; Ezetimibe
- Bexarotene
- Bosentan
- Canagliflozin
- Canagliflozin; Metformin
- Cannabidiol
- Carbamazepine
- Chenodiol
- Cholestyramine
- Clofarabine
- Colchicine
- Colchicine; Probenecid
- Colesevelam
- Colestipol
- Cyclosporine
- Dabrafenib
- Dapagliflozin
- Dapagliflozin; Metformin
- Dapagliflozin; Saxagliptin
- Dasabuvir; Ombitasvir; Paritaprevir; Ritonavir
- Diclofenac
- Diclofenac; Misoprostol
- Dipeptidyl Peptidase-4 Inhibitors
- Diphenhydramine; Naproxen
- Doxercalciferol
- Dronabinol
- Dulaglutide
- Elagolix
- Elagolix; Estradiol; Norethindrone acetate
- Elbasvir; Grazoprevir
- Eltrombopag
- Eluxadoline
- Empagliflozin
- Empagliflozin; Linagliptin
- Empagliflozin; Linagliptin; Metformin
- Empagliflozin; Metformin
- Enzalutamide
- Ertugliflozin
- Ertugliflozin; Metformin
- Ertugliflozin; Sitagliptin
- Esomeprazole; Naproxen
- Exenatide
- Ezetimibe
- Ezetimibe; Simvastatin
- Fluvastatin
- food
- Glecaprevir; Pibrentasvir
- Glimepiride; Pioglitazone
- Glimepiride; Rosiglitazone
- Glipizide; Metformin
- Glyburide; Metformin
- Hydrochlorothiazide, HCTZ; Olmesartan
- Hydrochlorothiazide, HCTZ; Valsartan
- Incretin Mimetics
- Insulin Degludec; Liraglutide
- Insulin Glargine; Lixisenatide
- Insulins
- Irinotecan
- Irinotecan Liposomal
- Isoniazid, INH; Pyrazinamide, PZA; Rifampin
- Isoniazid, INH; Rifampin
- Lansoprazole; Naproxen
- Lesinurad
- Lesinurad; Allopurinol
- Letermovir
- Linagliptin; Metformin
- Liraglutide
- Lixisenatide
- Loperamide
- Loperamide; Simethicone
- Lovastatin
- Lovastatin; Niacin
- Lumateperone
- Maraviroc
- Meloxicam
- Metformin
- Metformin; Pioglitazone
- Metformin; Repaglinide
- Metformin; Rosiglitazone
- Metformin; Saxagliptin
- Metformin; Sitagliptin
- Miglitol
- Montelukast
- Nanoparticle Albumin-Bound Paclitaxel
- Naproxen
- Naproxen; Pseudoephedrine
- Naproxen; Sumatriptan
- Nateglinide
- Nebivolol; Valsartan
- Niacin; Simvastatin
- Olmesartan
- Ozanimod
- Paclitaxel
- Pexidartinib
- Pioglitazone
- Pitavastatin
- Pramlintide
- Pravastatin
- Quinine
- Raltegravir
- Red Yeast Rice
- Repaglinide
- Revefenacin
- Rifampin
- Rifaximin
- Riociguat
- Rosiglitazone
- Rosuvastatin
- Sacituzumab Govitecan
- Sacubitril; Valsartan
- Selexipag
- Semaglutide
- SGLT2 Inhibitors
- Simeprevir
- Simvastatin
- Simvastatin; Sitagliptin
- Sulfonylureas
- Telbivudine
- Terbinafine
- Treprostinil
- Tucatinib
- Ursodeoxycholic Acid, Ursodiol
- Valsartan
- Warfarin
