Gemfibrozil

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

  1. abdominal pain
  2. alopecia
  3. anaphylactic shock
  4. anemia
  5. angioedema
  6. arthralgia
  7. atrial fibrillation
  8. blurred vision
  9. cataracts
  10. cholecystitis
  11. cholelithiasis
  12. cholestasis
  13. colitis
  14. confusion
  15. constipation
  16. depression
  17. diarrhea
  18. dizziness
  19. dyspepsia
  20. elevated hepatic enzymes
  21. eosinophilia
  22. exfoliative dermatitis
  23. fatigue
  24. headache
  25. hepatoma
  26. hyperbilirubinemia
  27. impotence (erectile dysfunction)
  28. infection
  29. intracranial bleeding
  30. jaundice
  31. laryngeal edema
  32. leukopenia
  33. libido decrease
  34. lupus-like symptoms
  35. myalgia
  36. myasthenia
  37. myopathy
  38. nausea
  39. neuritis
  40. pancreatitis
  41. paresthesias
  42. photosensitivity
  43. pruritus
  44. rash
  45. retinal edema
  46. rhabdomyolysis
  47. syncope
  48. synovitis
  49. thrombocytopenia
  50. urticaria
  51. vasculitis
  52. vomiting
  53. 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
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