gemfibrozil, Lopid

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GENERIC NAME: gemfibrozil

BRAND NAMES: Lopid

DRUG CLASS AND MECHANISM: Gemfibrozil is a blood lipid and cholesterol-modifying medicine. It is classified as a fibric acid derivative similar to fenofibrate (Tricor). It reduces triglycerides and increases cholesterol carried in high density lipoprotein (HDL) in the blood. HDL cholesterol is sometimes called "good" cholesterol because higher concentrations of HDL cholesterol in the blood are associated with a reduced risk of heart disease. Gemfibrozil modestly reduces low density lipoprotein (LDL or "bad") cholesterol. The mechanism of action of gemfibrozil is not known. The decrease in triglycerides is thought to be due in part to reduced production of triglycerides by the liver. Lopid was approved in September 1993.

PRESCRIPTION: Yes

GENERIC AVAILABLE: Yes

PREPARATIONS: Tablets: 600 mg

STORAGE: Tablets should be stored at room temperature between 20 – 25 C (68 – 77 F).

PRESCRIBED FOR: Gemfibrozil is used for reducing elevated triglyceride levels that are high enough to cause pancreatitis. Because gemfibrozil raises HDL and decreases triglycerides it is prescribed for preventing coronary heart disease in individuals without a history or symptoms of coronary heart disease who have low HDL, high LDL and high triglycerides. Gemfibrozil is prescribed after other therapies have failed, and it is not intended for treating patients who only have low HDL. Gemfibrozil is used together with diet and exercise.

DOSING: The recommended dose of gemfibrozil is 600 mg 30 minutes before breakfast and dinner.

DRUG INTERACTIONS: Gemfibrozil, when used together with the statin family of cholesterol-reducing medications, for example, lovastatin (Mevacor), pravastatin (Pravachol), simvastatin (Zocor), fluvastatin (Lescol), rosuvastatin (Crestor), and atorvastatin (Lipitor) increases the risk of a condition called rhabdomyolysis (muscle injury) which when severe can lead to kidney damage and seven death. Rhabdomyolysis may occur as early as three weeks or several months after starting combination therapy. The benefit of combining gemfibrozil with statins does not outweigh the risk of rhabdomyolysis.

Gemfibrozil can increase the effect of warfarin (Coumadin) and thus may lead to bleeding. Therefore, patients on warfarin may need to have their doses of warfarin reduced when starting gemfibrozil.

Gemfibrozil increases blood levels of repaglinide (Prandin) in people with diabetes, increasing the likelihood of developing low blood sugar (hypoglycemia). This combination should be avoided.

Colestipol (Colestid) and cholestyramine (Questran) reduce the absorption of gemfibrozil and reduce its effectiveness if taken at the same time. Therefore, gemfibrozil should be administered one hour before or 4-6 hours after administering colestipol or cholestyramine.




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