Pharmacy Author: Omudhome Ogbru, PharmD
Medical and Pharmacy Editor: Jay W. Marks, MD
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.
PREGNANCY: The effect of gemfibrozil in pregnant women has not been
well-studied. Gemfibrozil should be used during
pregnancy only if the potential
benefit justifies the unknown but potential risk to the fetus.
NURSING MOTHERS: It is not known whether gemfibrozil is excreted in
human
milk.
SIDE EFFECTS: Common side effects of gemfibrozil include upset stomach,
stomach pain, diarrhea, headache, tiredness, nausea, and
vomiting. Muscle aches
and pain also occur. Rarely, these muscle-related symptoms are associated with
damage to muscles that releases chemicals into the blood that that can damage
the kidney. Muscle damage is of greatest concern when gemfibrozil is combined
with statins. The formation of gallstones and gallbladder surgery have been
associated with the use of gemfibrozil. Pancreatitis,
abnormal blood liver
tests, as well as reduced red blood cells (anemia), white blood cells
(leukopenia) and blood platelets (thrombocytopenia) also have been reported.
Last Editorial Review: 3/26/2009
Report Problems to the Food and Drug Administration
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.
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