gemfibrozil (Lopid)

Gemfibrozil is a blood lipid and cholesterol-altering medicine.

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.

Is gemfibrozil available as a generic drug?

Yes

Do I need a prescription for gemfibrozil?

Yes

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.

The recommended dose of gemfibrozil is 600 mg twice daily (30 minutes before breakfast and dinner).

Gemfibrozil can cause problems 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)

All these increase the risk of a condition called rhabdomyolysis (muscle injury) that when severe can lead to kidney damage and even 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 the blood thinner, 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.

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.

It is not known whether gemfibrozil is excreted in human milk.

What preparations of gemfibrozil are available?

Tablets: 600 mg

How should I keep gemfibrozil stored?

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

How does gemfibrozil work?

Gemfibrozil 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.

When was gemfibrozil approved by the FDA?

Gemfibrozil was approved in September 1993.