What is gemfibrozil?
Gemfibrozil is a blood lipid and
cholesterol-altering medicine.
Why is gemfibrozil prescribed to patients?
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
What are the side effects of gemfibrozil?
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.
What is the dosage for gemfibrozil?
The recommended dose of gemfibrozil is 600 mg twice daily (30 minutes before breakfast and dinner).
Which drugs or supplements interact with gemfibrozil?
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.
Is gemfibrozil safe to use during pregnancy or while breastfeeding?
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.
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What else should I know about gemfibrozil?
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.