Gemfibrozil

Introduction

• Generic Name: Gemfibrozil
• Brand Names: Lopid
• Pharmacological Class: Fibric acid derivative (Fibrate)
• Mechanism of Action: Works by decreasing triglycerides and very low-density lipoprotein (VLDL) levels while increasing high-density lipoprotein (HDL) cholesterol. It does this through the activation of peroxisome proliferator-activated receptor alpha (PPARα) which influences the metabolism of lipoproteins.

Indications

• Primary Use: Treatment of severe hypertriglyceridemia and to reduce the risk of developing coronary heart disease in patients who have not responded adequately to other therapy.
• Other Uses: Occasionally used to manage pancreatitis associated with high blood triglyceride levels.

Dosage

• Adults: Typically, 600 mg taken orally twice daily, about 30 minutes before the morning and evening meals.
• Elderly: Dosage adjustment may not be necessary, but patients should be closely monitored for side effects.
• Children: Not recommended for use in children.

Administration

• Method: Oral intake.
• Precautions: Should be taken consistently in relation to meals to maximize absorption and therapeutic effect.

Forms Available

• Tablets: 600 mg

Side Effects

• Common: Dyspepsia, abdominal pain, diarrhea, nausea.
• Less Common: Fatigue, headache, vertigo.
• Rare but Serious: Rhabdomyolysis (severe muscle damage), liver toxicity, increased risk of gallstones.

Warnings

• Black Box Warning: None.
• Contraindications: Existing gallbladder disease, liver dysfunction, severe renal impairment, and hypersensitivity to gemfibrozil.

Precautions

• General: Regular monitoring of liver function and lipid levels. Avoid use with statins due to increased risk of muscle toxicity.
• Health Conditions: Use with caution in patients with a history of biliary tract disease as gemfibrozil can increase cholesterol excretion into the bile, leading to cholelithiasis.

Interactions

• Medications: Increases the effects of oral anticoagulants and can enhance the effects of other cholesterol-lowering drugs like statins, increasing the risk of myopathy.
• Food: No specific food interactions, but consistency in diet helps manage overall treatment efficacy.

Monitoring Parameters

• Liver Function: Periodic liver enzyme tests to detect hepatotoxicity.
• Lipid Profile: Regular monitoring of cholesterol and triglycerides levels.
• Renal Function: Monitor renal function in patients with pre-existing renal impairment.

Use in Children

• Guidelines: Not typically prescribed due to lack of safety and efficacy data in pediatric populations.

Use in Pregnancy

• FDA Category: C. Should only be used if the potential benefits justify the potential risks to the fetus.

Use in Elderly

• Considerations: Monitor closely due to an increased risk of side effects, particularly those related to muscle and liver health.

Use in Kidney Disease

• Adjustments: Use with caution; may require dose adjustments based on renal function.

Use in Liver Disease

• Caution: Contraindicated in patients with active liver disease. Monitor liver function regularly if therapy is initiated.

Patient Counselling Points

• Medication Use: Adherence to prescribed dosages and timing in relation to meals.
• Side Effects: Report any unusual muscle pain, weakness, abdominal pain, or signs of jaundice.
• Lifestyle: Encourage maintaining a healthy diet low in cholesterol and fats, along with regular exercise.

Table of Brand Names, Manufacturer, and Prices in USD

Brand Name	Manufacturer	Strength/Dosage Form	Price (USD)
Lopid	Pfizer	600 mg Tablet	$1.20

15 FAQs with Answers

1. What is Gemfibrozil used for? – Mainly to treat high triglycerides and to reduce the risk of coronary heart disease.
2. How does Gemfibrozil work? – It activates PPARα to reduce triglycerides and increase HDL cholesterol.
3. Can Gemfibrozil be taken with food? – Yes, it is recommended to take it 30 minutes before meals for best absorption.
4. What are common side effects of Gemfibrozil? – Includes abdominal pain, diarrhea, and dyspepsia.
5. Is Gemfibrozil safe during pregnancy? – It is a Category C drug; use only if necessary.
6. Can Gemfibrozil cause liver issues? – Yes, it can cause liver toxicity; liver function should be monitored.
7. How often should lipid levels be checked? – Regularly, as directed by your healthcare provider.
8. What should I do if I experience muscle pain while taking Gemfibrozil? – Contact your doctor immediately as this could be a sign of serious muscle damage.
9. Can I stop taking Gemfibrozil suddenly? – Consult your doctor, as abrupt cessation might lead to worsening symptoms.
10. Does Gemfibrozil interact with other medications? – Yes, especially with statins and oral anticoagulants.
11. Who should not take Gemfibrozil? – People with gallbladder disease, liver dysfunction, or severe renal impairment.
12. How should Gemfibrozil be stored? – Store at room temperature away from moisture and heat.
13. Can Gemfibrozil affect kidney function? – Use with caution in renal impairment, monitoring function regularly.
14. Is alcohol consumption safe with Gemfibrozil? – Alcohol may exacerbate liver issues and should be limited.
15. How does Gemfibrozil help prevent heart disease? – By lowering triglycerides and increasing HDL cholesterol, reducing overall cardiovascular risk.