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 NameManufacturerStrength/Dosage FormPrice (USD)
LopidPfizer600 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.