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