Other Brands/Names

Carlipid, Detrichol, Dubrozil, Fetinor, Lapibroz, Lexacholes, Lifibron, Lipira, Lipitrop, Lipres, Lopid, Lokoles, Mersikol, Merzasol, Nufalemzil, Renabrazin, Scantipid, Stachol, Zenibroz, Zilop.

How It Works

Gemfibrozil is a fibrate that lowers fat and cholesterol levels in the body. This medicine is used to reduce elevated triglyceride levels.

At very high levels, triglycerides can increase the risk of acute pancreatitis (pancreas inflammation). High triglyceride levels are also suspected to increase the risks of heart disease, although this effect is still not fully understood.

Gemfibrozil acts by inhibiting fat breakdown and VLDL formation (fat-carrying molecules), and by decreasing hepatic reuptake of fatty acids. It can also raise HDL (“good”) cholesterol levels and lower LDL (“bad”) cholesterol levels.

Indications

Gemfibrozil is indicated to reduce elevated triglyceride levels. This is especially relevant in patients with primary hyperlipidemia, when fat serum levels increase due to various causes. It is useful to help lower triglyceride levels when it still remains high despite the patients have done lifestyle modifications.

Contraindication

Do not use gemfibrozil in patients with one of these conditions:

• Hypersensitivity or allergy to this medicine.
• Breastfeeding women.
• Severe hepatic or renal dysfunction.
• Gallbladder disease (including gallstones).
• Currently being treated with a statin, repaglinide (an antidiabetic), or dasabuvir (an antiviral).

Side Effects

The most frequent side effect is dyspepsia, which may present with:

• Abdominal discomfort
• Epigastric pain or burning sensation
• Bloating and early satiety

Other possible side effects include:

• Fatigue
• Skin rash
• Diarrhea
• Nausea
• Vomiting
• Headache
• Dizziness
• Atrial fibrillation (a cardiac electrical rhythm disorder)

This medicine can also increase cholesterol excretion into bile, which may increase the risks of gallstone formation. Therefore, gemfibrozil should not be used in patients with gallstone disease.

Types

Gemfibrozil is available in capsules and tablets with dosages of 300 mg, 600 mg, and 900 mg.

Dosage

For adult patients:

• 600 mg twice daily, taken 30 minutes before breakfast and dinner.
• 900 mg once daily in the evening may be used for patients who cannot tolerate adverse effects.
• Maximum dose: 1,500 mg/day.

Safety

This medicine is categorized to category C for pregnant women according to the FDA, indicating there are still limited data available from animal or human studies. Adverse fetal effects have been seen in animals, but datas derived from researches in pregnant women are still lacking.

The use of gemfibrozil in breastfeeding women is not recommended because gemfibrozil may interfere with infant fat metabolism. It is unknown whether the drug is excreted in breast milk.

Drug Interactions

• Concomitant use with statins increases the risk of rhabdomyolysis, a condition in which damaged muscle tissue releases protein and electrolytes into the blood and may damage the kidneys.
• Concurrent use with repaglinide may cause severe hypoglycemia (low blood sugar).
• Warfarin’s anticoagulant effect may increase when it is used with gemfibrozil.
• Combined use of gemfibrozil with dasabuvir may increase the risk of QT prolongation, a cardiac rhythm disorder.

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