Gemfibrozil
Indications
Gemfibrozil is used for:
Hypertriglyceridemia, Hyperlipidemia
Adult Dose
Hypertriglyceridemia, Hypercholesterolemia
600 mg PO q12hr
Hepatic impairment
Contraindicated
Child Dose
Safety and efficacy not established
Renal Dose
Renal impairment
Mild to moderate: Use caution, if baseline serum creatine in patient is >2mg/dL; deterioration of renal function reported in such patients
Severe: Contraindicated
Administration
Should be taken on an empty stomach. Take ½ hr before meals.
Contra Indications
Hypersensitivity. Severe hepatic or renal dysfunction; gall stones; neonates, children, pregnancy, lactation.
Precautions
Causes of secondary hyperlipidaemia such as hypothyroidism and diabetes must be treated before initiating therapy. Renal impairment; blood disorders. Periodic monitoring of the serum lipids should be done; if no adequate response after 3 mth, treatment should be withdrawn. May increase risk of cholelithiasis.
Lactation: Not recommended
Pregnancy-Lactation
Interactions
Co-admin with repaglinide may increase serum levels of repaglinide. May enhance effects of oral anticoagulants. May also increase the plasma concentrations of ciclosporin and associated nephrotoxicity when used concurrently.
Potentially Fatal: Increased risk of myopathy and rhabdomyolysis when used with HMG-CoA reductase inhibitors.
Adverse Effects
Side effects of Gemfibrozil :
>10%
Dyspepsia (20%)
1-10%
Abdominal pain (10%),Atrial fibrillation (1%),Diarrhea (7%),Fatigue (4%),N/V (3%),Eczema (2%),Rash (2%),Vertigo (2%),Constipation (1%),Headache (1%)
<1%
Myalgia,Rhabdomyolysis (especially with admin with statin),Acute appendicitis,Cholelithiasis,Angioedema,Hypokalemia,Eosinophilia,Myopathy,Synovitis,Taste disturbance,Xerostomia,Flatulence,Rash
Potentially Fatal: Bone marrow hypoplasia; intracranial haemorrhage; nephrotoxicity; peripheral neuritis.
Mechanism of Action
Gemfibrozil exhibits its action by inhibition of lipolysis and reduction of hepatic fatty acid uptake. It also inhibits secretion of VLDL from the liver.