Gemfibrozil
Gemfibrozil (Lopid)
Gemfibrozil
(jem- FIH-broh-zill)
Pregnancy Category: B Apo-Gemfibrozil Gen-Fibro Gemcor Lopid Novo-Gemfibrozil Nu-Gemfibrozil PMS-Gemfibrozil (Rx)

Classification: Antihyperlipidemic

Action/Kinetics: Gemfibrozil, which resembles clofibrate, decreases triglycerides, cholesterol, and VLDL and increases HDL; LDL levels either decrease or do not change. Also, decreases hepatic triglyceride production by inhibiting peripheral lipolysis and decreasing extraction of free fatty acids by the liver. Also, gemfibrozil decreases VLDL synthesis by inhibiting synthesis of VLDL carrier apolipoprotein B as well as inhibits peripheral lipolysis and decreases hepatic extraction of free fatty acids (thus decreasing hepatic triglyceride production). May be beneficial in inhibiting development of atherosclerosis. Onset: 2-5 days. Peak plasma levels: 1-2 hr; t 1/2: 1.5 hr. Nearly 70% is excreted unchanged.

Uses: Hypertriglyceridemia (type IV and type V hyperlipidemia) unresponsive to dietary control or in clients who are at risk of pancreatitis and abdominal pain. Reduce risk of coronary heart disease in clients with type IIb hyperlipidemia who have not responded to diet, weight loss, exercise, and other drug therapy.

Contraindications: Gallbladder disease, primary biliary cirrhosis, hepatic or renal dysfunction.

Special Concerns: Use with caution during lactation. Safety and efficacy have not been established in children. The dose may have to be reduced in geriatric clients due to age-related decreases in renal function.

Side Effects: GI: Cholelithiasis, abdominal or epigastric pain, N&V;, diarrhea, dyspepsia, constipation, acute appendicitis, colitis, pancreatitis, cholestatic jaundice, hepatoma. CNS: Dizziness, headache, fatigue, vertigo, somnolence, paresthesia, hypesthesia, depression, confusion, syncope, seizures. CV: Atrial fibrillation, extrasystole, peripheral vascular disease, intracerebral hemorrhage. Hematopoietic: Anemia, leukopenia, eosinophilia, thrombocytopenia, bone marrow hypoplasia. Musculoskeletal: Painful extremities, arthralgia, myalgia, myopathy, myasthenia, rhabdomyolysis, synovitis. Allergic: Urticaria, lupus-like syndrome, angioedema, laryngeal edema vasculitis, anaphylaxis. Dermatologic: Eczema, dermatitis, pruritus, skin rashes, exfoliative dermatitis, alopecia. Ophthalmic: Blurred vision, retinal edema, cataracts. Miscellaneous: Increased chance of viral and bacterial infections, taste perversion, impotence, decreased male fertility, weight loss.

Laboratory Test Alterations: AST, ALT, LDH, CPK, alkaline phosphatase, bilirubin. Hypokalemia. Positive antinuclear antibody. Hemoglobin, WBCs, hematocrit.

Drug Interactions: Anticoagulants, oral / Anticoagulant effects; adjust dosage Lovastatin / Possible rhabdomyolysis Simvastatin / Possible rhabdomyolysis

How Supplied: Tablet: 600 mg

Dosage
?Tablets
Adults: 600 mg b.i.d. 30 min before the morning and evening meal. Dosage has not been established in children. Discontinue if significant improvement not observed within 3 months.