Gemfibrozil

Gemfibrozil is the generic name for an oral drug used to lower lipid levels. It belongs to a group of drugs known as fibrates. It is most commonly sold as the brand name, Lopid. Other brand names include Jezil and Gen-Fibro.

Actions

 * Is an activator of Peroxisome proliferator-activated receptor-alpha (PPARα), a nuclear receptor that is involved in metabolism of carbohydrates and fats, as well as adipose tissue differentiation.  This increase in the synthesis of lipoprotein lipase thereby increases the clearance of triglycerides.

Therapeutic effects

 * Reduce triglyceride levels
 * Reduce Very low density lipoprotein (VLDL) levels
 * Modest reduction of Low density lipoprotein (LDL) levels
 * Moderate increase in High density lipoprotein (HDL) levels

Nontherapeutic effects and toxicities

 * GI distress
 * Musculoskeletal pain
 * Increased incidence of gallstone
 * Hypokalemia
 * Increased risk of cancer

Indications

 * Hyperlipidemia (Type III): Gemfibrozil is the drug of choice for therapy.
 * Hypertriglyceridemia (Type IV): Gemfibrozil, though not as effective as niacin, is better tolerated.

Contraindications and Precautions

 * Gemfibrozil should not be given to these patients:
 * Hepatic dysfunction
 * Renal dysfunction


 * Gemfibrozil should be used with caution in these higher risk categories:
 * Biliary Tract Disease
 * Pregnant women
 * Obese patients
 * Native Americans

Drug Interactions

 * Anticoagulants: Gemfibrozil potentiates the action of coumadin and indanedione anticoagulants.
 * Statin drugs: Concomitant administration of fibrates (including gemfibrozil) with statin drugs increases the risk of muscle cramping, myopathy, and rhabdomyolysis.