gemfibrozil


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gemfibrozil

 [jem-fib´ro-zil]
an antilipidemic agent used for treatment of patients with very high serum triglyceride levels (type IV hyperlipoproteinemia) who do not respond to dietary management.

gemfibrozil

Apo-Gemfibrozil (CA), Dom-Gemfibrozil (CA), Gen-Gemfibrozil (CA), Lopid, Novo-Gemfibrozil (CA), Nu-Gemfibrozil (CA), PMS-Gemfibrozil (CA), Riva-Gemfibrozil (CA)

Pharmacologic class: Fibric acid derivative

Therapeutic class: Antihyperlipidemic

Pregnancy risk category C

Action

Inhibits peripheral lipolysis, resulting in decreased triglyceride levels. Also inhibits synthesis and increases clearance of very-low-density lipoproteins.

Availability

Tablets: 600 mg

Indications and dosages

Type IIb hyperlipidemia in patients without coronary artery disease who don't respond to other treatments; adjunctive therapy for types IV and V hyperlipidemia

Adults: 1,200 mg P.O. daily in two divided doses

Contraindications

• Hypersensitivity to drug
• Gallbladder disease
• Severe renal dysfunction
• Hepatic dysfunction

Precautions

Use cautiously in:
• renal impairment, cholelithiasis, diabetes, hypothyroidism
• pregnant or breastfeeding patients
• children (safety not established).

Administration

• Give 30 minutes before a meal.
• Know that before starting drug and throughout therapy, patient should use dietary measures and exercise, as appropriate, to control hyperlipidemia.

Adverse reactions

CNS: fatigue, hypoesthesia, paresthesia, drowsiness, syncope, vertigo, dizziness, headache, seizures

CV: vasculitis

EENT: cataracts, blurred vision, retinal edema, hoarseness

GI: nausea, vomiting, diarrhea, abdominal or epigastric pain, heartburn, flatulence, gallstones, dry mouth

GU: dysuria, erectile dysfunction, decreased male fertility

Hematologic: eosinophilia, anemia, bone marrow hypoplasia, leukopenia, thrombocytopenia

Hepatic: hepatotoxicity

Metabolic: hypoglycemia

Musculoskeletal: joint, back, or muscle pain; myasthenia; myopathy; synovitis; myositis; rhabdomyolysis

Respiratory: cough

Skin: alopecia, rash, urticaria, eczema, pruritus, angioedema

Other: abnormal taste, chills, weight loss, increased risk of bacterial and viral infection, lupuslike syndrome, anaphylaxis

Interactions

Drug-drug.Chenodiol, ursodiol: decreased gemfibrozil efficacy

Cyclosporine: decreased cyclosporine effects

HMG-CoA reductase inhibitors: increased risk of rhabdomyolysis

Sulfonylureas: increased hypoglycemic effects

Warfarin: increased bleeding risk

Drug-diagnostic tests.Alanine aminotransferase, alkaline phosphatase, aspartate aminotransferase, bilirubin, creatine kinase (CK), glucose, lactate dehydrogenase: increased values

Hematocrit, hemoglobin, potassium, white blood cells: decreased values

Patient monitoring

• Monitor kidney and liver function test results and serum lipid levels.

Watch for signs and symptoms of adverse reactions, especially bleeding tendency and hypersensitivity reaction.
• Monitor periodic blood counts during first year of therapy.
• Check CK level if myopathy occurs.

Patient teaching

• Tell patient to take drug 30 minutes before breakfast and dinner.

Advise patient to immediately report signs or symptoms of anaphylaxis (such as difficulty breathing or rash) or other allergic reactions.

Instruct patient to immediately report unusual bleeding or bruising or muscle pain.
• Caution patient to avoid driving and other hazardous activities until he knows how drug affects concentration and alertness.
• Stress importance of diet and exercise in lowering lipid levels.
• Inform patient that he'll undergo regular blood testing during therapy.
• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs and tests mentioned above.

gemfibrozil

/gem·fib·ro·zil/ (jem-fib´ro-zil) a hypolipidemic agent used for treatment of patients with very high serum triglyceride levels (type IV hyperlipoproteinemia) who do not respond to dietary management.

gemfibrozil

(jĕm-fī′brə-zĭl, -fĭb′rə-)
n.
A drug, C15H22O3, used to treat high levels of triglycerides and low levels of HDL.

gemfibrozil

[jemfī′brəzil]
an antihyperlipidemic agent.
indication It is prescribed for the treatment of hyperlipidemia, specifically high levels of plasma triglycerides.
contraindications Renal or hepatic dysfunction, gallbladder disease, or known hypersensitivity to this drug prohibits its use.
adverse effects Among the adverse effects are abdominal or epigastric pain, urticaria, dizziness, and anemia.

gemfibrozil

Lopid® Cardiovascular disease A drug that inhibits VLDL synthesis, which ↓ M&M due to CAD, nonfatal MIs and strokes, by ↑ HDL-C and ↓ TGs. See Cholesterol-lowering drugs, Lovastatin, VA-HIT.

gemfibrozil

A FIBRATE cholesterol-lowering drug. A brand name is Lopid.

gemfibrozil (jemfī´brəzil´),

n brand name: Lopid;
drug class: antihyperlipidemic;
action: reduces plasma triglycerides and very-low-density lipoproteins;
uses: type IIb, IV, and V hyperlipidemia.
References in periodicals archive ?
The marketed drug Gemfibrozil lowered the TC by 38%, TG by 36%, PL by 34%, LCAT reactivation by 42% and PHLA reactivation by 41% at 50 mg/kg dose.
Long-term safety and efficacy of combination gemfibrozil and HMG-CoA reductase inhibitors for the treatment of mixed lipid disorders.
8 mg dosage and among patients also taking gemfibrozil.
Who is at risk: Elderly patients, those who took a high dosage of Baycol, and those who also took Baycol and gemfibrozil (Lopid).
He was discharged from the hospital on gemfibrozil, pravastatin, meclizine, and aspirin.
If as much thinking went into niacin as has gone into gemfibrozil or lovastatin, we'd know how it works and why some types cause liver damage," says Roger Illingworth of the Oregon Health Sciences Center in Portland.
Because of the increased risk of myopathy/rhabdomyolysis, particularly at higher doses of simvastatin, concomitant use is contraindicated with drugs that are strong CYP3A4 inhibitors or with gemfibrozil, cyclosporine or danazol, and large quantities of grapefruit juice (>1 quart daily) should be avoided.
Gemfibrozil continued to be the primary fibrate used, although some patients had begun to use fenofibrate.
Hypolipidemic fibrates such as clofibrate and gemfibrozil have been used extensively over the past 20 years to treat cardiovascular disease and are enjoying a revival due to recent reconfirmation of efficacy (6).
Fenofibrate (Tricor) 67 to 200 mg per day or gemfibrozil (Lopid) 600 mg twice a day are effective in lowering triglyceride levels, and have some effect on cholesterol as well.
Another cholesterol-lowering drug, gemfibrozil (Lopid), showed a similar difference when measured in the two ways.