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.
Miller-Keane Encyclopedia and Dictionary of Medicine, Nursing, and Allied Health, Seventh Edition. © 2003 by Saunders, an imprint of Elsevier, Inc. All rights reserved.

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.

McGraw-Hill Nurse's Drug Handbook, 7th Ed. Copyright © 2013 by The McGraw-Hill Companies, Inc. All rights reserved

gemfibrozil

(jĕm-fī′brə-zĭl, -fĭb′rə-)
n.
A drug, C15H22O3, used to treat high levels of triglycerides and low levels of HDL.
The American Heritage® Medical Dictionary Copyright © 2007, 2004 by Houghton Mifflin Company. Published by Houghton Mifflin Company. All rights reserved.

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.
McGraw-Hill Concise Dictionary of Modern Medicine. © 2002 by The McGraw-Hill Companies, Inc.

gemfibrozil

A FIBRATE cholesterol-lowering drug. A brand name is Lopid.
Collins Dictionary of Medicine © Robert M. Youngson 2004, 2005
References in periodicals archive ?
Group A received pioglitazone 30mg and group B received gemfibrozil 600mg once daily at night for 12 weeks, whereas group C served as the healthy control.
Gemfibrozil was from Pfizer Canada (Kirkland, Canada).
This was an off-label use of gemfibrozil, which has not been studied formally in children with metabolic syndrome.
If it is necessary to use both gemfibrozil and a statin--a common scenario--it's important to document the reason.
(14) However, the clinical advisory on statins by American Heart Association/American College of Cardiology/National Heart, Lung and Blood Institute warns that statin/fibrate combinations (especially with gemfibrozil) or statin/niacin (although rare) are risk factors for statin-associated myopathy.
Who is at risk: Elderly patients, those who took a high dosage of Baycol, and those who also took Baycol and gemfibrozil (Lopid).
The company said it will not recall Baycol in Japan because gemfibrozil is not an approved drug in Japan.
He was discharged from the hospital on gemfibrozil, pravastatin, meclizine, and aspirin.
The findings of the Helsinki Heart Study show that men who have a high ratio of low-density lipoprotein (LDP) to high-density lipoprotein (HDP)--low being "bad" cholesterol and high being "good" cholesterol--and high triglyceride levels have a high CHD risk and can benefit substantially from treatment with gemfibrozil.
"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.
From 4th to 8th week, Group A (control) was given 0.5ml of distilled water, Group B was given pioglitazone 10mg/kg body weight, and Group C was given gemfibrozil 10mg/kg body weight as single morning dose by oral route for a period of 04 weeks in addition to hyperlipidaemic diet.