Gemfibrozil
LOPID
Pronunciation: jem-FI-broe-zil
“Loppy Gym Fiber”
What it isPPAR-alpha agonist reducing triglycerides; severe hypertriglyceridemia.
Why this oneUnlike fenofibrate, it strongly inhibits statin clearance, so it is the fibrate not to pair with a statin.
What limits itRhabdomyolysis can follow statin coadministration; strong CYP2C8 inhibition also raises susceptible drugs.
FDA-approved for
- hyperlipidemia (1981)
FDA label
Read the full label on DailyMed ↗
| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| Hyperlipidemia / hypertriglyceridemia | Adults | 600 mg BID (1200 mg/day) | 600 mg BID | 1200 mg/day |
Renal Contraindicated in severe renal dysfunction
Hepatic Contraindicated in hepatic dysfunction (incl. primary biliary cirrhosis)
Instructions
- Take 30 minutes before the morning and evening meals
Available strengths
- tab 600 mg
Contraindications
- Hepatic or severe renal dysfunction, including primary biliary cirrhosis
- Preexisting gallbladder disease
- Combination therapy with simvastatin, repaglinide, dasabuvir, or selexipag
Cautions
- Cholelithiasis/gallbladder disease
- Myopathy/rhabdomyolysis risk (esp. with statins)
- Hepatic effects
Adverse reactions
- Dyspepsia
- Abdominal pain
- Diarrhea
- Nausea/vomiting
- Eczema/rash
- Vertigo
- Fatigue
- Increased gallbladder surgery
Pregnancy Undefined
Lactation Undefined
Cost
| Strength | #/mo | generic $/mo | CostPlus | |
|---|---|---|---|---|
| 600 mg | tab | 60 BID | $6.23 | offered |
Generic entry1993
NO BOXED WARNINGS
Principal riskMyopathy with a statin; a strong CYP2C8 inhibitor
Classes and tags
Clinical profile
Legacy pregnancy categoryC
Defining liabilityMyopathy/rhabdomyolysis and hepatotoxicity; interaction burden varies by agent.
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