Gemfibrozil

Indications

Gemfibrozil is used for: Hypertriglyceridemia, Hyperlipidemia

Adult Dose

Hypertriglyceridemia, Hypercholesterolemia 600 mg PO q12hr Hepatic impairment Contraindicated

Child Dose

Safety and efficacy not established

Renal Dose

Renal impairment Mild to moderate: Use caution, if baseline serum creatine in patient is >2mg/dL; deterioration of renal function reported in such patients Severe: Contraindicated

Administration

Should be taken on an empty stomach. Take ½ hr before meals.

Contra Indications

Hypersensitivity. Severe hepatic or renal dysfunction; gall stones; neonates, children, pregnancy, lactation.

Precautions

Causes of secondary hyperlipidaemia such as hypothyroidism and diabetes must be treated before initiating therapy. Renal impairment; blood disorders. Periodic monitoring of the serum lipids should be done; if no adequate response after 3 mth, treatment should be withdrawn. May increase risk of cholelithiasis. Lactation: Not recommended

Pregnancy-Lactation

Pregnancy category: C Lactation: Not recommended

Interactions

Co-admin with repaglinide may increase serum levels of repaglinide. May enhance effects of oral anticoagulants. May also increase the plasma concentrations of ciclosporin and associated nephrotoxicity when used concurrently. Potentially Fatal: Increased risk of myopathy and rhabdomyolysis when used with HMG-CoA reductase inhibitors.

Adverse Effects

Side effects of Gemfibrozil : >10% Dyspepsia (20%) 1-10% Abdominal pain (10%), Atrial fibrillation (1%), Diarrhea (7%), Fatigue (4%), N/V (3%), Eczema (2%), Rash (2%), Vertigo (2%), Constipation (1%), Headache (1%) <1% Myalgia, Rhabdomyolysis (especially with admin with statin), Acute appendicitis, Cholelithiasis, Angioedema, Hypokalemia, Eosinophilia, Myopathy, Synovitis, Taste disturbance, Xerostomia, Flatulence, Rash Potentially Fatal: Bone marrow hypoplasia; intracranial haemorrhage; nephrotoxicity; peripheral neuritis.

Mechanism of Action

Gemfibrozil exhibits its action by inhibition of lipolysis and reduction of hepatic fatty acid uptake. It also inhibits secretion of VLDL from the liver.