Gemfibrozil
Synonym :
Lopid
Mechanism :
Gemfibrozil is a lipid regulating agent which decreases serum triglycerides and very low-density lipoprotein (VLDL) cholesterol and increases high density lipoprotein (HDL) cholesterol.
Indication :
- Hyperlipidemia
- Familial hypercholesterolemia
- Neonatal hyperbilirubinemia
Contraindications :
Known hypersensitivity to gemfibrozil, renal and hepatic dysfunction, and gall bladder disease are contraindications for its use.
Dosing :
Limited experience in children (Doses based on clinical trials).
Hyperlipidemia:
150-600 mg twice a day orally.
Neonatal hyperbilirubinemia:
60 mg/kg 2 doses for 1 day PO.
Adverse Effect :
Nausea, anorexia, gastric pain, headache, pruritus, urticaria, myopathy, cholestatic jaundice, arrhythmias.
Interaction :
Warfarin: Enhanced effect.
HMG-COA reductase inhibitors: Increased risk of rhabdomyolysis.
Bile acid sequestrants: Elevation in liver enzymes.
Repaglinide and Simvastatin: Cannot be used with Gemfibrozil.
Renal Dose :
Dose in Renal Impairment GFR (mL/min)
| 20-50 | Initially 900 mg daily |
| 10-20 | Initially 900 mg daily. Monitor carefully |
| <10 | Initially 900 mg daily. Monitor carefully |
Dose in Patients undergoing Renal Replacement Therapies
| CAPD | Not dialysed. Dose as in GFR<10 mL/min |
| HD | Not dialysed. Dose as in GFR<10 mL/min |
| HDF/High flux | Not dialysed. Dose as in GFR<10 mL/min |
| CAV/VVHD | Not dialysed. Dose as in GFR=10– 20 mL/min |
Hepatic Dose :
Use is contraindicated in hepatic impairment and in primary biliary cirrhosis.