Gemfibrozil is a fibric acid derivative which effectively lowers plasma TG level by enhancing breakdown and suppressing hepatic synthesis of TGs. Besides high efficacy in type III hyperlipoproteinemia, gemfibrozil has shown action in subjects with raised blood CH in addition. In the ‘Helsinki Heart Study’ men without known CAD treated with gemfibrozil had a 34% reduction in fatal and nonfatal MI, although overall mortality was not affected. Additional actions to decrease the level of clotting factor Vll – phospholipid complex and promotion of fibrinolysis have been observed, which may contribute to the antiatherosclerotic effect.
Pharmacokinetics Gemfibrozil is completely absorbed orally metabolized by glucuronidation and undergoes some enterohepatic circulation. It is excreted in urine; elimination t½ 1—2 hr.
Gemfibrozil Side effects :
Common side effects are epigastric distress, loose motions.
Skin rashes, body ache, eosinophilia, impotence, headache and blurred vision have been reported. Myopathy is uncommon. Gemfibrozil + statin increases risk of myopathy.
Incidence of gallstone is not increased as seen with clofibrate.
It is contraindicated during pregnancy.
Commercial names:
GEMPAR, NORMOLIP 300 mg cap. LOPID 300 mg cap, 600 mg and 900 mg tabs.
Gemfibrozil Dosage :
Use In a dose of 600mg BD taken before meals, it is the drug of choice for patients with markedly raised TG levels, whether or not CH levels are also raised. Episodes of acute pancreatitis are prevented in patients with chylomicronaemia and severe hypertriglyceridaemia. It is most effective in type III hyperlipoproteinaemia; also a first line drug in type IV and type V disease. It may be used as an adjuvant drug in type llb patients.