Lipofor (Gemfibrozil)

Gemfibrozil acts on lipid metabolism pathways to correct abnormal triglyceride and cholesterol levels.

• Hypertriglyceridaemia: lowers elevated triglyceride concentrations.
• Mixed dyslipidaemia: reduces triglycerides and modestly raises HDL‑C, improving overall lipid profile.
• Prevention of pancreatitis secondary to severe hypertriglyceridaemia: decreases the risk of pancreatitis by controlling triglyceride levels.

• Gemfibrozil activates peroxisome proliferator‑activated receptor α (PPARα), which increases lipoprotein lipase activity and reduces hepatic very‑low‑density lipoprotein (VLDL) synthesis. The combined effect accelerates catabolism of triglyceride‑rich lipoproteins and modestly raises high‑density lipoprotein cholesterol, resulting in lowered plasma triglyceride levels.

Gemfibrozil may cause a range of adverse reactions, most of which are mild and reversible.

Common Side Effects

• Gastrointestinal upset: nausea, dyspepsia, abdominal pain, or diarrhea.
• Headache: mild to moderate intensity.
• Elevated liver enzymes: transient increases in ALT/AST.
• Skin reactions: rash or pruritus.
• Muscle pain: mild myalgia without weakness.

Serious or Rare Side Effects

• Myopathy or rhabdomyolysis, especially when combined with statins.
• Severe hepatotoxicity: marked elevation of liver enzymes or hepatitis.
• Acute pancreatitis.
• Blood dyscrasias: leukopenia, thrombocytopenia.
• Severe skin reactions: Stevens‑Johnson syndrome or toxic epidermal necrolysis.

Before initiating therapy, clinicians should assess patient-specific risk factors and monitor relevant parameters.

• Liver function monitoring: obtain baseline and periodic ALT/AST levels.
• Renal function assessment: evaluate creatinine clearance, especially in the elderly.
• Gallstone risk: consider history of biliary disease before use.
• Hepatic impairment: avoid in patients with severe liver dysfunction.
• Statin co‑therapy: review dosage and monitor for muscle toxicity.
• Store at ambient temperature: keep in the original container, protect from moisture and direct sunlight.

Gemfibrozil interacts with several drug classes; some combinations require avoidance while others need close monitoring.

Major Interactions (Avoid)

• Statins (especially high‑dose simvastatin or atorvastatin): increased risk of myopathy.
• Anticoagulants (warfarin): potentiation of anticoagulant effect, may raise INR.
• Cyclosporine: heightened risk of hepatotoxicity and myopathy.
• Oral contraceptives: may reduce contraceptive efficacy.
• Dual fibrate therapy: elevated risk of liver and muscle toxicity.

Moderate Interactions (Monitor Closely)

• Digoxin: possible increase in serum digoxin levels.
• Beta‑blockers: may enhance bradycardic effects.
• ACE inhibitors: monitor renal function and potassium levels.