Gemfibrozil

Gemfibrozil

Systematic (IUPAC) name
5-(2,5-dimethylphenoxy)-2,2-dimethyl-pentanoic acid
Clinical data
Trade names	Lopid
AHFS/Drugs.com	monograph
MedlinePlus	a686002
Pregnancy cat.	Category C
Legal status	By Prescription
Routes	Oral
Pharmacokinetic data
Bioavailability	Close to 100%
Protein binding	95%
Metabolism	Hepatic (CYP3A4)
Half-life	1.5 hours
Excretion	Renal 94% Feces 6%
Identifiers
CAS number	25812-30-0 Y
ATC code	C10AB04
PubChem	CID 3463
DrugBank	APRD00293
ChemSpider	3345 Y
UNII	Q8X02027X3 Y
KEGG	D00334 Y
ChEBI	CHEBI:5296 Y
ChEMBL	CHEMBL457 Y
Chemical data
Formula	C15H22O3
Mol. mass	250.333 g/mol
SMILES	eMolecules & PubChem
InChI InChI=1S/C15H22O3/c1-11-6-7-12(2)13(10-11)18-9-5-8-15(3,4)14(16)17/h6-7,10H,5,8-9H2,1-4H3,(H,16,17) Y Key:HEMJJKBWTPKOJG-UHFFFAOYSA-N Y
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Gemfibrozil is the generic name for an oral drug used to lower lipid levels. It belongs to a group of drugs known as fibrates. It is most commonly sold as the brand name, Lopid. Other brand names include Jezil and Gen-Fibro.

Actions

• Is an activator of Peroxisome proliferator-activated receptor-alpha (PPARα), a nuclear receptor that is involved in metabolism of carbohydrates and fats, as well as adipose tissue differentiation. This increase in the synthesis of lipoprotein lipase thereby increases the clearance of triglycerides.

Therapeutic effects

• Reduce triglyceride levels
• Reduce very low density lipoprotein (VLDL) levels
• Modest reduction of low density lipoprotein (LDL) levels
• Moderate increase in high density lipoprotein (HDL) levels

Nontherapeutic effects and toxicities

• GI distress
• Musculoskeletal pain
• Increased incidence of gallstone
• Hypokalemia
• Increased risk of cancer[1]

Indications

• Hyperlipidemia (Type III): Gemfibrozil is the drug of choice for therapy.
• Hypertriglyceridemia (Type IV): Gemfibrozil, though not as effective as niacin, is better tolerated.

Contraindications and precautions

• Gemfibrozil should not be given to these patients:
  • Hepatic dysfunction
  • Renal dysfunction

• Gemfibrozil should be used with caution in these higher risk categories:
  • Biliary tract disease
  • Pregnant women
  • Obese patients
  • Native Americans

Drug Interactions

• Anticoagulants: Gemfibrozil potentiates the action of warfarin and indanedione anticoagulants.
• Statin drugs: Concomitant administration of fibrates (including gemfibrozil) with statin drugs increases the risk of muscle cramping, myopathy, and rhabdomyolysis.

External links

• DrugBank Gemfibrozil
• NIH Gemfibrozil Drug Info}
• Lopid International Study
• Safety of Statins - Circulation. 2004;109:III-50 – III-57