ʻO Gemfibrozil (Hawaiian)
What is Gemfibrozil?
It is used to treat hyperlipidemia as well as to reduce the risk of coronary heart disease only in patients with hyperlipidemia type IIb (without symptoms or history of coronary artery disease) and to be treated through diet control, exercise, weight loss and Medication alone does not respond and is consumed with low levels of HDL cholesterol, high levels of LDL cholesterol and triglycerides.
Mechanism of action of Gemfibrozil
Gemfibrozil decreases plasma triglyceride (VLDL) concentration and increases HDL plasma concentration. Although this drug may slightly lower total cholesterol and low-density lipoprotein (LDL), its use in patients with high triglycerides and high IV lipids often leads to a significant increase in LDL. It may inhibit peripheral lipolysis, reduce hepatic uptake of free fatty acids and reduce the production of hepatic glycerides, inhibit the production of hepatic glycerides, inhibit the production of apolipoprotein B, which carries VLDL, and increase clearance, thereby reducing VLDL production.
Side effects of Gemfibrozil
Cardiovascular: Atrial fibrillation
Central nervous system: fatigue, dizziness
Skin: Eczema, skin rash
Gastrointestinal: Abdominal pain, nausea and vomiting
Pharmacokinetics of Gemfibrozil
This drug is well absorbed from the gastrointestinal tract. Metabolism of gemfibrozil is hepatic. The half-life of the drug after taking a single dose is 1.5 hours and after consuming multiple doses is 1.3 hours. The time required to reach the peak concentration is 1-2 hours. The effect of this drug in reducing plasma VLDL concentration begins after 2-5 days. The time required to reach the peak effect of reducing plasma VLDL concentration is 4 weeks. Excretion of the drug is mainly from the kidneys
Contraindications to the use of Gemfibrozil
This drug should not be used in patients with primary biliary cirrhosis.
Reducing the effects of drugs by Gemfibrozil:
Chenodiol, cyclosporine (systemic), imatinib, ursodiol
Category X Interactions (Avoidance):
Amodiaquine, Svnaprvyr, atorvastatin, Bksarvtn (systemic), Syprvfybrat, Dasabvvyr, Alagvlyks, Alagvlyks / estradiol / norethindrone, ezetimibe, fluvastatin, Grazvprvyr, lovastatin, Avmbytasvyr / Parytaprvyr / ritonavir / Dasabvvyr, Pytavastatyn, pravastatin, repaglinide, Rvfnasyn, rosuvastatin, Slksypg , Simvastatin, Voxilaproir
Reducing the effects of Gemfibrozil by drugs
Bile acid complexing agents
Increased effects by drugs
Acypimox, Ciprofibrate, Cyclosporine (Systemic), Raltgravir
AUC is reduced if gemfibrozil is taken after a meal.
Solution: Take 30 minutes before breakfast and dinner.
1- This drug should be used with great caution in patients with renal and hepatic impairment.
Cholesterol and triglyceride levels, complete blood cell counts, and liver function tests are essential before long-term treatment is started.
If after three months of treatment, an adequate response is not obtained or the results of liver function tests show a significant increase or disturbance, or if gallstones are diagnosed and myositis is diagnosed or suspected, gemfibrozil should be discontinued. In this case, it is recommended to use a proper diet to reduce blood lipids to stabilize the patient’s condition.
Gemfibrozil drug recommendations
1- Adherence to a proper diet is preferable to drug treatment.
2- It is necessary to contact a doctor before stopping the use, because the concentration of lipids in the blood may increase significantly.
3- This medicine should not be taken less or more than the recommended amount.
4- Dermatitis should be completed with medication.
5. If you miss a dose, take it as soon as you remember, unless it is almost time for your next dose. In this case, the next dose should not be doubled.
6- During treatment with this drug, regular visits to the doctor are necessary.
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