Gemfibrozil

Also indexed as: Apo-Gemfibrozil®, Lopid®, Novo-Gemfibrozil®

Gemfibrozil is a drug used to lower cholesterol and triglycerides in people with high cholesterol. Other drugs, especially members of the HMG-CoA reductase inhibitor drug family, are more commonly used.

Summary of Interactions with Vitamins, Herbs, and Foods
(for details about the summarized interactions, read the full article)

Beneficial May be Beneficial: Depletion or interference—The medication may deplete or interfere with the absorption or function of the nutrient. Taking these nutrients may help replenish them.

Coenzyme Q10*

Vitamin E*
Beneficial May be Beneficial: Supportive interaction—Taking these supplements may support or otherwise help your medication work better.

Vitamin B3 (niacin)
Avoid Avoid: Adverse interaction—Avoid these supplements when taking this medication because taking them together may cause undesirable or dangerous results.

Red yeast rice*
Side effect reduction/prevention

None known
Reduced drug absorption/bioavailability

None known

An asterisk (*) next to an item in the summary indicates that the interaction is supported only by weak, fragmentary, and/or contradictory scientific evidence.

Interactions with Dietary Supplements

Coenzyme Q10
In a randomized study of 21 men with combined hyperlipidemia, ten to twelve weeks of gemfibrozil therapy reduced coenzyme Q10 blood levels to the levels seen in healthy men.1 The clinical significance of this finding is unknown.

Vitamin E
In a randomized study of 21 men with combined hyperlipidemia, ten to twelve weeks of gemfibrozil therapy reduced alpha- and gamma-tocopherol blood levels to the levels seen in healthy men.2 The clinical significance of this finding is unknown and may reflect a normal physiological response to a reduction in serum cholesterol levels.

Vitamin B3 (Niacin)
Niacin (not niacinamide) and gemfibrozil have successfully raised HDL (good) cholesterol levels, both alone and in combination.3

Interactions with Herbs

Red yeast rice  (Monascus purpureus)
Monascus purpureus, a form of red yeast, is fermented with rice to produce a dietary supplement, Cholestin®, that contains low levels of lovastatin, a drug otherwise available only by prescription. Gemfibrozil taken with the prescription drug lovastatin has been reported to cause rhabdomyolysis, a potentially life-threatening muscle disease.4 People taking gemfibrozil should avoid lovastatin-containing products, including Cholestin®, until more is known. The levels of lovastatin in Cholestin® are significantly lower than those given of the drug as a single agent. Cholestin® also contains numerous other compounds that may alter the interaction of lovastatin and gemfibrozil.

Interactions with Foods and Other Compounds

Food
Gemfibrozil should be taken 30 minutes before meals.5

Alcohol
Gemfibrozil may cause dizziness or blurred vision.6 Alcohol may intensify these effects, increasing the risk for accidental injury. People taking gemfibrozil should avoid alcohol.

References

1. Aberg F, Appelkvist EL, Broijersen A, et al. Gemfibrozil-induced decrease in serum ubiquinone and alpha- and gamma-tocopherol levels in men with combined hyperlipidaemia. Eur J Clin Invest 1998;28:235–42.

2. Aberg F, Appelkvist EL, Broijersen A, et al. Gemfibrozil-induced decrease in serum ubiquinone and alpha- and gamma-tocopherol levels in men with combined hyperlipidaemia. Eur J Clin Invest 1998;28:235–42.

3. Zema MJ. Gemfibrozil, nicotinic acid and combination therapy in patients with isolated hypoalphalipoproteinemia: a randomized, open-label, crossover study. J Am Coll Cardiol 2000;35:640–6.

4. Garnett WR. Interactions with hydroxymethylglutaryl-coenzyme A reductase inhibitors. Am J Health Syst Pharm 1995;52:1639–45 [review].

5. Threlkeld DS, ed. Diuretics and Cardiovasculars, Antihyperlipidemic Agents, Gemfibrozil. In Facts and Comparisons Drug Information. St. Louis, MO, Facts and Comparisons, Feb 1997, 172h–2j.

6. Threlkeld DS, ed. Diuretics and Cardiovasculars, Antihyperlipidemic Agents, Gemfibrozil. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, Feb 1997, 172h–2j.