Lopid (gemfibrozil) is a lipid-regulating medication belonging to the fibrate class, specifically indicated for the treatment of adults with severe hypertriglyceridemia and primary hyperlipoproteinemia. It functions by modulating lipoprotein lipase activity and reducing hepatic very low-density lipoprotein (VLDL) synthesis, leading to a significant reduction in serum triglycerides and a moderate increase in high-density lipoprotein (HDL) cholesterol. This agent is a cornerstone in managing specific dyslipidemias, particularly when triglyceride levels pose a significant cardiovascular risk. Its targeted mechanism offers a specialized approach for patients unresponsive to dietary modifications and other first-line lipid-lowering strategies.

Features

• Active ingredient: Gemfibrozil 600 mg
• Pharmaceutical form: Film-coated tablet
• Pharmacologic class: Fibric acid derivative (fibrate)
• Mechanism: Activates peroxisome proliferator-activated receptor-alpha (PPAR-α)
• Half-life: Approximately 1.5 hours
• Bioavailability: Well-absorbed orally
• Excretion: Primarily renal

Benefits

• Significantly reduces elevated serum triglyceride levels, decreasing pancreatitis risk
• Moderately increases HDL cholesterol, supporting reverse cholesterol transport
• May reduce VLDL and intermediate-density lipoprotein (IDL) particles
• Provides an alternative therapeutic pathway for statin-intolerant patients with specific dyslipidemia profiles
• Supported by long-term clinical data demonstrating efficacy in appropriate patient populations
• Convenient twice-daily dosing supports treatment adherence

Common use

Lopid is primarily prescribed for adult patients with severe hypertriglyceridemia (type IV and V hyperlipoproteinemia) who demonstrate triglyceride levels >500 mg/dL despite non-pharmacological interventions. It is also indicated for reducing the risk of coronary heart disease in type IIb hyperlipoproteinemia patients with low HDL cholesterol and elevated LDL cholesterol and triglycerides who have failed adequate trial of diet and other appropriate measures. Its use is generally reserved for specific lipid abnormalities rather than general cholesterol management.

Dosage and direction

The recommended adult dosage is 600 mg administered orally twice daily, approximately 30 minutes before the morning and evening meals. Dosage adjustments are not typically required for elderly patients with normal renal and hepatic function. Treatment should be initiated only after a thorough lipid assessment and failure of appropriate dietary measures. Regular lipid profiles should be obtained during therapy, with consideration for discontinuation if adequate response is not achieved within 3 months.

Precautions

Periodic monitoring of liver function tests, blood counts, and lipid levels is essential during therapy. Use with caution in patients with mild to moderate renal impairment (consider dosage reduction) and generally avoid in severe renal dysfunction. May cause cholelithiasis; evaluate abdominal symptoms promptly. Monitor for musculoskeletal symptoms and consider CPK measurements if myalgia occurs. Cataract formation has been reported with long-term use; regular ophthalmological examinations are recommended.

Contraindications

Hypersensitivity to gemfibrozil or any component of the formulation; hepatic dysfunction including primary biliary cirrhosis; pre-existing gallbladder disease; severe renal impairment; concurrent use with repaglinide or simvastatin.

Possible side effect

Common adverse reactions (>5%) include dyspepsia, abdominal pain, diarrhea, and nausea. Less frequent effects (1-5%) may include headache, dizziness, rash, and constipation. Rare but serious adverse events include cholelithiasis, hepatobiliary abnormalities, myopathy, rhabdomyolysis, anemia, leukopenia, thrombocytopenia, and hypersensitivity reactions. Periodic laboratory monitoring is essential to detect potential hematological and hepatic abnormalities.

Drug interaction

Significant interactions occur with: warfarin (enhanced anticoagulant effect requiring INR monitoring); statins (increased risk of myopathy, particularly with simvastatin); repaglinide (contraindicated due to severe hypoglycemia risk); cyclosporine (increased nephrotoxicity potential); and colchicine (increased myopathy risk). Caution with other highly protein-bound drugs. Concomitant use with bile acid sequestrants may reduce Lopid absorption; administer at least 2 hours apart.

Missed dose

If a dose is missed, take it as soon as remembered unless it is nearly time for the next scheduled dose. Do not double the dose to make up for a missed one. Maintain regular dosing schedule to ensure consistent therapeutic effect. If multiple doses are missed, consult healthcare provider for guidance on resumption of therapy.

Overdose

Symptoms may include abdominal cramps, diarrhea, nausea, and vomiting. Specific antidote is unknown. Management involves supportive care and symptomatic treatment. Gastric lavage may be considered if presented soon after ingestion. Hemodialysis is not effective due to high protein binding. Monitor for potential hypoglycemia and provide appropriate supportive measures.

Storage

Store at controlled room temperature (20-25°C or 68-77°F) in original container. Protect from moisture and light. Keep tightly closed and out of reach of children. Do not use if tablets show evidence of discoloration or deterioration. Properly discard expired or unused medication according to local regulations.

Disclaimer

This information is provided for educational purposes only and does not constitute medical advice. Lopid should be used only under the supervision of a qualified healthcare professional. Individual response to therapy may vary. Patients should not discontinue or modify dosage without consulting their physician. The full prescribing information should be consulted before initiating therapy.

Reviews

Clinical studies demonstrate Lopid’s efficacy in reducing triglyceride levels by 35-50% and increasing HDL cholesterol by 10-15% in appropriate patient populations. The Helsinki Heart Study showed significant reduction in coronary heart disease incidence in specific patient subgroups. Many clinicians report satisfactory results in managing severe hypertriglyceridemia when used according to guidelines. Patient experiences vary, with some reporting gastrointestinal discomfort while others tolerate therapy well with proper administration timing.