Use Caution/Monitor. Monitor Closely (1)gemfibrozil increases effects of insulin glargine by unspecified interaction mechanism. The serious risk of myopathy or rhabdomyolysis should be weighed carefully against the benefits of combined statin and gemfibrozil therapy; there is no assurance that periodic monitoring of CK will prevent the occurrence of severe myopathy and renal damage. Contraindicated. Ursodeoxycholic Acid, Ursodiol: (Major) Fibric acid derivatives increase hepatic cholesterol secretion, and encourage cholesterol gallstone formation and hence may counteract the effectiveness of ursodeoxycholic acid, ursodiol. Please confirm that you would like to log out of Medscape. Use olmesartan and gemfibrozil together with caution. Gemfibrozil inhibits CYP2C8.gemfibrozil will increase the level or effect of paclitaxel protein bound by Other (see comment). The exact mechanism of action has not been fully defined. apalutamide will decrease the level or effect of gemfibrozil by increasing elimination. Concomitant use may cause an increased blood glucose-lowering effect with risk of hypoglycemia. Consider reducing the dose when concomitantly using UGT2B7 substrates. (Moderate) Monitor blood glucose during concomitant SGLT2 inhibitor and fibric acid derivative use; a SGLT2 inhibitor dose adjustment may be necessary. Hypoglycemia; increased risk in hypoalbuminemia. Coadministration with gemfibrozil increased the composite AUC of enzalutamide plus N-desmethyl enzalutamide by 2.2-fold. Gemfibrozil should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.[48366]. gemfibrozil will increase the level or effect of repaglinide by Other (see comment). Fibric acid derivatives may also enhance the hypoglycemic effects of antidiabetic agents through increased insulin sensitivity and decreased glucagon secretion. 1200 mg/day PO, up to 1600 mg/day PO has been studied. Coadministration may increase the exposure of pioglitazone, increasing the risk for hypoglycemia. In a preclinical study in dogs, ezetimibe increased cholesterol in the gallbladder bile. commonly, these are "non-preferred" brand drugs or specialty In a preclinical study in dogs, ezetimibe increased cholesterol in the gallbladder bile. Eluxadoline: (Major) When administered concurrently with gemfibrozil, the dose of eluxadoline must be reduced to 75 mg PO twice daily, and the patient should be closely monitored for eluxadoline-related adverse effects (i.e., decreased mental and physical acuity). Myopathy or rhabdomyolysis with or without acute renal failure have been reported as early as 3 weeks after initiation of combined therapy or after several months. Letermovir is a substrate of the organic anion-transporting polypeptide (OATP1B1); gemfibrozil is an inhibitor of OATP1B1. Paclitaxel levels/toxicity may increase when coadministered with CYP2C8 inhibitors gemfibrozil increases levels of paclitaxel protein bound by altering metabolism. Monitor Closely (2)gemfibrozil increases levels of eluxadoline by affecting hepatic enzyme CYP2C9/10 metabolism. Avoid or Use Alternate Drug. Valsartan is a substrate of the hepatic uptake transporter OATP1B1 and gemfibrozil is an inhibitor of OATP. Concomitant use may cause an increased blood glucose-lowering effect with risk of hypoglycemia. Hypoglycemia; increased risk in hypoalbuminemia.gemfibrozil increases levels of glyburide by affecting hepatic enzyme CYP2C9/10 metabolism. UGT1A1 inhibitors decrease irinotecan metabolism, Serious - Use Alternative (1)gemfibrozil will increase the level or effect of irinotecan liposomal by decreasing metabolism. Contraindicated. Comment: OATP1B1 and OATP1B3 transport inhibitors may increase systemic exposure of revefenacin's active metabolite. Avoid or Use Alternate Drug. Avoid or Use Alternate Drug. Protein binding is approximately 95%. Serious - Use Alternative (1)gemfibrozil will increase the level or effect of pioglitazone by decreasing metabolism. A dose reduction of quinine may be required if used concomitantly with gemfibrozil. It decreases very low-density lipoprotein (VLDL)- triglyceride concentration and to a lesser extent, LDL triglyceride concentration. Absorption. Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Sumatriptan; Naproxen: (Moderate) Use naproxen and gemfibrozil together with caution. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses. Colestipol: (Moderate) Separate the administration of gemfibrozil and colestipol by at least 2 hours. Avoid or Use Alternate Drug. Use Caution/Monitor. These products can react with gemfibrozil, preventing its full absorption.Take this medication regularly in order to get the most benefit from it. Monitor Closely (1)gemfibrozil will increase the level or effect of montelukast by decreasing metabolism. Cannabidiol may potentially inhibit UGT2B7 activity. If concomitant use is unavoidable, reduce the dose of enzalutamide to 80 mg once daily; the original dose of enzalutamide may be resumed when gemfibrozil is discontinued. Naproxen is a substrate of CYP2C8, and gemfibrozil is a strong CYP2C8 inhibitor. Gemfibrozil may further increase risk for rhabdomyolysis when added to optimal statin regimen to further decrease TG and increase HDLs. gemfibrozil will increase the level or effect of selexipag by decreasing metabolism. The first look at the 'middle aged Love Island' set has been released, which has already been nicknamed the 'Viagra House' by locals after single parents searched for love As a precautionary measure due to incomplete information on the metabolism of eluxadoline, use caution when coadministered with strong CYP2C9/10 inhibitors. Closely monitor patients for signs and symptoms of muscle pain, tenderness, or weakness especially during the initial months of therapy and during upward titration of either drug. Coadministration of siponimod with drugs that cause moderate CYP2C9 AND a moderate or strong CYP3A4 inhibition is not recommended. Concomitant use may cause an increased blood glucose-lowering effect with risk of hypoglycemia. Use Caution/Monitor. Discontinue gemfibrozil if lipid response is inadequate after 3 months of therapy. Coadministration not recommended. Gemfibrozil has been shown to produce adverse effects in animals at doses between 0.5 and 3 times the human dose. Concurrent use may increase loperamide exposure. Atorvastatin: (Major) Use caution and the lowest atorvastatin dose necessary if coadministration with gemfibrozil is necessary due to an increased risk of myopathy and rhabdomyolysis. commonly, these are "non-preferred" brand drugs. Contraindicated. The timing of the last dose of gemfibrozil has been studied in 10 healthy volunteers who took repaglinide 0.25 mg without gemfibrozil and then again 0, 3, 6, or 12 hours after gemfibrozil 600 mg [70 c].The AUC was increased for all doses taken with or after . Concomitant use may cause an increased blood glucose-lowering effect with risk of hypoglycemia. Use this medicine only as directed by your doctor. The exposure to pioglitazone is increased approximately 3-fold when combined with gemfibrozil. Hypoglycemia; increased risk in hypoalbuminemia. Administer 30 minutes before the morning and evening meals. gemfibrozil, insulin inhaled. Use Caution/Monitor. All rights reserved. Gemfibrozil increases the blood glucose-lowering effect of repaglinide. If unable to avoid coadministration with strong CYP2C9 inhibitors, monitor closely for adverse reactions and consider decreasing dose accordingly. Contraindicated. Concurrent use may increase loperamide exposure. Dulaglutide: (Moderate) Monitor blood glucose during concomitant incretin mimetic and fibric acid derivative use; an incretin mimetic dose adjustment may be necessary. Avoid or Use Alternate Drug. Gemfibrozil may further increase risk for rhabdomyolysis when added to optimal statin regimen to further decrease TG and increase HDLs. Metformin; Sitagliptin: (Moderate) Monitor blood glucose during concomitant metformin and fibric acid derivative use; a metformin dose adjustment may be necessary. Use Caution/Monitor. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Strong or moderate CYP2C19 inhibitors may increase mavacamten systemic exposure, resulting in heart failure due to systolic dysfunction. Dapagliflozin; Saxagliptin: (Moderate) Monitor blood glucose during concomitant SGLT2 inhibitor and fibric acid derivative use; a SGLT2 inhibitor dose adjustment may be necessary. Contact the applicable plan There is no assurance that periodic monitoring of creatine kinase will prevent the occurrence of severe myopathy and kidney damage. This document does not contain all possible drug interactions. Modify Therapy/Monitor Closely. Pravastatin: (Major) Avoid concomitant use of pravastatin and gemfibrozil due to increased risk for rhabdomyolysis. If it is near the time of the next dose, skip the missed dose. Monitor for anemia and hypoxia and reduce belzutifan dose as recommended. Colesevelam: (Moderate) Separate the administration of gemfibrozil and colesevelam by at least 2 hours. Monitor Closely (1)gemfibrozil, insulin inhaled. Niacin; Simvastatin: (Contraindicated) The use of simvastatin with gemfibrozil is contraindicated due to an increased risk for myopathy and rhabdomyolysis. Dronabinol is a CYP2C9 and 3A4 substrate; gemfibrozil is a weak inhibitor of CYP2C9. Gemfibrozil is contraindicated in patients with renal disease associated with severe renal impairment or renal failure. Find LOPID medical information: Strong CYP2C8 inhibitors are shown to increase dasabuvir plasma concentrations (~10-fold), and therefore increase risk of QT prolongation. Glecaprevir is a substrate of organic anion transporting polypeptide (OATP)1B1; gemfibrozil is an inhibitor of OATP1B1. Avoid lorazepam extended-release capsules and utilize lorazepam immediate-release dosage forms that can be easily titrated. Use Caution/Monitor. Contraindicated. However, resins bind fat-soluble vitamins and prolonged use may result in deficiencies of these vitamins in the mother and her nursing infant. Either increases effects of the other by pharmacodynamic synergism. Gemfibrozil can cause myopathy when used alone, and the risk of myopathy and rhabdomyolysis is increased by concomitant use with simvastatin. Coadministration may result in a significant increase in naproxen exposure. gemfibrozil, pitavastatin. Gemfibrozil may further increase risk for rhabdomyolysis when added to optimal statin regimen to further decrease TG and increase HDLs. Concomitant administration of gemfibrozil (600 mg twice daily) and rosiglitazone (4 mg once daily) for 7 days increased rosiglitazone AUC by 127%, compared to the administration of rosiglitazone (4 mg once daily) alone. Coadministration may result in a significant increase in naproxen exposure. Lowering triglycerides in people with very high triglyceride blood. Fibric acid derivatives also enhance the hypoglycemic effects of antidiabetic agents through increased insulin sensitivity and decreased glucagon secretion. Copyright: Merative US L.P. 1973, 2023. Gemfibrozil inhibits OATP1B1. 11 In healthy volunteers, a 900mg oral dose of gemfibrozil has a C max of 4616g/mL with a T max of 2.21.1h. Acarbose: (Moderate) Dose reductions and increased frequency of glucose monitoring may be required when antidiabetic agents are administered with fibric acid derivatives (e.g., clofibrate, fenofibric acid, fenofibrate, gemfibrozil). Lansoprazole; Naproxen: (Moderate) Use naproxen and gemfibrozil together with caution. Contraindicated (1)gemfibrozil will increase the level or effect of selexipag by decreasing metabolism. Access your plan list on any device mobile or desktop. Use of elagolix with drugs that inhibit OATP1B1 may increase elagolix plasma concentrations. Ozanimod: (Major) Coadministration of ozanimod with gemfibrozil is not recommended. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. Lonafarnib is a CYP2C9 substrate and gemfibrozil is a CYP2C9 inhibitor. Tucatinib is a CYP2C8 substrate and gemfibrozil is a strong CYP2C8 inhibitor. Therefore, coadministration of ozanimod with strong CYP2C8 inhibitors is not recommended. Contraindicated (1)gemfibrozil increases toxicity of pitavastatin by Other (see comment). Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. Ezetimibe; Simvastatin: (Contraindicated) The use of simvastatin with gemfibrozil is contraindicated due to an increased risk for myopathy and rhabdomyolysis. Gemfibrozil inhibits OATP1B1. Lopid:- Avoid excessive humidity- Protect from light- Store at controlled room temperature (between 68 and 77 degrees F). Repaglinide: (Contraindicated) Concurrent use of repaglinide and gemfibrozil is contraindicated, due to significantly increased repaglinide exposure and hypoglycemic risk. 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