I. Efficacy
-
Lipid effects
- Decreases Triglycerides (20-50%)
- Increases LDL Cholesterol (10-15%)
- Decreases VLDL Cholesterol
- Increases HDL Cholesterol (10-15%)
- Outcome effects
- No effect on all cause mortality
- NNT to prevent one coronary event: 46-125
II. Adverse effects
- Gastrointestinal effects
- Gastrointestinal upset
- Abdominal Pain
- Higher rate of Gastrointestinal Disease
- Cholecystitis (increased risk by 2-3%)
- Appendicitis
- Miscellaneous
- Rash
- Renal dysfunction (rare)
- Myopathy (rare)
III. Drug Interactions
- May potentiate effects of:
- Coumadin
- Oral Hypoglycemic Agents
IV. Contraindications
V. Preparations
- Gemfibrozil (Lopid)
- Dose: 600 mg bid ($75/month)
- Fenofibrate (Tricor)
- Less likely to cause Rhabdomyolysis with Statin
- Fenofibrate (Trilipix)
- Rebranded version of Tricor in time for generic Fenofibrate release in 2011
- Clofibrate
- Discontinued in 2002
- Increased mortality from malignant and GI disease
Images: Related links to external sites (from Bing)
Related Studies (from Trip Database) Open in New Window
| gemfibrozil (on 3/23/2016 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
| GEMFIBROZIL 600 MG TABLET | Generic | $0.09 each |
| fenofibrate (on 3/23/2016 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
| FENOFIBRATE 130 MG CAPSULE | Generic | $3.73 each |
| FENOFIBRATE 134 MG CAPSULE | Generic | $1.29 each |
| FENOFIBRATE 145 MG TABLET | Generic | $0.89 each |
| FENOFIBRATE 150 MG CAPSULE | Generic | $4.62 each |
| FENOFIBRATE 160 MG TABLET | Generic | $0.73 each |
| FENOFIBRATE 200 MG CAPSULE | Generic | $2.05 each |
| FENOFIBRATE 43 MG CAPSULE | Generic | $1.32 each |
| FENOFIBRATE 48 MG TABLET | Generic | $0.61 each |
| FENOFIBRATE 50 MG CAPSULE | Generic | $1.97 each |
| FENOFIBRATE 54 MG TABLET | Generic | $0.50 each |
| FENOFIBRATE 67 MG CAPSULE | Generic | $0.69 each |
| tricor (on 12/23/2015 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
| TRICOR 145 MG TABLET | Generic | $0.89 each |
| TRICOR 48 MG TABLET | Generic | $0.61 each |
| trilipix (on 12/23/2015 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
| TRILIPIX DR 135 MG CAPSULE | Generic | $2.15 each |
| TRILIPIX DR 45 MG CAPSULE | Generic | $0.98 each |
Ontology: Clofibrate (C0009002)
| Definition (NCI) | An aryloxyisobutyric acid derivate with antihyperlipidemic activity. Although the exact mechanism of action has not been fully characterized, clofibrate may enhance the conversion of very-low-density lipoprotein (VLDL) to low-density lipoprotein (LDL), decreasing the production of hepatic VLDL, inhibiting cholesterol production, and increasing fecal excretion of neutral sterols. |
| Definition (MSH) | A fibric acid derivative used in the treatment of HYPERLIPOPROTEINEMIA TYPE III and severe HYPERTRIGLYCERIDEMIA. (From Martindale, The Extra Pharmacopoeia, 30th ed, p986) |
| Definition (CSP) | fibric acid derivative used in the treatment of hyperlipoproteinemia and hypertriglyceridemia. |
| Definition (PDQ) | An aryloxyisobutyric acid derivate with antihyperlipidemic activity. Although the exact mechanism of action has not been fully characterized, clofibrate may enhance the conversion of very-low-density lipoprotein (VLDL) to low-density lipoprotein (LDL), decreasing the production of hepatic VLDL, inhibiting cholesterol production, and increasing fecal excretion of neutral sterols. Check for "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=42108&idtype=1" active clinical trials or "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=42108&idtype=1&closed=1" closed clinical trials using this agent. ("http://nciterms.nci.nih.gov:80/NCIBrowser/ConceptReport.jsp?dictionary=NCI_Thesaurus&code=C378" NCI Thesaurus) |
| Concepts | Pharmacologic Substance (T121) , Organic Chemical (T109) |
| MSH | D002994 |
| SnomedCT | 387439004, 77035009 |
| LNC | LP16082-7, MTHU016298 |
| English | clofibrate, Chlorophenoxyisobutyrate, Ethyl, Ethyl Chlorophenoxyisobutyrate, Propanoic acid, 2-(4-chlorophenoxy)-2-methyl-, ethyl ester, 2-(4-Chlorophenoxy)-2-methylpropanoic acid ethyl ester, Ethyl 2-(4-Chlorophenoxy)-2-methylpropanoate, Ethyl p-Chlorophenoxyisobyturate, Clofibrate, CFB, clofibrate (medication), Clofibrate [Chemical/Ingredient], clofibrates, Clofibric Acid, Ethyl Ester, Clofibrate (product), Clofibrate (substance), CLOFIBRATE |
| Swedish | Klofibrat |
| Czech | klofibrát |
| Finnish | Klofibraatti |
| Russian | KLOFIBRAT, КЛОФИБР�Т |
| Italian | Etil clorofenossi isobutirrato, Clofibrato |
| Croatian | KLOFIBRAT |
| Polish | Klofibrat |
| Japanese | クãƒãƒ•ã‚£ãƒ–レート, クãƒãƒ•ã‚£ãƒ–ラート |
| Spanish | clofibrato (producto), clofibrato (sustancia), clofibrato, Clofibrato |
| French | Clofibrate |
| German | Clofibrat |
| Portuguese | Clofibrato |
Ontology: Gemfibrozil (C0017245)
| Definition (NCI) | A fibric acid derivative with hypolipidemic effects. Gemfibrozil interacts with peroxisome proliferator-activated receptors (PPARalpha) resulting in PPARalpha-mediated stimulation of fatty acid oxidation and an increase in lipoprotein lipase (LPL) synthesis. This enhances triglyceride-rich lipoprotein clearance and reduces the expression of apolipoprotein C-III (apoC-III). The reduction in hepatic production of apoC-III results in subsequent reduction of serum levels of very-low-density-lipoprotein cholesterol (VLDL-C). In addition, gemfibrozil-mediated PPARalpha stimulation of apoA-I and apoA-II expression results in an increase in high-density lipoprotein cholesterol (HDL-C). |
| Definition (MSH) | A lipid-regulating agent that lowers elevated serum lipids primarily by decreasing serum triglycerides with a variable reduction in total cholesterol. |
| Definition (CSP) | lipid regulating agent that lowers elevated serum lipids primarily by decreasing serum triglycerides with a variable reduction in total cholesterol. |
| Concepts | Pharmacologic Substance (T121) , Lipid (T119) |
| MSH | D015248 |
| SnomedCT | 35282000, 387189002 |
| LNC | LP15168-5, MTHU002557 |
| English | Gemfibrozil, Gemfibrosil, Pentanoic acid, 5-(2,5-dimethylphenoxy)-2,2-dimethyl-, gemfibrozil, gemfibrozil (medication), gemfibrozil (Lopid), GEMFIBROZIL, Gemfibrozil [Chemical/Ingredient], gemfibrosil, Gemfibrozil product, Gemfibrozil (product), Gemfibrozil (substance) |
| Swedish | Gemfibrozil |
| Czech | gemfibrozil |
| Finnish | Gemfibrotsiili |
| Russian | GEMFIBROZIL, ГЕМФИБРОЗИЛ |
| Japanese | ジェムフィブãƒã‚¸ã‚£ãƒ«, ゲムフィブãƒã‚¸ãƒ«, ゲンフィブãƒã‚¸ãƒ« |
| Spanish | genfibrocil (producto), gemfibrozilo (producto), genfibrocil, Gemfibrozil, gemfibrozilo (sustancia), gemfibrozilo, gemfibrozil, genfibrocil (sustancia), Gemfibrozilo |
| Italian | Gemfibrosil, Gemfibrozil |
| French | Gemfibrosil, Gemfibrozil |
| Polish | Gemfibrozil |
| Croatian | Gemfibrozil |
| Portuguese | Genfibrozil, Genfibrozila |
| German | Gemfibrozil |
