Effects of gemfibrozil and other fibric acid derivatives on blood lipids and lipoproteins.

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Zimetbaum P, Frishman WH, Kahn S

Effects of gemfibrozil and other fibric acid derivatives on blood lipids and lipoproteins.

J Clin Pharmacol. 1991 Jan;31(1):25-37.

PubMed ID

2045526 [ View in PubMed

]

Abstract

Fibric acid derivatives (FADs) are a class of drugs that have been shown to reduce the production of very low-density lipoprotein (VLDL) while enhancing VLDL clearance due to the stimulation of lipoprotein lipase activity. The drugs can reduce plasma triglyceride levels while raising high-density lipoprotein (HDL) cholesterol levels. Their effects on low-density lipoprotein (LDL) cholesterol levels are less marked and more variable. There is evidence that oral gemfibrozil (Lopid, Parke-Davis, Morris Plains, NJ) can reduce the risk of serious coronary events, specifically in those patients who had elevations of both LDL cholesterol levels and total plasma triglyceride levels with lower HDL cholesterol levels. Newer FADs (bezafibrate, ciprofibrate, fenofibrate) have been shown to have greater efficacy in reducing LDL cholesterol than gemfibrozil but, in general, these drugs are not as effective as the other primary drugs used to lower LDL levels. The FADs are also used to treat adult patients with very high levels of triglycerides who have pancreatitis and whose disease cannot be managed with dietary therapy. The FADs are well tolerated, with dyspepsia and abdominal pain the most common adverse effects. A small risk of cholelithiasis exists with these drugs, and caution should be used when combining these drugs with HMG-CoA reductase inhibitors because the combination increases the incidence of hyperlipidemic myositis and rhabdomyolysis.

DrugBank Data that Cites this Article

Pharmaco-metabolomics

Drug	Drug Groups	Metabolite	Change	Description
Ciprofibrate	Approved Investigational	LDL cholesterol	decreased	Ciprofibrate decreases the level of LDL cholesterol in the blood
Ciprofibrate	Approved Investigational	Total cholesterol	decreased	Ciprofibrate decreases the level of Total cholesterol in the blood
Fenofibrate	Approved	Total cholesterol	decreased	Fenofibrate decreases the level of Total cholesterol in the blood
Gemfibrozil	Approved	LDL cholesterol	increased	Gemfibrozil increases the level of LDL cholesterol in the blood
Gemfibrozil	Approved	Total cholesterol	decreased	Gemfibrozil decreases the level of Total cholesterol in the blood
Gemfibrozil	Approved	LDL cholesterol	decreased	Gemfibrozil decreases the level of LDL cholesterol in the blood
Bezafibrate	Approved Investigational	LDL cholesterol	decreased	Bezafibrate decreases the level of LDL cholesterol in the blood
Bezafibrate	Approved Investigational	Total cholesterol	decreased	Bezafibrate decreases the level of Total cholesterol in the blood
Clofibrate	Approved Investigational	LDL cholesterol	decreased	Clofibrate decreases the level of LDL cholesterol in the blood
Fenofibrate	Approved	LDL cholesterol	decreased	Fenofibrate decreases the level of LDL cholesterol in the blood
Gemfibrozil	Approved	Triglycerides	decreased	Gemfibrozil decreases the level of Triglycerides in the blood
Ciprofibrate	Approved Investigational	Triglycerides	decreased	Ciprofibrate decreases the level of Triglycerides in the blood
Bezafibrate	Approved Investigational	Triglycerides	decreased	Bezafibrate decreases the level of Triglycerides in the blood
Fenofibrate	Approved	Triglycerides	decreased	Fenofibrate decreases the level of Triglycerides in the blood