Treating High Cholesterol With Lopid: What To Know

Key highlights for Lopid

To get the best result from Lopid (gemfibrozil) therapy, you should take this medication 30 minutes before breakfast and dinner daily.
Lopid is only a part of a complete treatment program. You should follow a consistent exercise regimen and consume a healthful, low-fat diet with high fiber content, meaning you should eat more fruits, vegetables, legumes, and whole grain products.
Always read the prescription label carefully and go to all your doctor visits and blood work appointments.
As always, you should inform your doctor and pharmacist of all your medications to prevent undesirable or even dangerous side effects.

What is Lopid used for?

Lowering blood cholesterol and triglycerides in adults

Lopid (gemfibrozil) is used to lower cholesterol and triglycerides in adults who are at an increased risk for pancreatitis, and dietary restrictions alone are not enough to reduce blood triglyceride levels.

Gemfibrozil is used in adults with extremely elevated triglycerides (over 2000 mg/dL). If your triglyceride levels are between 1000 and 2000 mg/dL and you have a history of pancreatitis with abdominal pain, your doctor may determine that gemfibrozil is an appropriate therapy for you.

Lowering the risk of coronary heart disease

Lopid (gemfibrozil) is used in people who have:

High cholesterol and triglycerides, such as low HDL cholesterol levels, high LDL cholesterol levels, and elevated triglycerides, which increase your risk of developing coronary heart disease.
Inadequate response from other treatment methods including lifestyle modification with diet, exercise, and other drugs such as bile acid sequestrants (also referred to as bile acid binding resins), and nicotinic acid.

Very high cholesterol and triglyceride levels are associated with a higher risk for cardiovascular disease, including myocardial infarction (heart attack) and stroke. Keeping your lipid levels at a healthy level reduces your risk of coronary artery disease (problems with the blood vessels supplying the heart) as well as peripheral vascular disease (circulation problems caused by limited blood flow to your limbs).

How Lopid works

Lopid (gemfibrozil) belongs to a drug class called fibrate. The exact mechanism of action of gemfibrozil is not entirely understood. However, it is believed that Lopid lowers the amount of fat produced by the liver.

Lopid also works by increasing the production of lipoprotein lipase which then breaks down triglycerides. Lopid also increases the formation of HDL (high-density lipoprotein), known as the “good” cholesterol.

Instructions for taking Lopid

Adults

The typical Lopid dosage for adults between 18 and 64 years old is 600 mg by mouth twice daily taken 30 minutes before morning and evening meals.

Pediatric

Lopid is not approved to be used in children younger than 18 years old.

Dosage adjustments for kidney disease and elderly patients

For patients aged 65 years and older or who have kidney disease, your doctor may start you on the lower end of dosing. Follow your doctor’s dosing instructions to avoid adverse effects.

Useful tips on taking Lopid

How should I take Lopid?

Read the prescription label and medication guides carefully and follow instructions from your healthcare professional on how to use Lopid (gemfibrozil tablets).

Lopid dosage is typically divided into two doses taken 30 minutes before morning and evening meals.

Talk to your doctor about a diet and exercise regimen that would work best for you. This medication is only part of a complete treatment program that consists of a healthful diet, consistent exercise, and maintaining an individualized goal weight. Frequent medical tests are required even when you are feeling well to monitor your liver and kidney function.

What should I avoid while being on Lopid?

You should avoid eating foods high in cholesterol or fat, such as fried food, butter, red meat, full-fat dairy, and baked goods. You should also avoid drinking alcohol, as excessive alcohol consumption can contribute to elevated triglyceride levels.

What if I miss a dose?

If you miss a dose of Lopid, you should take the missed dose as soon as you remember. However, if it is almost time for your next dose, take only that dose and skip the missed dose. Do not take twice the amount to make up for the missed dose, as this can cause serious side effects.

Overdosage

If you think you’ve taken more than the usual dose, call your doctor or the American Association of Poison Control Center at 80-222-1222.

If your symptoms are severe, call 911 or get emergency medical attention at the nearest emergency department if the symptoms are severe.

Pregnancy/Lactation

Talk to your doctor if you get pregnant while taking Lopid or are planning to get pregnant.

Lopid contraindications

Lopid therapy may not be safe for you if you have:

Severe liver and kidney disease, including primary biliary cirrhosis
Gallbladder disease
Allergy to gemfibrozil therapy
Concomitant administration of repaglinide, a medication used for type 2 diabetes

Other warnings

Before starting Lopid drug therapy, tell your doctor if you have:

Kidney disease or liver disease — Lopid can increase the risk of liver disease or kidney disease. If you have pre-existing kidney problems, Lopid can cause severe renal dysfunction.
Gallbladder disease or gallstones — Lopid can result in the development of gallstones due to the increased cholesterol excretion into the bile. You will need to stop taking this medication if gallstones are found.
Prescription blood thinners like warfarin (Jantoven, Coumadin) — Lopid can interact with blood thinner such as warfarin leading to dangerous side effects. Your doctor may reduce the dosage of blood thinner to prevent bleeding complications if you are taking Lopid.
Increased risk of rhabdomyolysis — Taking Lopid with a statin (HMG-CoA reductase inhibitor) can increase the risk of serious muscle problems. Rhabdomyolysis (often called rhabdo) can be life-threatening if left untreated. Rhabdo occurs when skeletal muscle tissue is broken down and releases its proteins into the blood; this can cause serious damage to the heart and kidneys, leading to permanent disability and even death in severe cases.

The drug information contained herein of Lopid is for educational purposes only and may not include all possible indications, adverse effects, drug interaction, and potential warnings.

What are the side effects of Lopid?

Serious side effects

Anaphylactic allergic reaction — Seek emergency medical attention if you experience the following symptoms: difficulty breathing, hives, rash, and swelling of the face, tongue, lips, or throat.

Rhabdomyolysis — This is a rare adverse reaction that can be potentially fatal if left untreated. This health complication can cause the breakdown of skeletal muscle tissue leading to acute renal failure. Call your doctor immediately if you experience unexplained muscle pain, severe cramps, dark-colored urine, unusual tiredness, and weakness.

Gallstones — This can be present with nausea, vomiting, and stomach pain, especially in the right upper quadrant of the abdomen.

Call your doctor if you experience the following signs and symptoms:

Blurred vision, change in eyesight, or eye pain
Painful urination
Low blood cell counts with symptoms like unusual bleeding, paleness, unusual tiredness, shortness of breath, feeling lightheaded, or cold extremities

Common side effects

These side effects should get better within a few weeks. Let your doctor know if these side effects do not go away or become severe.

Stomach pain
Unusual taste
Nausea, vomiting, diarrhea
Muscle pain, joint pain
Dizziness
Headache
Reduced libido

What precautions should I be aware of on Lopid therapy?

Laboratory work for Lopid therapy

Frequent medical tests are important while you are taking Lopid, as instructed by your healthcare professional. Discontinuation of Lopid is recommended if your blood cholesterol and triglycerides are not well-controlled after three months of therapy.

Combination therapy of gemfibrozil with certain medications

Lopid can interact with other medications leading to serious side effects. Tell your doctor all the medications you are taking, including prescriptions and over-the-counter medications. Certain drug combinations can cause dangerous adverse effects, especially with the following medications:

HMG-CoA reductase inhibitors — this is the statin drug class. Combining Lopid with a statin can significantly increase the risk of rhabdomyolysis, serious muscle problems that can result in kidney failure or even death. These serious muscle side effects can happen as early as three weeks after starting the combination therapy or after several months. Tell your doctor if you experience any unexplained muscle pain while taking these medications.
Blood thinners such as warfarin (Coumadin, Jantoven) — the risk of bleeding complications is higher when a blood thinner medication is given with Lopid (gemfibrozil). Blood work can help your doctor determine the best dosage for your blood thinner to minimize this risk while on Lopid.
Repaglinide — this is a medication used in combination with diet and exercise to treat type 2 diabetes. A study has shown an increase in blood levels of repaglinide when it’s being given together with Lopid. If you are taking this combination of medications, your doctor will closely monitor your blood sugar. The repaglinide dosage may be adjusted to avoid dangerous adverse effects.

Blood disorders

Low blood cell counts, specifically a mild drop in hemoglobin, hematocrit, and white blood cells, have been seen in some cases after starting Lopid therapy. Rarely, severe anemia, leukopenia, and bone marrow hypoplasia have been reported. Your doctor will monitor your blood counts to watch out for these side effects during the first 12 months of therapy. These levels tend to stabilize with long-term use.

Kidney impairment

Worsening kidney disease has been reported in patients after starting Lopid therapy, especially in those individuals with a baseline serum creatinine of 2 mg/dL or more. Normal serum creatinine levels are between 0.7 to 1.3 mg/dL in men and between 0.6 and 1.1 mg/dL in women. A lower dose of Lopid may be considered, and another lipid-lowering agent should be considered for people with moderate to severe kidney disease.

Liver impairment

Elevation of liver enzymes can occur in some people on Lopid therapy. Liver enzymes tend to normalize after Lopid discontinuation.

Pregnancy and lactation

Lopid is a category C pregnancy drug, meaning:

Animal research shows adverse effects on the fetus taken during pregnancy.
There is not enough data specific for humans to know the exact effects of this medication on a human fetus.

Call your doctor right away if you become pregnant while taking Lopid. Tell your doctor if you are planning to get pregnant.

Lopid may pass into breast milk. Talk to your doctor if you are breastfeeding or plan to breastfeed.

Drug Interactions

Lopid can interact with other medications. Drug interactions can affect blood tests that evaluate blood levels and can lead to worsening side effects or cause other drugs to be less effective.

Tell your doctor or pharmacist about other drugs you are currently taking, including other prescription medications, over-the-counter products, and herbal and dietary supplements. The following drugs can have an interaction with Lopid leading to undesirable or even dangerous side effects:

HMG-CoA reductase inhibitor (statins)

Do not use Lopid in combination with the following drugs:

Certain lipid-lowering medications

The following medications can make Lopid less effective if taken less than 2 hours after taking Lopid:

Anticoagulants (blood thinners)

Taking Lopid with the following blood thinner can increase bleeding complications:

Warfarin (Jantoven, Coumadin)

Certain diabetes medications

Some diabetes medications that may require discontinuation or dosage adjustments when taken in combination with Lopid include:

Cancer therapy

Lopid can increase the effects of cancer therapy in the below medications:

Not all drug interactions are listed here. Ask your doctor or pharmacist about the potential drug interactions between your current medications and Lopid.

Hepatitis C medicine

Dasabuvir (Exviera) — It is not recommended to use Lopid in combination with medication used to treat hepatitis C infection.

Gout medicine

Colchicine (Colcrys) — Using Lopid with colchicine, a gout medication, can increase the risk of muscle problems, especially in elderly patients and people with kidney disease.

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