.
Gemfibrozil is a drug used to lower cholesterol and triglycerides in people with high cholesterol. Other drugs, especially members of the HMG-CoA reductase inhibitor drug family, are more commonly used.
Interactions with Dietary Supplements
Coenzyme Q10
In a randomized study of 21 men with combined hyperlipidemia, ten to twelve weeks of
gemfibrozil therapy reduced coenzyme Q10 blood levels to the levels seen in healthy
men.1 The clinical significance of this finding is unknown.
Vitamin E
In a randomized study of 21 men with combined hyperlipidemia, ten to twelve weeks of
gemfibrozil therapy reduced alpha- and gamma-tocopherol blood levels to the levels seen in
healthy men.2 The clinical significance of this finding is unknown and may reflect
a normal physiological response to a reduction in serum cholesterol levels.
Vitamin B3
(Niacin)
Niacin (not niacinamide) and gemfibrozil have successfully raised HDL (good) cholesterol
levels, both alone and in combination.3
Interactions with Herbs
Red yeast rice
(Monascus purpureus)
Monascus purpureus, a form of red yeast, is fermented with rice to produce a dietary
supplement, Cholestin®, that contains low levels of
lovastatin, a drug otherwise available only by prescription. Gemfibrozil taken with the
prescription drug lovastatin has been reported to cause rhabdomyolysis, a potentially
life-threatening muscle disease.4 People taking gemfibrozil should avoid
lovastatin-containing products, including Cholestin®, until more is known. The levels of
lovastatin in Cholestin® are significantly lower than those given of the drug as a single
agent. Cholestin® also contains numerous other compounds that may alter the interaction
of lovastatin and gemfibrozil.
Interactions with Foods and Other Compounds
Food
Gemfibrozil should be taken 30 minutes before meals.5
Alcohol
Gemfibrozil may cause dizziness or blurred vision.6 Alcohol may intensify these
effects, increasing the risk for accidental injury. People taking gemfibrozil should avoid
alcohol.
Summary of Interactions for Gemfibrozil
| Depletion or interference | Coenzyme
Q10* Vitamin E* |
|---|---|
| Adverse interaction | Red yeast rice* |
| Side effect reduction/prevention | None known |
| Supportive interaction | Vitamin B3 (niacin) |
| Reduced drug absorption/bioavailability | None known |
For the convenience of the reader, the information in the summary is categorized as follows: “Depletion or interference” indicates the drug may deplete or interfere with the absorption or function of the supplement or herb. “Adverse interaction” indicates that the supplement or herb used together with the drug may result in undesirable effects. “Side effect reduction/prevention” indicates the supplement or herb may reduce the likelihood and/or severity of a potential side effect caused by the drug. “Supportive interaction” indicates the supplement or herb may support or aid the function of the drug. “Reduced drug absorption/bioavailability” indicates that the supplement or herb may decrease the absorption and/or activity of the drug in the body. An asterisk (*) next to an item in the summary indicates that the interaction is supported only by weak, fragmentary, and/or contradictory scientific evidence.
References:
1. Aberg F, Appelkvist EL, Broijersen A, et al. Gemfibrozil-induced decrease in serum ubiquinone and alpha- and gamma-tocopherol levels in men with combined hyperlipidaemia. Eur J Clin Invest 1998;28:235–42.
2. Aberg F, Appelkvist EL, Broijersen A, et al. Gemfibrozil-induced decrease in serum ubiquinone and alpha- and gamma-tocopherol levels in men with combined hyperlipidaemia. Eur J Clin Invest 1998;28:235–42.
3. Zema MJ. Gemfibrozil, nicotinic acid and combination therapy in patients with isolated hypoalphalipoproteinemia: a randomized, open-label, crossover study. J Am Coll Cardiol 2000;35:640–6.
4. Garnett WR. Interactions with hydroxymethylglutaryl-coenzyme A reductase inhibitors. Am J Health Syst Pharm 1995;52:1639–45 [review].
5. Threlkeld DS, ed. Diuretics and Cardiovasculars, Antihyperlipidemic Agents, Gemfibrozil. In Facts and Comparisons Drug Information. St. Louis, MO, Facts and Comparisons, Feb 1997, 172h–2j.
6. Threlkeld DS, ed. Diuretics and Cardiovasculars, Antihyperlipidemic Agents, Gemfibrozil. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, Feb 1997, 172h–2j.
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