Gemfibrozil

What gemfibrozil is and how it works

Gemfibrozil is a prescription-only fibrate medicine used to lower very high triglyceride levels and to treat mixed lipid disorders, particularly when statins are contraindicated or not tolerated. It works by increasing the breakdown of triglyceride-rich particles and raising HDL ('good') cholesterol. (1) (2)

Gemfibrozil carries a real, well-documented risk of serious muscle damage (myopathy/rhabdomyolysis) when combined with certain other medicines -- most importantly statins -- so it is essential to tell every prescriber and pharmacist about all your other medicines. It can also increase the risk of gallstones. Regular blood tests are needed to monitor your liver, blood counts, and lipid response.

Mechanism of action: how gemfibrozil works

Gemfibrozil is a fibric acid derivative that activates peroxisome proliferator-activated receptor alpha (PPAR-alpha), increasing lipoprotein lipase activity and reducing hepatic VLDL/triglyceride production, while also raising HDL cholesterol. It is a potent inhibitor of CYP2C8 and of the glucuronidation of several statins, which underlies its clinically significant interactions with repaglinide and statins. (1) (2) (3)

What gemfibrozil is used for

Before taking gemfibrozil

Do not take / not appropriate for

• Do not take gemfibrozil if you have significant liver disease, severe kidney impairment, or primary biliary cirrhosis. (all countries) (1) (3)
• Do not take gemfibrozil if you have current or past gallbladder disease or gallstones. (all countries) (1) (2) (5)
• Do not take gemfibrozil together with simvastatin or rosuvastatin 40 mg -- this combination is specifically contraindicated because of a real risk of severe rhabdomyolysis. (United States, United Kingdom, France) (1) (2) (5)
• Gemfibrozil should not be combined with any statin (HMG-CoA reductase inhibitor) at all, not only simvastatin or high-dose rosuvastatin. (Canada) (3)
• Do not take gemfibrozil together with repaglinide, dasabuvir, or selexipag. (all countries) (1) (2)
• Do not take gemfibrozil if you are pregnant or breastfeeding. (all countries) (3) (5)

Tell your clinician about

• Every other medicine you take, especially any statin, repaglinide, colchicine, warfarin, or bexarotene.
• Any personal or family history of gallbladder disease.
• Any history of liver or kidney problems.
• Whether you are pregnant, planning pregnancy, or breastfeeding.
• Any history of jaundice or hepatic disorder.

How to take gemfibrozil

• Take exactly as prescribed, usually about 30 minutes before your morning and evening meals.
• Continue your prescribed diet, exercise, and weight-management plan alongside gemfibrozil -- it is used together with these measures, not instead of them.
• Attend all scheduled blood tests (liver function, blood counts, and lipid levels) -- these are a required part of safe treatment, not optional.
• If a significant improvement in your lipid levels is not seen after 3 months, your prescriber may decide to stop gemfibrozil.

Procedures and treatment changes

Tell the treating team before surgery, procedures, or any medicine change. Do not alter treatment without the responsible clinician. (1) (2) (3) (4) (5) (6)

Missed dose

If you miss a dose, take it as soon as you remember, unless it is close to the time of your next scheduled dose -- in that case, skip the missed dose and continue with your regular schedule. Do not take a double dose to make up for a missed one.

Overdose

Contact your regional poison control centre or seek emergency medical help if you think you have taken too much gemfibrozil. Reported overdose symptoms include abdominal cramps, abnormal liver test results, diarrhoea, increased creatine kinase (a muscle enzyme), joint and muscle pain, nausea, and vomiting. A reported case of a child accidentally swallowing a large amount recovered fully after supportive care. (3)

Side effects

Side effects and their urgency vary; report severe, persistent, or concerning symptoms.

Serious warnings

Interactions

• Statins (HMG-CoA reductase inhibitors): simvastatin and rosuvastatin 40 mg are specifically contraindicated because of a real risk of severe rhabdomyolysis; Health Canada's current guidance advises against combining gemfibrozil with any statin at all. (1) (2) (3)
• Repaglinide: contraindicated -- combination increases repaglinide levels approximately 8-fold, raising the risk of dangerously low blood sugar. (1) (2)
• Dasabuvir and selexipag: contraindicated -- gemfibrozil significantly raises the levels of both, with dasabuvir combination raising a heart-rhythm (QT-prolongation) risk. (1)
• Colchicine: caution required -- combined use can increase the risk of muscle toxicity/myopathy. (1) (2)
• Warfarin and other vitamin K antagonists: gemfibrozil can increase their blood-thinning effect -- dose reduction and more frequent INR monitoring are usually needed. (1)
• Bexarotene: combined use is not recommended -- gemfibrozil substantially increases bexarotene levels. (2)
• Other CYP2C8 substrate medicines: gemfibrozil is a potent inhibitor of this liver enzyme pathway, so dose reduction of affected medicines may be needed. (2)

Pregnancy, breastfeeding, kidney/liver function, age

Monitoring

Before starting

• Baseline liver function tests
• Baseline lipid panel to confirm elevated triglycerides or low HDL cholesterol
• Review of all other medicines for statin, repaglinide, dasabuvir, selexipag, colchicine, or warfarin interactions
• Assessment of gallbladder history

During treatment

• Periodic liver function tests throughout treatment; your prescriber may decide to stop gemfibrozil if abnormalities persist.
• Periodic blood counts during the first 12 months of treatment.
• Periodic lipid level checks to confirm ongoing benefit -- treatment is generally stopped if a significant response is not seen within 3 months.
• Prompt creatine kinase (CPK) testing if muscle symptoms occur.

Storage

Store at room temperature, protected from moisture, out of reach of children.

Frequently asked questions

References

1. LOPID (gemfibrozil) tablets -- full prescribing informationDailyMed (U.S. National Library of Medicine) -- FDA prescribing information · United States · accessed 2026-07-30 · source 1
2. Gemfibrozil 600mg Film-Coated Tablets -- Summary of Product Characteristics (SmPC)electronic medicines compendium (emc), United Kingdom -- Summary of Product Characteristics · United Kingdom · accessed 2026-07-30 · source 2
3. TEVA-GEMFIBROZIL (Gemfibrozil Tablets, 600 mg) -- Product Monograph including Patient Medication InformationHealth Canada -- Product Monograph (Teva Canada Limited) · Canada · accessed 2026-07-30 · source 3
4. Gemfibrozil -- healthdirect medicinal-product and brand pages (Gemfibrozil AS/GA/GenRx/Pharmacor, Ausgem, Lipigem, Gemfitril)healthdirect Australia (Australian Government-funded consumer medicines service) · Australia · accessed 2026-07-30 · source 4
5. LIPUR 450 mg, comprime pellicule (gemfibrozil 450 mg) -- national marketing authorisation recordAgence Nationale de Securite du Medicament et des produits de sante (ANSM), France -- Base de Donnees Publique des Medicaments (national public medicines database) · European Union (France, national authorisation) · accessed 2026-07-30 · source 5
6. Gemfibrozil -- Healthify NZ medicine information pageHealthify NZ (formerly Health Navigator NZ) -- New Zealand Government-funded health information service · New Zealand · accessed 2026-07-30 · source 6

Brand names by country

Single-ingredient gemfibrozil names are shown separately by country. Product availability, strengths, and supply rules can change; combination products are not included here.

Priority countries