Gemfibrozil

Gemfibrozil is used with diet changes (restriction of cholesterol and fat intake) to reduce the amount of cholesterol and triglycerides (other fatty substances) in the blood in certain people with very high triglycerides who are at risk of pancreatic disease (conditions affecting the pancreas, a gland that produces fluid to break down food and hormones to control blood sugar). Gemfibrozil is also used in people with a combination of low high-density lipoprotein (HDL; 'good cholesterol') levels and high low-density lipoprotein (LDL; 'bad cholesterol') and triglyceride levels to reduce the risk of heart disease. Gemfibrozil is in a class of lipid-regulating medications called fibrates. It works by reducing the production of triglycerides in the liver.

Gemfibrozil comes as a tablet to take by mouth. It is usually taken twice a day, 30 minutes before the morning and evening meals. Take gemfibrozil at around the same times every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take gemfibrozil exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Gemfibrozil controls high triglycerides and low HDL, but does not cure them. Continue to take gemfibrozil even if you feel well. Do not stop taking gemfibrozil without talking to your doctor.

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

Before taking gemfibrozil,

• tell your doctor and pharmacist if you are allergic to gemfibrozil, any other medications, or any of the ingredients in gemfibrozil tablets. Ask your pharmacist for a list of the ingredients.
• some medications should not be taken with gemfibrozil. Other medications may cause dosing changes or extra monitoring when taken with gemfibrozil. Make sure you have discussed any medications you are currently taking or plan to take before starting gemfibrozil with your doctor and pharmacist. Before starting, stopping, or changing any medications while taking gemfibrozil, please get the advice of your doctor or pharmacist.
• if you are taking colestipol (Colestid), take this medication 2 hours before or 2 hours after gemfibrozil.
• tell your doctor if you have kidney, liver, or gallbladder disease. Your doctor may tell you not to take gemfibrozil.
• tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking gemfibrozil, call your doctor.

Eat a low-fat, low-cholesterol diet. Be sure to follow all exercise and dietary recommendations made by your doctor or dietitian. You can also visit the National Cholesterol Education Program (NCEP) website for additional dietary information at https://www.nhlbi.nih.gov/health/public/heart/chol/chol_tlc.pdf.

Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

Gemfibrozil may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• stomach pain
• heartburn

Some side effects can be serious. If you experience any of these symptoms, call your doctor immediately:

• muscle pain, tenderness, or weakness
• blurred vision

A medication called clofibrate (Atromid-S; no longer available in the U.S.), which is similar to gemfibrozil, has been known to cause cancer, gallbladder disease, and stomach pain leading to appendectomy. Talk to your doctor about the risks of taking this medication.

Gemfibrozil may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (https://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from light, excess heat and moisture (not in the bathroom).

Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA's Safe Disposal of Medicines website (https://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program.

It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location — one that is up and away and out of their sight and reach. https://www.upandaway.org

In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911.

Symptoms of overdose may include:

• stomach cramps
• diarrhea
• joint and muscle pain
• nausea
• vomiting

Keep all appointments with your doctor and the laboratory. Your doctor will order certain lab tests to check your body's response to gemfibrozil.

Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

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