Gemfibrozil with Pitavastatin Interaction Details
Brand Names Associated with Gemfibrozil
- Gemfibrozil
- Lopid®
Brand Names Associated with Pitavastatin
- Livalo®
- Pitavastatin
- Zypitamag®
Medical Content Editor Dr. Brian Staiger, PharmD
Last updated
Nov 25, 2023
Interaction Effect
Increased pitavastatin plasma concentrations and increased risk of myopathy or rhabdomyolysis
Interaction Summary
The concomitant use of gemfibrozil and pitavastatin has resulted in increased pitavastatin exposure and may increase the risk of myopathy and rhabdomyolysis. The AUC and Cmax of pitavastatin increased 45% and 31%, respectively when coadministered with gemfibrozil, compared with pitavastatin alone . The concomitant use of gemfibrozil and HMG-CoA reductase inhibitors has markedly elevated creatine kinase (CPK) levels, and myoglobinuria, resulting in cases of acute renal failure and death. In patients not adequately responded to the individual drug therapy, the benefit of combined therapy does not outweigh the risks and should be avoided .
Severity
Major
Onset
Unspecified
Evidence
Probable
How To Manage Interaction
The concomitant use of gemfibrozil and pitavastatin should be avoided as this has resulted in increased pitavastatin plasma concentrations and may increase the risk of myopathy and rhabdomyolysis .
Mechanism Of Interaction
Unknown
Literature Reports
A) Cases of myopathy or rhabdomyolysis with or without acute renal failure have been reported as early as 3 weeks after initiation of combined gemfibrozil and HMG-CoA reductase inhibitor therapy or after several months. There is no guarantee that periodic monitoring of creatine kinase will prevent the occurrence of severe myopathy and kidney damage .
B) In a study of the effects of the concomitant use of gemfibrozil 600 mg twice a day and pitavastatin 4 mg once a day for 7 days, the AUC of pitavastatin increased 45% and Cmax increased by 31% when coadministered with gemfibrozil, compared with pitavastatin alone .
Gemfibrozil Overview
-
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.
Pitavastatin Overview
-
Pitavastatin is used together with diet, weight-loss, and exercise to reduce the amount of fatty substances such as low-density lipoprotein (LDL) cholesterol ('bad cholesterol') in the blood and to increase the amount of high-density lipoprotein (HDL) cholesterol ('good cholesterol') in adults. Pitavastatin is also used together with diet to decrease the amount of cholesterol and other fatty substances in the blood in teenagers and children 8 years of age and older who have familial heterozygous hypercholesterolemia (an inherited condition in which cholesterol cannot be removed from the body normally). Pitavastatin is in a class of medications called HMG-CoA reductase inhibitors (statins). It works by slowing the production of cholesterol in the body to decrease the amount of cholesterol that may build up on the walls of the arteries and block blood flow to the heart, brain, and other parts of the body.
-
Accumulation of cholesterol and fats along the walls of your arteries (a process known as atherosclerosis) decreases blood flow and, therefore, the oxygen supply to your heart, brain, and other parts of your body. Lowering your blood level of cholesterol and fats with pitavastatin has been shown to prevent heart disease, angina (chest pain), strokes, and heart attacks.
Return To Our Drug Interaction Homepage
Feedback, Question Or Comment About This Information?
Ask Dr. Brian Staiger, PharmD, our medical editor, directly! He's always more than happy to assist.
Definitions
Severity Categories
Contraindicated
These drugs, generally, should not be used together simultaneously due to the high risk of severe adverse effects. Combining these medications can lead to dangerous health outcomes and should be strictly avoided unless otherwise instructed by your provider.
Major
This interaction could result in very serious and potentially life-threatening consequences. If you are taking this drug combination, it is very important to be under close medical supervision to minimize severe side effects and ensure your safety. It may be necessary to change a medication or dosage to prevent harm.
Moderate
This interaction has the potential to worsen your medical condition or alter the effectiveness of your treatment. It's important that you are monitored closely and you potentially may need to make adjustments in your treatment plan or drug dosage to maintain optimal health.
Minor
While this interaction is unlikely to cause significant problems, it could intensify side effects or reduce the effectiveness of one or both medications. Monitoring for changes in symptoms and your condition is recommended, and adjustments may be made if needed to manage any increased or more pronounced side effects.
Onset
Rapid: Onset of drug interaction typically occurs within 24 hours of co-administration.
Delayed: Onset of drug interaction typically occurs more than 24 hours after co-administration.
Evidence
Level of documentation of the interaction.
Established: The interaction is documented and substantiated in peer-reviewed medical literature.
Theoretical: This interaction is not fully supported by current medical evidence or well-documented sources, but it is based on known drug mechanisms, drug effects, and other relevant information.
How To Manage The Interaction
Provides a detailed discussion on how patients and clinicians can approach the identified drug interaction as well as offers guidance on what to expect and strategies to potentially mitigate the effects of the interaction. This may include recommendations on adjusting medication dosages, altering the timing of drug administration, or closely monitoring for specific symptoms.
It's important to note that all medical situations are unique, and management approaches should be tailored to individual circumstances. Patients should always consult their healthcare provider for personalized advice and guidance on managing drug interactions effectively.
Mechanism Of Interaction
The theorized or clinically determined reason (i.e., mechanism) why the drug-drug interaction occurs.
Disclaimer: The information provided on this page is for informational purposes only and should not be considered medical advice. Always consult with a qualified healthcare professional regarding your specific circumstances and medical conditions.
Where Does Our Information Come From?
Information for our drug interactions is compiled from several drug compendia, including:
The prescribing information for each drug, as published on DailyMED, is also used.
Individual drug-drug interaction detail pages contain references specific to that interaction. You can click on the reference number within brackets '[]' to see what reference was utilized.
The information posted is fact-checked by HelloPharmacist clinicians and reviewed quarterly.