Drug Interaction Report

Gemfibrozil and Resmetirom: Interaction Details

Name: Gemfibrozil and Resmetirom Interaction
Creator: Dr. Brian Staiger, PharmD, BCPS

A pharmacist-reviewed analysis of the Gemfibrozil and Resmetirom interaction: the documented clinical effects, severity rating, onset, mechanism, and management considerations, with cited references throughout.

AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature

Gemfibrozil

Lopid Lopid®

Resmetirom

Rezdiffra

Medically reviewed by

Dr. Brian Staiger, PharmD, BCPS

Updated Aug 8, 2026

Editorial policy · Data sources

Interaction severity

Major

Potentially serious — often needs a change or close monitoring.

Minor

Moderate

Major

Contraindicated

How we grade severity & evidence

Severity levels

Contraindicated: These should generally not be used together.
Major: Potentially serious — often needs a change or close monitoring.
Moderate: Can be significant — usually manageable with monitoring.
Minor: Usually limited clinical impact.

Evidence grades

Established: Well documented — supported by controlled studies or strong clinical data.
Probable: Good supporting evidence, though not definitively proven.
Suspected: Some evidence suggests this interaction, but it is not well established.
Possible: Limited or conflicting evidence; the interaction may occur.
Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.

Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.

Of 80 documented Gemfibrozil interactions, 47 are rated major — including this one.

Worried about symptoms right now? Contact your pharmacist or prescriber, or call Poison Control at 1-800-222-1222 (US). Call 911 for an emergency.

Onset

unspecified

Evidence

theoretical

Severity

Major

What happens

Increased resmetirom exposure and an increased risk of resmetirom-related adverse reactions

Interaction Deep Dive

Concomitant use of resmetirom (CYP2C8 substrate) with gemfibrozil (strong CYP2C8 inhibitor) is not recommended as it can increase resmetirom exposure, which may increase the risk of resmetirom-related adverse reactions¹.

Why it happens (mechanism)

Inhibition of CYP2C8-mediated metabolism of resmetirom

Common questions

Can I take Gemfibrozil and Resmetirom together?

Increased resmetirom exposure and an increased risk of resmetirom-related adverse reactions Always confirm with your pharmacist or prescriber before making any change.

How serious is the Gemfibrozil and Resmetirom interaction?

It is rated major. Potentially serious — often needs a change or close monitoring.

How quickly could this interaction happen?

The documented onset is "unspecified". The timing of this interaction is not well characterized.

How strong is the evidence for this interaction?

The evidence is graded "theoretical". Predicted from the drugs' pharmacology; not yet confirmed in people.

Questions for your pharmacist

Does my dose of Gemfibrozil or Resmetirom need adjusting while I take them together?
What symptoms should prompt me to call you or my prescriber right away?
Does the timing of my doses matter for this combination?
Is there a safer alternative to one of these medications for me?

References (1)

Product Information: REZDIFFRA oral tablets, resmetirom oral tablets. Madrigal Pharmaceuticals, Inc. (per FDA), West Conshohocken, PA, 2025. DailyMed

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Gemfibrozil

Keep reading about Gemfibrozil

All Gemfibrozil interactions (80) Gemfibrozil drug information

Also serious with: Grazoprevir Ciprofibrate Dasabuvir Elagolix

Resmetirom

Keep reading about Resmetirom

All Resmetirom interactions (10)

Also serious with: Simvastatin Alpelisib Atogepant Atorvastatin

Beyond drug–drug

These medications also interact with supplements

Prescription drugs aren't the whole picture — herbal and dietary supplements can interact with them too. From the evidence-graded Natural Medicines database:

Gemfibrozil + Activated Charcoal Beer Siberian Cocklebur Wine Ashwagandha Black Cohosh Boldo Buchu + 51 more

Resmetirom + Activated Charcoal Beer Siberian Cocklebur Wine African Wild Potato Ashwagandha Black Cohosh Boldo + 57 more

major · moderate · minor — check everything you take with our drug–supplement interaction checker.

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A message from HelloPharmacist

About our interaction database: depth, not breadth

HelloPharmacist doesn't license one of the big commercial interaction databases, so what you'll find here is not a complete list of every known drug interaction. Instead, each entry is researched, analyzed, and written up individually — documented from the published literature, reviewed by a pharmacist, and cited so you can check every source yourself.

If a combination isn't listed here, it means we haven't documented it yet — never that it's safe. For screening a full medication list, we recommend pairing this site with a comprehensive tool like the Drugs.com Interaction Checker and, most importantly, a review by your own pharmacist. For a deep, plain-English, fully sourced explanation of a specific documented interaction — that's exactly what we built this for.

This information is for education, not a substitute for professional medical advice. Do not start, stop, or change any medication without talking to your pharmacist or prescriber.