gemfibrozil Nursing Considerations & Management

Drug Name

Generic Name : gemfibrozil

Brand Name:  Apo-Gemfibrozil (CAN), Gen-Gemfibrozil (CAN), Lopid, Novo-Gemfibrozil (CAN)

Classification:  Antihyperlipidemic

Pregnancy Category C

Dosage & Route
  • Available forms : Tablets—600 mg
ADULTS
  • WARNING: 1,200 mg/day PO in two divided doses, 30 min before morning and evening meals. Caution: Use only if strongly indicated and lipid studies show a definite response; hepatic tumorigenicity occurs in laboratory animals.
PEDIATRIC PATIENTS
  • Safety and efficacy not established.
Therapeutic actions
  • Gemfibrozil exhibits its action by inhibition of lipolysis and reduction of hepatic fatty acid uptake. It also inhibits secretion of VLDL from the liver.
Indications
  • Hypertriglyceridemia in adult patients with very high elevations of triglyceride levels (type IV and V hyperlipidemia) at risk of pancreatitis unresponsive to diet therapy
  • Reduction of coronary heart disease risk in patients who have not responded to diet, exercise, and other agents and have low HDL levels in addition to high LDL and triglyceride levels
Adverse effects
  • Myositic syndrome, cholelithiasis, GI disturbances, rash, headache, blood dyscrasias, myalgia. Impotence, painful extremities, blurred vision; pruritus, urticaria; impotence; dizziness; cholestatic jaundice.
  • Potentially Fatal: Bone marrow hypoplasia; intracranial haemorrhage; nephrotoxicity; peripheral neuritis.
Contraindications
  • Hypersensitivity. Severe hepatic or renal dysfunction; gall stones; neonates, children, pregnancy, lactation.
Nursing considerations
Assessment
  • History: Allergy to gemfibrozil, hepatic or renal impairment, primary biliary cirrhosis, gallbladder disease, pregnancy, lactation
  • Physical: Skin lesions, color, T; gait, range of motion; orientation, affect, reflexes; bowel sounds, normal output, liver evaluation; lipid studies, CBC, LFTs, renal function tests, blood glucose
Interventions
  • Administer drug with meals or milk if GI upset occurs.
  • Arrange for regular follow-up visits, including blood tests for lipids, liver function, CBC, and blood glucose during long-term therapy.
Teaching points
  • Take the drug with meals or with milk if GI upset occurs; changes in diet will be needed.
  • Have regular follow-up visits to your health care provider for blood tests to evaluate drug effectiveness.
  • You may experience these side effects: Diarrhea, loss of appetite, flatulence (eat frequent small meals); muscular aches and pains, bone and joint discomfort; dizziness, faintness, blurred vision (use caution if driving or operating dangerous equipment).
  • Report severe stomach pain with nausea and vomiting, fever and chills or sore throat, severe headache, vision changes.