Drug Name

Lopid (Gemfibrozil)

Drug Uses

Lopid (also known as a fibrate medication) is used along with a proper diet to help lower fats (triglycerides) and cholesterol in the blood. This drug is usually prescribed after non-drug treatment options have not been fully successful at lowering cholesterol (e.g., diet change, increase in exercise, weight loss if overweight). This drug is thought to work by decreasing the amount of fat produced by the liver. Reducing cholesterol and triglycerides lowers the risk of heart disease and helps prevent strokes and heart attacks. This drug also helps to prevent pancreas disease (pancreatitis) in patients with very high blood levels of triglycerides.

How Taken

Take this medication by mouth usually twice a day, 30 minutes before your morning and evening meals, or as directed by your doctor. Dosage is based on your medical condition and response to therapy. Use this medication regularly in order to get the most benefit from it. Remember to use it at the same times each day. It may take between 1-3 months before the full benefit of this drug takes effect. It is important to continue taking this medication even if you feel well. Most people with high triglycerides or cholesterol do not feel sick.

Drug Class and Mechanism

Lopid is a lipid- and cholesterol-modifying medicine. It reduces triglycerides and increases cholesterol carried in high density lipoprotein (HDL) in the blood. HDL cholesterol is sometimes called "good" cholesterol because higher concentrations of HDL cholesterol in the blood are associated with a reduced risk of heart disease. The decrease in triglycerides is thought to be due in part to reduced release of triglycerides from fat tissue in the body. In one large study, lopid decreased the risk of heart attacks but did not affect the overall survival of persons with high cholesterols.

Missed Dose

If you miss a dose, use it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch up.

Storage

Store the US product at room temperature between 68-77 degrees F (20-25 degrees C) away from light and moisture. Store the Canadian product at room temperature between 59-86 degrees F (15-30 degrees C) away from light and moisture. Do not store in the bathroom. Keep all medicines away from children and pets.

Warnings/Precautions

Before taking lopid, tell your doctor or pharmacist if you are allergic to it, or if you have any other allergies. This medication should not be used if you have certain medical conditions.

Before using this medicine, consult your doctor or pharmacist if you have:

• liver disease (e.g., primary biliary cirrhosis),
• gallbladder disease,
• severe kidney disease.

Before using this medication, tell your doctor or pharmacist your medical history, especially of:

• diabetes (poorly controlled),
• underactive thyroid (hypothyroidism),
• alcohol use.

The rare development of severe muscle damage (see Side Effects) can infrequently lead to serious kidney problems. This medication is usually stopped temporarily if you have any condition which can increase your risk of developing kidney problems.

Before stopping your medication, notify your doctor immediately if you have any of the following conditions:

• major surgery,
• trauma,
• serious illness (e.g., sepsis, severe metabolic/endocrine/electrolyte disorders),
• very low blood pressure,
• uncontrolled seizures.

This drug may make you dizzy or drowsy; use caution engaging in activities requiring alertness such as driving or using machinery. Limit alcoholic beverages. This medication should be used only when clearly needed during pregnancy. Discuss the risks and benefits with your doctor. It is not known whether this drug passes into breast milk. Breast-feeding is not recommended while using this drug. Consult your doctor before breast-feeding.

Possible Side Effects

Stomach/abdominal upset or pain, dizziness, drowsiness, unusual taste, numbness/tingling of hands/feet, or blurred vision may occur. If any of these effects persist or worsen, notify your doctor or pharmacist promptly.

Tell your doctor immediately if any of these serious side effects occur:

• decreased sexual desire or ability,
• depression.

Tell your doctor immediately if any of these highly unlikely but very serious side effects occur:

• signs of infection (e.g. fever, persistent sore throat),
• easy bruising/bleeding,
• unusual fatigue,
• irregular heartbeat.

This medication may infrequently cause muscle damage (which can rarely lead to a very serious, possibly fatal, condition called rhabdomyolysis).

Stop taking this drug and tell your doctor immediately if you develop:

• muscle pain/tenderness/weakness (especially with fever or unusual tiredness),
• unusual change in the amount of urine.

This drug may infrequently cause abdominal problems (e.g., gallstones, gallbladder disease requiring surgery).

Stop taking this drug and tell your doctor immediately if you develop:

• severe stomach/abdominal pain,
• persistent nausea/vomiting,
• yellowing eyes or skin,
• dark urine,
• unusual tiredness.

A serious allergic reaction to this drug is unlikely, but seek immediate medical attention if it occurs. Symptoms of a serious allergic reaction include: rash, itching, swelling, severe dizziness, trouble breathing. If you notice other effects not listed above, contact your doctor or pharmacist.

More Information

Do not share this medication with others. Laboratory and/or medical tests (e.g., blood triglyceride and cholesterol levels, liver function tests, complete blood count, fasting blood sugar levels or FBS) should be performed periodically to monitor your progress or check for side effects. Consult your doctor for more details. For best results this medication should be used along with exercise, a low-fat/low-cholesterol diet, and weight loss program if you are overweight. In addition, check your blood pressure regularly, seek medical treatment if your blood pressure is high, and stop smoking to further help reduce your risk for a heart attack or stroke. Consult your doctor for more details.

What is the shelf life of the pills?

• The expiry date is mentioned on each blister. It is different for different batches. The shelf life is 2 years from the date of manufacture and would differ from batch to batch depending on when they were manufactured.

Other Useful Information:

Radiation: 1. Rays of energy. Gamma rays and X-rays are two of the types of energy waves often used in medicine. 2. The use of energy waves to diagnose or treat disease.

Replantation: 1. Literally, the act of planting again. 2. In surgery, the restoration of any part of the body to its original site. Also known as reimplantation.

The Chinese surgeon Zhong Wei Chen (1929-2004) was the "father of replantation." Dr. Chen was the first to reattach a severed hand with success which he did in 1963. Dr. Chen also developed many microsurgical procedures including techniques for preserving severed extremities, reattaching amputated fingers and thumbs, reconstructing muscles and repairing nerves and blood vessels.

Rheumatism: Rheumatism is an older term, used to describe any of a number of painful conditions of muscles, tendons, joints, and bones.

Rheumatism conditions have been classified as either localized, regional, or generalized. Localized rheumatism conditions include bursitis and tendinitis. Regional rheumatism conditions include chest wall pain, temporomandibular joint pain, and myofascial pain syndromes. Generalized rheumatism conditions include fibromyalgia.

Another category of rheumatism is psychogenic rheumatism. With this term it is understood that the patient is reporting inconsistent pains of muscles and joints that do not correspond to true anatomy and physiology. The patient is felt to have underlying psychological causes for the symptoms.

Rheumatology: A subspecialty of internal medicine that involves the non-surgical evaluation and treatment of the rheumatic diseases and conditions. Rheumatic diseases and conditions are characterized by symptoms involving the musculoskeletal system. Many of the rheumatic diseases and conditions feature immune system abnormalities. Therefore, rheumatology also involves the study of the immune system. Classical rheumatology training includes 4 years of medical school, 1 year of internship in internal medicine, 2 years of internal medicine residency, and 2 years of rheumatology fellowship. There is a subspecialty board for rheumatology certification. The American College of Rheumatology is the official organization acting on behalf of the field of rheumatology in the United States.

T cell: A type of white blood cell that is of key importance to the immune system and is at the core of adaptive immunity, the system that tailors the body's immune response to specific pathogens. The T cells are like soldiers who search out and destroy the targeted invaders.

Immature T cells (termed T-stem cells) migrate to the thymus gland in the neck, where they mature and differentiate into various types of mature T cells and become active in the immune system in response to a hormone called thymosin and other factors. T-cells that are potentially activated against the body's own tissues are normally killed or changed ("down-regulated") during this maturational process.

There are several different types of mature T cells. Not all of their functions are known. T cells can produce substances called cytokines such as the interleukins which further stimulate the immune response. T-cell activation is measured as a way to assess the health of patients with HIV/AIDS and less frequently in other disorders.

T cell are also known as T lymphocytes. The "T" stands for "thymus" -- the organ in which these cells mature. As opposed to B cells which mature in the bone marrow.

Teleology: The study of the ultimate purpose of the design of something in nature.

For example, "what is the true purpose of the nose?" is a teleological question and, to say that all evolutionary changes occur for a definite purpose is a teleological explanation of evolution.

"Teleology" comes from ancient Greek roots but it (and teleological) did not enter English until the 18th century. It is a compound of the Greek "tele-, telos," meaning "end or purpose" + the ending "logos" meaning "the science or study of" = the study of the ends or purposes.

Testosterone: A "male hormone" -- a sex hormone produced by the testes that encourages the development of male sexual characteristics, stimulates the activity of the male secondary sex characteristics, and prevents changes in them following castration. Chemically, testosterone is 17-beta-hydroxy-4-androstene-3-one.

Testosterone is the most potent of the naturally occurring androgens. The androgens cause the development of male sex characteristics, such as a deep voice and a beard; they also strengthen muscle tone and bone mass.

High levels of testosterone appear to promote good health in men, for example, lowering the risks of high blood pressure and heart attack. High testosterone levels also correlate with risky behavior, however, including increased aggressiveness and smoking, which may cancel out these health benefits.

Testosterone may be given to treat medical conditions, including female (but not male) breast cancer, hypogonadism (low gonadal function) in the male, cryptorchism (nondescent of the testis into the scrotum), and menorrhagia (irregular periods).