Effect of gemfibrozil on lipoprotein concentrations in different types of hyperlipoproteinaemia

The lipoprotein lowering effect of gemfibrozil, 400 mg twice daily, was studied for 24 weeks in 26 subjects with primary hyperlipoproteinaemia (type IIa, 5; IIb, 3; III, 3; and IV, 15). Maximum effects were noted after four weeks on very low density lipoproteins (VLDL) and after 12 weeks on low density lipoproteins (LDL), these effects remaining throughout the study. Gemfibrozil decreased VLDL triglycerides (TG) in all types of hyperlipoproteinaemia according to the equation: deltaVLDL TG (mmol/l) = -0.80 X initial VLDL TG concentration + 0.68 The drug affected the low density lipoprotein (LDL) cholesterol= -0.45 X initial LDL cholesterol + 61 This means that LDL cholesterol on average decreased if the initial LDL concentration was above 135 mg/100 ml and increased below that concentration. LDL TG and high density lipoprotein (HDL) TG concentrations also decreased significantly. A slight increase in HDL cholesterol concentration occurred after administration of gemfibrozil. Two subjects had to stop treatment because of nausea and abdominal pain respectively, attributed to the drug. No biochemical side effects were noted.