gemfibrozil / Generic mfg. - LARVOL DELTA

RECURRENT PANCREATITIS: IDENTIFYING FAMILIAL CHYLOMICRONEMIA SYNDROME IN AN ADULT (ACC 2026) - "Her pancreatitis occurred despite maximal lifestyle (strict low-fat diet, alcohol abstinence, BMI of 24, apolipoprotein B 75mg/dL) and medical therapy (fenofibrate, gemfibrozil, icosapent ethyl, rosuvastatin, evolocumab, and levocarnitine)...She was subsequently started on olezarsen, which lowered TG to 100 mg/dL... FCS is a rare and underdiagnosed genetic form of HTG. This case highlights the importance of evaluating for FCS in adults with refractory HTG in the absence of secondary factors. Accurate classification enables the use of precision therapy, such as APOC3 inhibition, which may improve outcomes."

Clinical • Cardiovascular • Congestive Heart Failure • Diabetes • Dyslipidemia • Familial Chylomicronemia Syndrome • Heart Failure • Hypertriglyceridemia • Pancreatitis • Severe Hypertriglyceridemia • APOB • LPL

ACQUIRED CHYLOMICRONEMIA SYNDROME WITH SEVERE HYPERTRIGLYCERIDEMIC PANCREATITIS AND CONCURRENT IMMUNE THROMBOCYTOPENIA IN A RENAL TRANSPLANT RECIPIENT (ACC 2026) - "Decision-Making: Triglycerides improved with insulin infusion, but thrombocytopenia was refractory to dexamethasone, IVIG, and romiplostim during the index admission...Lipid therapy was intensified with ezetimibe, icosapent ethyl, and a switch from gemfibrozil to fenofibrate...Olezarsen was initiated, resulting in rapid, sustained triglyceride reduction... We report an extremely rare autoimmune overlap syndrome involving acquired chylomicronemia and ITP. While APOC3 inhibitors have shown efficacy in familial and multifactorial forms, their use in acquired chylomicronemia has not been previously described. This successful response supports the need for further investigation of APOC3 inhibition in this population."

Clinical • Chronic Kidney Disease • Diabetes • Dyslipidemia • Focal Segmental Glomerulosclerosis • Genetic Disorders • Glomerulonephritis • Hematological Disorders • Immune Thrombocytopenic Purpura • Immunology • Infectious Disease • Obesity • Pancreatitis • Rare Diseases • Renal Disease • Severe Hypertriglyceridemia • Thrombocytopenia • Thrombocytopenic Purpura • Transplantation • Type 2 Diabetes Mellitus

The role of biofilms formed on different mesoplastics as a carrier of a range of diverse contaminants in estuarine water. (PubMed, J Contam Hydrol) - "In terms of pollutant concentrations, the biofilm on PE recorded the highest levels of gemfibrozil (GFZ), measuring 2.2 μg/cm2 during the experiment...These findings indicate that mesoplastics serve as passive samplers, providing surfaces conducive to microbial colonization and thereby enhancing the accumulation and retention of pollutants from the surrounding aquatic environment within biofilms. Therefore, a comprehensive assessment of plastic pollution in marine ecosystems must incorporate considerations of the biological activity and interactions of plastics with environmental contaminants to fully understand their ecological impact."

Journal • Infectious Disease

Drug-drug interaction by metabolites: Challenges and solutions during therapeutics innovation. (PubMed, Drug Metab Dispos) - "Actually, the clinical risks of Met DDIs had been identified as gemfibrozil and mibefradil; mibefradil was withdrawn from the market because of serious adverse reactions. This review comprehensively analyzes regulatory guidelines by major authorities (National Medical Product Administration, US Food and Drug Administration, Pharmaceuticals and Medical Devices Agency, European Medicines Agency, and the International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use), summarizing their consensus on proactive Met DDI risk assessment while highlighting key discrepancies in scope, thresholds, and implementation requirements. Furthermore, it presents a translational evaluation strategy-from early in vitro characterization to advanced modeling approaches (physiologically based pharmacokinetic/population pharmacokinetic simulations) and optimized clinical study designs-with critical support from multiple case studies that illustrate practical..."

Journal • Review

Therapy in diabetic dyslipidemia. (PubMed, Indian J Pharmacol) - "Hence, the combination of saroglitazar and gemfibrozil has shown a good safety profile and may represent a novel therapeutic agent that will fulfill the unmet needs in T2DM and diabetic dyslipidemia."

Journal • Cardiovascular • Dyslipidemia • Metabolic Disorders • Type 2 Diabetes Mellitus

High risk of potential resmetirom-drug interactions in older adults with metabolic dysfunction-associated steatotic liver disease – a modelling analysis using data from the ASPREE trial (EASL-SLD 2026) - "Drugs evaluated included statins, gemfibrozil, verapamil, amiodarone, clopidogrel, pioglitazone, rosiglitazone, fluoxetine, olanzapine, and leflunomide. Conclusion MASLD was common in older adults, and when modelling risk of potential DDIs with potential resmetirom prescribing there was a high risk of both statin and non-stain resmetirom-drug interactions. Clinicians should be alert for potential interactions and consider increased monitoring or resmetirom dose adjustment depending on the nature of the interaction(s)."

Clinical • Metabolic Disorders • Metabolic Dysfunction-Associated Steatohepatitis • Metabolic Dysfunction-Associated Steatotic Liver Disease

P1-IMU838DDI-CYP2C8: A Phase 1, Single-Center, Open-Label, Fixed-Sequence, 2-Part Study to Assess the Pharmacokinetics of IMU-838 Administered Alone and in Combination with Multiple Doses of Gemfibrozil as CYP2C8 Inhibitor, or Rifampicin as CYP2C8 Inducer, in Healthy Subjects (clinicaltrialsregister.eu) - P1 | N=24 | Active, not recruiting | Sponsor: Immunic AG | Recruiting ➔ Active, not recruiting

Enrollment closed • CNS Disorders • Multiple Sclerosis

Pharmaceuticals in leachate from worldwide municipal waste landfills: a review. (PubMed, J Environ Health Sci Eng) - "The largest number of studies concerned diclofenac, carbamazepine, ibuprofen and gemfibrozil, where diclofenac and ibuprofen had the highest concentrations in their group. Even treated landfill leachates can be a source of pharmaceuticals in surface waters. Therefore, the need to define standards or guidelines regarding limit values ​​for selected pharmaceuticals contained in treated leachates should be considered, with emphasis on substances presenting the highest ecological risk."

Journal • Review • Pain

Gemfibrozil Prevents Myocardial Ischemia-Reperfusion Injury in Mice Through AMPK Activation. (PubMed, Clin Exp Pharmacol Physiol) - "Myocardial ischemia-reperfusion injury (MIRI) causes severe clinical complications in patients. Further analysis showed that GEM administration prevented the I/R-induced decrease in phospho-AMPK levels in ischemic cardiac tissue, and pharmacological inhibition of AMPK with dorsomorphin (DSMF) abolished all cardioprotective effects of GEM. Taken together, these results suggest that GEM mitigates MIRI-induced cardiac injury by inhibiting apoptosis and oxidative stress via modulation of AMPK, supporting its potential for reducing MIRI-related cardiac damage."

IO biomarker • Journal • Preclinical • Cardiovascular • Inflammation • Metabolic Disorders • Myocardial Ischemia • Oncology • Reperfusion Injury • BCL2 • CASP3 • CASP9 • IL1B • IL6 • TNFA

Seasonal and spatial dynamics of organic micropollutants in a Mediterranean river: implications for environmental risk assessment. (PubMed, Environ Geochem Health) - "Among the 27 tested pharmaceuticals, ibuprofen (4.7 µg/L), caffeine (23.6 µg/L), telmisartan (833.5 ng/L), carbamazepine (658.5 ng/L), gemfibrozil (71.0 ng/L), mefenamic acid (64.7 ng/L), and diphenhydramine (65.9 ng/L) were the most frequently detected, with some reaching notably high concentrations in the µg/L range in surface water. Sediments revealed ubiquitous contamination by ibuprofen, telmisartan, climbazole, diphenhydramine, and azithromycin...The findings from this study contribute to the state of knowledge of pollution levels of emerging contaminants in a major Mediterranean river and permit to inform and guide future mitigation and management strategies. The environmental risk assessment applied in this study enabled the translation of measured concentrations into ecologically meaningful indicators allowing the identification of priority contaminants and high-risk locations."

Journal

Managing Drug-Drug Interactions Involving the Non-Prescription Opioid Loperamide Through Physiologically Based Pharmacokinetic Modeling. (PubMed, CPT Pharmacometrics Syst Pharmacol) - "The inhibitor drugs tested included quinidine (P-gp), ritonavir (CYP3A/P-gp), gemfibrozil (CYP2C8), itraconazole (CYP3A/P-gp), gemfibrozil+itraconazole, and abemaciclib (CYP1A). Predicted AUC ratios (AUC of loperamide in the presence to absence of inhibitor) were within 0.78-1.09-fold of observed ratios. This novel PBPK model for loperamide could be used to guide loperamide dosing under untested DDI scenarios when the drug is coadministered with certain CYP/transporter inhibitors to minimize toxicity risk."

Journal • PK/PD data • Addiction (Opioid and Alcohol)

Ni-Catalyzed Asymmetric Reductive Arylation and Alkenylation of N-Sulfonyl Imines. (PubMed, Org Lett) - "Demonstrating exceptional generality (>85 substrates), the protocol enables the direct late-stage functionalization of complex drug-derived scaffolds (e.g., naproxen, ibuprofen, oxaprozin, gemfibrozil). The synthetic utility is further highlighted through chemoselective derivatizations. DFT calculations support a mechanism involving NiI-mediated oxidative cyclometalation proceeding via a key aza-nickelacycle intermediate."

Journal

Lipid Armor Loaded with Doxylamine and Gemfibrozil for Glioblastoma Therapy: Particle Engineering and Multidimensional Two-Dimensional/Three-Dimensional Antitumor Efficacy. (PubMed, ACS Omega) - "Temozolomide (TMZ), the current standard chemotherapeutic agent, often fails due to acquired resistance and its high systemic toxicity at therapeutic doses. Mechanistic studies carried out in 2D and 3D cultures of U87 cells revealed that both free and nanoformulation-encapsulated drugs inhibited autophagy flux and triggered apoptotic pathways in GBM cells, with the nanoformulations exhibiting greater selectivity and efficiency. These results underscore the advantages of SLN-based Doxylamine and Gemfibrozil delivery over their free forms, highlighting their promise as safer and more effective treatment options for GBM."

Journal • Brain Cancer • Glioblastoma • Oncology • Solid Tumor

Drug Development. (PubMed, Alzheimers Dement) - "In summary, we demonstrated a single-cell digital twin framework for cell type-specific target identification and drug repurposing in AD and other AD-related dementia if broadly applied."

Journal • Alzheimer's Disease • CNS Disorders • Dementia • ABCA1

Activation of PPARα by gemfibrozil lowers tau-associated neuropathology in the MAPT mouse model of Alzheimer's disease. (PubMed, Brain Res) - "These data suggest that neuroprotective effects of gemfibrozil in MAPT mice is mediated by PPARα. Moreover, targeting PPARα by small molecules like gemfibrozil may hold translational potential against tauopathy."

Journal • Preclinical • Alzheimer's Disease • CNS Disorders • Cognitive Disorders • DLG4 • MAPT • PPARA

Integrative Toxicology Profiling of Thuja sutchuenensis Essential Oil: From LD50 Safety Assessment to Hepatic Apoptosis and Gut Microbiota Modulation. (PubMed, Food Sci Nutr) - "Metabolomics detected 611 differential metabolites (log2FC ≥ 2, p < 0.05); representative changes were Picric acid and Gemfibrozil 1-O-beta-Glucuronide, consistent with oxidative stress...The median lethal dose (LD₅₀) of TEO in mice was found to be approximately 3800 mg/kg. These findings provide a foundation for further studies on the protective effects and potential applications of TEO."

Journal • CYP3A4 • PPARG

Combined impacts of a lipid lowering drug, gemfibrozil, and temperature on bioenergetics and digestive gland function of a marine bivalve Mytilus edulis. (PubMed, Aquat Toxicol) - "Moderate warming partly offsets energetic costs by enhancing filtration and energy acquisition but does not reverse cellular and tissue-level damage in the digestive gland. These results indicate that warming coastal seas may buffer some functional consequences of fibrate exposure while allowing persistent sub-lethal pathology, with implications for long-term ecological risk to marine ecosystems from lipid-lowering drugs."

Journal • Gastrointestinal Disorder • Metabolic Disorders • CTSD

Unraveling the Function of PPARα in Neurodegenerative Disorders: A Potential Pathway to Novel Therapies. (PubMed, Biomedicines) - "Indicatively, gemfibrozil (PPARα agonist) markedly reduced the beta-amyloid burden, microgliosis, and astrogliosis in the hippocampus of 5xFAD mice and ameliorated their spatial learning and memory. Fenofibrate (PPARα agonist) reduced the depressive-like behavior and memory deficits in rotenone-lesioned rats developing Parkinsonism...Although current findings are promising, they underscore the necessity of further rigorous clinical validation of the efficacy of various PPARα agonists in the retardation or even prevention of AD and PD symptomatology in both genders and the development of reliable biomarkers for the early assessment of the impact of PPARα agonists on NDs. The safety of these drugs in the elderly and their longitudinal effectiveness should also be evaluated."

Journal • Review • Alzheimer's Disease • CNS Disorders • Inflammation • Metabolic Disorders • Movement Disorders • Parkinson's Disease • PPARA

Lipid-Lowering Therapy Is Underutilized Across LDL-C Levels in Autoimmune Disease Compared to Diabetes: A Nationwide Analysis (AHA 2025) - "Statins included atorvastatin, rosuvastatin, simvastatin, pravastatin, lovastatin, fluvastatin, pitavastatin. Non-statin therapies included icosapent ethyl, colesevelam, alirocumab, evolocumab, Bempedoic acid, cholestyramine, Inclisiran, colestipol, ezetimibe, gemfibrozil, omega-3 acid, fenofibrate...Non-statin lipid-lowering therapy use was significantly lower in autoimmune patients compared to those with diabetes across all LDL-C tertiles, with the largest differences observed at LDL <70 mg/dL (6.19% vs 10.24%, p<0.0001) and 70–99 mg/dL (4.05% vs 7.06%, p<0.0001).ConclusionDespite comparable ASCVD risk, patients with autoimmune disease are significantly less likely to receive statins or non-statin lipid-lowering therapy than those with DM across LDL-C levels. These findings show a need for improved cardiovascular prevention in this high-risk population."

Atherosclerosis • Cardiovascular • Diabetes • Dyslipidemia • Hepatology • Immunology • Inflammatory Arthritis • Lupus • Metabolic Disorders • Rheumatoid Arthritis • Rheumatology • Systemic Lupus Erythematosus

A QSPR study of coronary artery disease drugs using eccentricity-based indices. (PubMed, Sci Rep) - "This study advances QSPR modeling by using eccentricity-based graphical invariants, specifically designed to enhance the predictive accuracy for physicochemical properties of drugs used to treat coronary artery disease, including atorvastatin, simvastatin, rosuvastatin, aspirin, clopidogrel, metoprolol, atenolol, enalapril, lisinopril, amlodipine, diltiazem, nitroglycerin, isosorbide dinitrate, ranolazine, gemfibrozil, and fenofibrate. The experimental values were compared with forecasted data, revealing a strong correlation between them. This demonstrates the reliability of our regression models in assessing these vital physicochemical parameters."

Journal • Cardiovascular • Coronary Artery Disease

Bezafibrate, a Pan PPAR agonist, attenuates experimental rheumatoid arthritis via PPAR dependent modulation of inflammatory pathways with emphasis on PPAR γ activity. (PubMed, Int Immunopharmacol) - "Initially, molecular docking was performed using a panel of fibrate-class compounds (including pemafibrate, bezafibrate, fenofibrate, gemfibrozil, and clofibrate) against the ligand-binding domain of PPAR-γ (PDB ID: 7WGO). These findings suggest that bezafibrate, selected through integrative computational and pharmacological screening, effectively ameliorates experimental autoimmune arthritis via PPAR-γ activation. This highlights its promise as a repurposed therapeutic candidate and warrants further investigation."

Journal • Immunology • Inflammation • Inflammatory Arthritis • Rheumatoid Arthritis • Rheumatology • IL1B • IL6 • TNFA

Successful Use of GLP-1 Receptor Agonist in Patient With Recurrent Hypertriglyceridemia-Induced Pancreatitis: A Case Report (ACG 2025) - "Her history included >25 hospitalizations for HTG-AP, with persistently elevated TG (up to 10,500 mg/dL) despite aggressive interventions, including maximum-dose lipid-lowering agents (gemfibrozil, orlistat, pravastatin), ileal bypass, and plasmapheresis. Two months prior, she started liraglutide therapy (0.6 mg/day), which significantly improved symptoms and prevented HTG-AP recurrence...Remarkably, the patient's most recent TG level of approximately 400 mg/dL represents the lowest value recorded in over a decade (Figure 1), indicating a clinically significant and sustained TG-lowering effect. This favorable response highlights the importance of individualized, patient-centered care and challenges conventional contraindications.Figure: Figure 1: Trend of serum triglyceride and lipase levels over time"

Case report • Clinical • Diabetes • Dyslipidemia • Genetic Disorders • Hypertriglyceridemia • Metabolic Disorders • Obesity • Pancreatitis • Type 2 Diabetes Mellitus • LPL

Fibrates as an Adjunct Therapy in Primary Biliary Cholangitis: A Propensity-Matched Analysis of Major Adverse Cardiovascular Events (ACG 2025) - "Cohort A was also prescribed an additional fibrate (fenofibrate, gemfibrozil, bezafibrate, or ciprofibrate); Cohort B received UDCA monotherapy. The fibrate cohort had higher baseline total cholesterol (212.7 ± 90.0 vs 191.5 ± 66.7 mg/dL, p 0.05). Over a five-year period, fibrate and UCDA-only patients did not differ in the incidence of MACE (HR 1.09, 0.91-1.29, p = 0.35), no individual MACE components (all p-values > 0.05) , or all-cause mortality (HR 0.92, 0.73-1.16, p = 0.47). In this large U.S. real-world cohort, adding a fibrate to UDCA did not significantly increase MACE or mortality despite a more atherogenic lipid profile at baseline. The modest, nonsignificant excess in event rates likely reflects residual confounding from patients selected for fibrate therapy because of dyslipidemia."

Adverse events • Cardiovascular • CNS Disorders • Congestive Heart Failure • Coronary Artery Disease • Diabetes • Dyslipidemia • Heart Failure • Hepatology • Hypertension • Immunology • Metabolic Disorders • Myocardial Infarction • Primary Biliary Cholangitis

Fibrates as an Adjunct Therapy in Primary Biliary Cholangitis Is Associated With Lower Hospitalization and Healthcare Utilization: A Propensity-Matched Analysis (ACG 2025) - "Introduction: Fibrates is considered a second line agent for primary biliary cholangitis (PBC) and improves biochemical responses in PBC patients not responding to ursodeoxycholic acid (UDCA)...Cohort A was also prescribed additional fibrate (fenofibrate, gemfibrozil, bezafibrate, or ciprofibrate); Cohort B was on UDCA monotherapy... Over five years, fibrate patients were less likely to develop spontaneous bacterial peritonitis (2.0 % vs. 1.1%, HR 0.52, 0.29-0.92), and had fewer incidences of all-cause hospitalizations ( 26.7 % vs. 21.8%, HR 0.75, 0.65-0.86)."

Clinical • HEOR • CNS Disorders • Fatigue • Fibrosis • Hepatic Encephalopathy • Hepatocellular Cancer • Hepatology • Immunology • Musculoskeletal Diseases • Osteoporosis • Primary Biliary Cholangitis • Rheumatology • Solid Tumor

Not all fibrates are made equal: Learning from biology and clinical trials. (PubMed, Atherosclerosis) - "However, only fenofibrate appears to reduce apoB, whereas gemfibrozil and pemafibrate do not. Real-world efficacy studies and CVD outcome trials have shown that fenofibrate may be an option in combination with statins compared to other fibrates and is well tolerated. Additionally, evidence from real-world studies of the fenofibrate-statin combination in patients over a period of up to 20 years has dispelled safety concerns regarding long-term use of fenofibrate."

Journal • Review • Cardiovascular • Diabetes • Dyslipidemia • Genetic Disorders • Metabolic Disorders • Obesity • Type 2 Diabetes Mellitus • APOB