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Gemfibrozil was patented in 1968, and came into medical use in 1982. [6] It is available as a generic medication. [4] In 2022, it was the 231st most commonly prescribed medication in the United States, with more than 1 million prescriptions. [7] [8]
Selexipag, sold under the brand name Uptravi, is a medication developed by Actelion for the treatment of pulmonary arterial hypertension (PAH). [3] [4] Selexipag and its active metabolite, ACT-333679 (or MRE-269, the free carboxylic acid), are agonists of the prostacyclin receptor, which leads to vasodilation in the pulmonary circulation. [5]
Fibrates are used in accessory therapy in many forms of hypercholesterolemia, but the combination of some fibrates (e.g., gemfibrozil) with statins is contraindicated due to an increased risk of rhabdomyolysis. [2]
Fenofibrate (sold under the brand name Tricor among others), is an oral medication of the fibrate class used to treat abnormal blood lipid levels. [3] It is less commonly used compared to statins because it treats a different type of cholesterol abnormality to statins.
Risks were higher in patients using fibrates, mainly gemfibrozil (Lopid), and in patients using the highest (0.8 mg/day) dose of cerivastatin. Bayer A.G. added a contraindication for the concomitant use of cerivastatin and gemfibrozil to the package 18 months after the drug interaction was found. [ 3 ]
Among atypical adverse effects, myositis can occur in patients under gemfibrozil therapy, especially in those with renal insufficiency or under co-treatment with statins. In contrast, the risk of myopathy is much lower if fenofibrate is used in replacement of gemfibrozil owing to its different pharmacokinetic pathway.
Lipid-lowering agents, also sometimes referred to as hypolipidemic agents, cholesterol-lowering drugs, or antihyperlipidemic agents are a diverse group of pharmaceuticals that are used to lower the level of lipids and lipoproteins, such as cholesterol, in the blood (hyperlipidemia).
PPARα (alpha) is the main target of fibrate drugs, a class of amphipathic carboxylic acids (clofibrate, gemfibrozil, ciprofibrate, bezafibrate, and fenofibrate). They were originally indicated for dyslipidemia of cholesterol and more recently for disorders characterized by high triglycerides.