Drug General Information (ID: DDIGV8AEUI)
Drug Name			Gemfibrozil		Drug Info		Pitavastatin		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Antihyperammonia Agents				Statins/Antihyperlipidemic Agents
Structure

Mechanism of Gemfibrozil-Pitavastatin Interaction (Severity Level: Major)
Increased risk of other adverse reactions (Unspecific) Click to Show/Hide Mechanism Graph
Drug Name		Gemfibrozil				Pitavastatin
Mechanism		Rhabdomyolysis				Rhabdomyolysis
Key Mechanism Factor 1
		Factor Name		Adverse reactions
		Factor Description		An adverse reaction is an unexpected negative reaction to a medication or treatment that happens even when it's used correctly.
Mechanism Description		Increased risk of adverse reactions by the combination of Gemfibrozil and Pitavastatin

Recommended Action
Management		Concurrent use of fibric acid derivatives and HMG-CoA reductase inhibitors should generally be avoided unless the benefit of further alterations in lipid levels is anticipated to outweigh the potential risks. Addition of fibrates to HMG-CoA reductase inhibitor therapy typically provides little additional reduction in LDL cholesterol, but further reductions of triglycerides and increases in HDL cholesterol may be attained. Lovastatin labeling recommends that the dosage not exceed 20 mg daily when prescribed with gemfibrozil or other fibrates. All patients treated with HMG-CoA reductase inhibitors and/or fibrates should be advised to promptly report any unexplained muscle pain, tenderness or weakness, particularly if accompanied by fever, malaise and/or dark colored urine. Therapy should be discontinued if creatine kinase is markedly elevated in the absence of strenuous exercise or if myopathy is otherwise suspected or diagnosed. In addition, patients should be closely monitored for hepatotoxicity.

References
1	Backman JT, Kyrklund C, Neuvonen M, Neuvonen PJ "Gemfibrozil greatly increases plasma concentrations of cerivastatin." Clin Pharmacol Ther 72 (2002): 685-91.[PMID: 12496749]
2	Duell PB, Connor WE, Illingworth DR "Rhabdomyolysis after taking atorvastatin with gemfibrozil." Am J Cardiol 81 (1998): 368-9.[PMID: 9468088]
3	Mastroianni CM, dEttorre G, Forcina G, Lichtner M, Corpolongo A, Coletta S, Vullo V "Rhabdomyolysis after cerivastatin-gemfibrozil therapy in an HIV-infected patient with protease inhibitor-related hyperlipidemia." AIDS 15 (2001): 820-1.[PMID: 11371708]