Serious. These medicines may interact and cause very harmful effects. Contact your healthcare professional (e.g. doctor or pharmacist) for more information.
How the interaction occurs:
Gemfibrozil slows down how quickly your liver processes pioglitazone and rosiglitazone.
What might happen:
The amount of pioglitazone or rosiglitazone in your blood may increase and it may lower your blood sugar too much.
What you should do about this interaction:
Let your healthcare professionals (e.g. doctor or pharmacist) know that you are taking these medicines together. Your doctor may want you to check your blood sugar more frequently when you first start taking these medicines together and if you stop taking gemfibrozil. Inform your healthcare professionals if you have any signs of low blood sugar such as sweating, rapid heartbeat, and dizziness. Your doctor may need to change the dose of your diabetes medicine or change your cholesterol medicine.Your healthcare professionals may already be aware of this interaction and may be monitoring you for it. Do not start, stop, or change the dosage of any medicine before checking with them first.
1.Deng LJ, Wang F, Li HD. Effect of gemfibrozil on the pharmacokinetics of pioglitazone. Eur J Clin Pharmacol 2005 Dec;61(11):831-6.
2.Actos (pioglitazone hydrochloride) US prescribing information. Takeda Pharmaceuticals Inc. November, 2013.
3.Jaakkola T, Backman JT, Neuvonen M, Neuvonen PJ. Effects of gemfibrozil, itraconazole, and their combination on the pharmacokinetics of pioglitazone. Clin Pharmacol Ther 2005 May;77(5):404-14.
4.Jaakkola T, Laitila J, Neuvonen PJ, Backman JT. Pioglitazone is metabolised by CYP2C8 and CYP3A4 in vitro: potential for interactions with CYP2C8 inhibitors. Basic Clin Pharmacol Toxicol 2006 Jul;99(1):44-51.
5.Aquilante CL, Kosmiski LA, Bourne DW, Bushman L, Daily EB, Hammond KP, Hopley CW, Kadam RS, Kanack AT, Kompella UB, Le M, Predhomme JA, Rower JE, Sidhom MS. Impact of the CYP2C8*3 polymorphism on the drug-drug interaction between gemfibrozil and pioglitazone. Br J Clin Pharmacol 2012 May 25.
6.Niemi M, Backman JT, Granfors M, Laitila J, Neuvonen M, Neuvonen PJ. Gemfibrozil considerably increases the plasma concentrations of rosiglitazone. Diabetologia 2003 Oct;46(10):1319-23.
7.Avandia (rosiglitazone) US prescribing information. GlaxoSmithKline May, 2012.