Skip to Content

Gemfibrozil Side Effects

In Summary

Commonly reported side effects of gemfibrozil include: pancreatitis, malignant neoplasm, dyspepsia, and cholelithiasis. Other side effects include: abdominal pain. See below for a comprehensive list of adverse effects.

For the Consumer

Applies to gemfibrozil: oral capsule, oral tablet

In addition to its needed effects, some unwanted effects may be caused by gemfibrozil. In the event that any of these side effects do occur, they may require medical attention.

Severity: Major

You should check with your doctor immediately if any of these side effects occur when taking gemfibrozil:

More common:
  • Bladder pain
  • bloody or cloudy urine
  • cough or hoarseness
  • difficult, burning, or painful urination
  • fever or chills
  • frequent urge to urinate
  • lower back or side pain
Incidence not known:
  • Black, tarry stools
  • chest pain
  • dark-colored urine
  • indigestion
  • large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
  • muscle cramps or spasms
  • muscle pain or stiffness
  • muscular pain, tenderness, wasting, or weakness
  • pale skin
  • severe nausea or vomiting
  • shortness of breath
  • sore throat
  • sores, ulcers, or white spots on the lips or in the mouth
  • stomach pain
  • swollen glands
  • troubled breathing with exertion
  • unusual bleeding or bruising
  • unusual tiredness or weakness

Severity: Minor

Some of the side effects that can occur with gemfibrozil may not need medical attention. As your body adjusts to the medicine during treatment these side effects may go away. Your health care professional may also be able to tell you about ways to reduce or prevent some of these side effects. If any of the following side effects continue, are bothersome or if you have any questions about them, check with your health care professional:

More common:
  • Acid or sour stomach
  • belching
  • burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
  • change in taste bad unusual or unpleasant (after) taste
  • diarrhea
  • heartburn
  • stomach discomfort or upset
Less common:
  • Difficulty having a bowel movement (stool)
  • dizziness or lightheadedness
  • feeling of constant movement of self or surroundings
  • headache
  • nausea
  • sensation of spinning
  • skin rash, encrusted, scaly and oozing
  • vomiting

For Healthcare Professionals

Applies to gemfibrozil: compounding powder, oral tablet


Gemfibrozil is generally well tolerated. The most common side effects are those relating to the gastrointestinal tract.[Ref]


Gastrointestinal side effects of gemfibrozil include dyspepsia (19.6%), abdominal pain (9.8%), diarrhea (4.8%), nausea (4.0%), vomiting (1.2%), and dry mouth.[Ref]


Hepatic side effects of gemfibrozil include alterations in liver function tests and increased risk of gallstone formation. Cholestatic jaundice and cases of cholelithiasis have also been reported.[Ref]

Gemfibrozil decreases bile acid and increases cholesterol secretion thus increasing lithogenicity of the bile and promoting gallstone formation. If a patient develops evidence of gallstones during gemfibrozil therapy, gemfibrozil should be discontinued. In general, gemfibrozil is considered contraindicated in patients with a history of gallbladder disease.[Ref]


Renal side effects of gemfibrozil include acute renal failure associated with myositis and rhabdomyolysis.[Ref]

Gemfibrozil is reported to cause rhabdomyolysis and subsequent renal failure. In one review, all patients in whom outcome was reported either significantly improved or completely recovered.[Ref]


Musculoskeletal side effects of gemfibrozil include arthralgia, myopathy, myalgia, polyarthritis, and rhabdomyolysis. Myositis induced compartment syndrome is reported in one patient.[Ref]

Gemfibrozil has been associated with severe myopathy and rhabdomyolysis. This is accompanied by elevations in creatine kinase, myoglobinuria, and proteinuria, as well as renal failure. Elevations in creatine kinase are more marked when gemfibrozil has been combined with another agent which is also capable of causing myopathy (i.e., HMG CoA reductase inhibitors, niacin). One review noted a case report with a creatine kinase level of 148,000 units/mL in a 79-year-old woman taking both gemfibrozil and lovastatin. Additional studies have confirmed that the combination of gemfibrozil and a HMG CoA reductase inhibitor increases the incidence and severity of myotoxicity.

Patients should be instructed to report symptoms of muscle pain, weakness, or tenderness. If such symptoms develop, creatine kinase should be measured, and, if elevated, gemfibrozil should be discontinued.

Gemfibrozil is associated with a higher incidence of myotoxicity (i.e., rhabdomyolysis) than fenofibrate when used in combination with any HMG CoA reductase inhibitor (statin). Fenofibrate is primarily metabolized by glucuronidation, whereas gemfibrozil undergoes extensive oxidative metabolism which results in higher plasma levels of statins. This pharmacokinetic difference may account for the differences in the rates of myotoxicity.[Ref]


Hematologic side effects of gemfibrozil include minor, transient decreases in hemoglobin, hematocrit, and white blood cell count which occur occasionally when gemfibrozil therapy is initiated but normalize with continued use. Leukopenia, leukocytosis, anemia, and eosinophilia are also reported. In addition, gemfibrozil may alter blood coagulation.[Ref]

Nervous system

Nervous system side effects of gemfibrozil include dizziness, somnolence, headache, vertigo, hyperesthesia, paresthesias, taste perversion, and confusion.[Ref]


Cardiovascular side effects of gemfibrozil include rare cases of atrial fibrillation, vasculitis, and Raynaud's phenomenon.[Ref]


Dermatologic side effects of gemfibrozil include rash, dermatitis, pruritus, psoriasis, and exfoliative dermatitis.[Ref]


Genitourinary side effects of gemfibrozil include impotence and decreased male fertility.[Ref]


Hypersensitivity reactions are reported rarely with gemfibrozil and include urticaria, angioedema, laryngeal edema, and anaphylaxis. In addition, at least one case of eosinophilic gastroenteritis associated with gemfibrozil use has been reported.[Ref]

A 56-year-old women with a one month history of progressive, watery diarrhea and lower abdominal cramps was admitted to the hospital for evaluation. The only change noted in the patient's history was the initiation of gemfibrozil two weeks before the diarrhea and mild abdominal cramping began. Initial laboratory values revealed an elevated eosinophil count of 1820/mm3 and a serum IgE level of 1990 intl units/mL. The gemfibrozil was discontinued and it was later determined that the patient's presentation was consistent with eosinophilic gastroenteritis. Methylprednisolone was initiated and the patient gradually recovered. On two subsequent follow-up visits, the patient was challenged with gemfibrozil and experienced the return of mild diarrhea and peripheral eosinophilia.[Ref]


Immunologic effects of gemfibrozil include a Lupus-like syndrome and positive antinuclear antibody tests; causality is not established.[Ref]


Ocular side effects of gemfibrozil include blurred vision, retinal edema, and cataracts.[Ref]


Metabolic side effects of gemfibrozil include a case report of gout of the acromioclavicular joint.[Ref]


Psychiatric side effects of gemfibrozil include decreased libido and depression.[Ref]


Many lipid-lowering drugs have been associated with tumor growth in rodents. Gemfibrozil has been specifically associated with liver tumors and Leydig cell tumors. Long-term clinical trials are needed to define the risk of cancer in humans.[Ref]


1. "Multum Information Services, Inc. Expert Review Panel"

2. Arellano F, de Cos MA, Valiente R, Quiros C "Gemfibrozil-induced headache ." Lancet 1 (1988): 705

3. Frick MH, Syvanne M, Nieminen MS, Kauma H, Majahalme S, Virtanen V, Kesaniemi YA, Pasternack A, Taskinen MR "Prevention of the angiographic progression of coronary and vein-graft atherosclerosis by gemfibrozil after coronary bypass surgery in men with low levels of HDL cholesterol. Lopid Coronary Angiography Trial (LOCAT) Study Group." Circulation 96 (1997): 2137-43

4. Alvarez-Sabin J, Codina A, Rodriguez C, Laporte JR "Gemfibrozil-induced headache ." Lancet 2 (1988): 1246

5. Todd PA, Ward A "Gemfibrozil: a review of its pharmacodynamic and pharmacokinetic properties, and therapeutic use in dyslipidaemia." Drugs 36 (1988): 314-39

6. "Product Information. Lopid (gemfibrozil)." Parke-Davis, Morris Plains, NJ.

7. Pierce LR, Wysowski DK, Gross TP "Myopathy and rhabdomyolysis associated with lovastatin-gemfibrozil combination therapy." JAMA 264 (1990): 71-5

8. Gorriz JL, Sancho A, Lopez-Martin JM, Alcoy E, Catalan C, Pallardo LM "Rhabdomyolysis and acute renal failure associated with gemfibrozil therapy" Nephron 74 (1996): 437-8

9. Pogson GW, Kindred LH, Carper BG "Rhabdomyolysis and renal failure associated with cerivastatin-gemfibrozil combination therapy." Am J Cardiol 83 (1999): 1146

10. Gorriz JL, Sancho A, Lopezmartin JM, Alcoy E, Catalan C, Pallardo LM "Rhabdomyolysis and acute renal failure associated with gemfibrozil therapy." Nephron 74 (1996): 437-8

11. Layne RD, Sehbai AS, Stark LJ "Rhabdomyolysis and renal failure associated with gemfibrozil monotherapy." Ann Pharmacother 38 (2004): 232-4

12. Dealava E, Sola JJ, Lozano MD, Pardomindan FJ "Rhabdomyolysis and acute renal failure in a heart transplant recipient treated with hypolipemiants." Nephron 66 (1994): 242-3

13. Goldman JA, Fishman AB, Lee JE, Johnson RJ "The role of cholesterol-lowering agents in drug-induced rhabdomyolysis and polymyositis ." Arthritis Rheum 32 (1989): 358-9

14. van Puijenbroek EP, Du Buf-Vereijken PW, Spooren PF, van Doormaal JJ "Possible increased risk of rhabdomyolysis during concomitant use of simvastatin and gemfibrozil." J Intern Med 240 (1996): 403-4

15. Smith GW, Hurst NP "Vasculitis, Raynaud's phenomenon and polyarthritis associated with gemfibrozil therapy." Br J Rheumatol 32 (1993): 84-5

16. Jones PH, Davidson MH "Reporting rate of rhabdomyolysis with fenofibrate + statin versus gemfibrozil + any statin." Am J Cardiol 95 (2005): 120-2

17. Iliadis EA, Rosenson RS "Long-term safety of pravastatin-gemfibrozil therapy in mixed hyperlipidemia." Clin Cardiol 22 (1999): 25-8

18. Bruno-Joyce J, Dugas JM, MacCausland OE "Cerivastatin and gemfibrozil-associated rhabdomyolysis." Ann Pharmacother 35 (2001): 1016-9

19. Thompson CH, Irish A, Kemp GJ, Taylor DJ, Radda GK "Skeletal muscle metabolism before and after gemfibrozil treatment in dialysed patients with chronic renal failure." Clin Nephrol 45 (1996): 386-9

20. Hammoudeh M, Siam AR, Khanjar I "Spondylitis-like and symmetric polyarthralgia associated with gemfibrozil therapy." Br J Rheumatol 34 (1995): 692-3

21. Alexandridis G, Pappas GA, Elisaf MS "Rhabdomyolysis due to combination therapy with cerivastatin and gemfibrozil." Am J Med 109 (2000): 261-2

22. Alsheikh-Ali AA, Kuvin JT, Karas RH "Risk of adverse events with fibrates." Am J Cardiol 94 (2004): 935-8

23. Chow LT, Chow WH "Acute compartment syndrome: an unusual presentation of gemfibrozil induced myositis." Med J Aust 158 (1993): 48-9

24. Fusella J, Strosberg JM "Polymyositis exacerbated by gemfibrozil ." J Rheumatol 17 (1990): 572-3

25. Fisher DA, Elias PM, LeBoit PL "Exacerbation of psoriasis by the hypolipidemic agent, gemfibrozil." Arch Dermatol 124 (1988): 854-5

26. James CW, Wu TS, McNelis KC "Sexual dysfunction secondary to gemfibrozil." Pharmacotherapy 22 (2002): 123-5

27. Figueras A, Castel JM, LaPorte JR, Capella D "Gemfibrozil-induced impotence." Ann Pharmacother 27 (1993): 982

28. Bain SC, Lemon M, Jones AF "Gemfibrozil-induced impotence." Lancet 336 (1990): 1389

29. Bharani A "Sexual dysfunction after gemfibrozil." Br Med J 305 (1992): 693

30. Lee JY, Medellin MV, Tumpkin C "Allergic reaction to gemfibrozil manifesting as eosinophilic gastroenteritis." South Med J 93 (2000): 807-8

31. Lee JY, Medellin MV, Tumpkin C "Allergic reaction to gemfibrozil manifesting as eosinophilic gastroenteritis." South Med J J 93 (2000): 807-8

32. Miller-Blair D, White R, Greenspan A "Acute gout involving the acromioclavicular joint following treatment with gemfibrozil." J Rheumatol 19 (1992): 166-8

33. Aberg F, Appelkvist EL, Broijersen A, Eriksson M, Angelin B, Hjemdahl P, Dallner G "Gemfibrozil-induced decrease in serum ubiquinone and alpha- and gamma-tocopherol levels in men with combined hyperlipidaemia." Eur J Clin Invest 28 (1998): 235-42

34. Newman TB, Hulley SB "Carcinogenicity of lipid-lowering drugs." JAMA 275 (1996): 55-60

Not all side effects for gemfibrozil may be reported. You should always consult a doctor or healthcare professional for medical advice. Side effects can be reported to the FDA here.

Disclaimer: Every effort has been made to ensure that the information provided is accurate, up-to-date and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. This material does not endorse drugs, diagnose patients, or recommend therapy. This information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill , knowledge, and judgement of healthcare practitioners in patient care. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate safety, effectiveness, or appropriateness for any given patient. does not assume any responsibility for any aspect of healthcare administered with the aid of materials provided. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the substances you are taking, check with your doctor, nurse, or pharmacist.