What type of lipid-lowering agent is gemfibrozil?

Gemfibrozil is classified as a fibrate, which is a type of lipid-lowering agent primarily used to reduce triglyceride levels in the blood and can also help to raise high-density lipoprotein (HDL) cholesterol. Fibrates work by activating peroxisome proliferator-activated receptor alpha (PPAR-α), which leads to increased lipolysis and decreased hepatic production of triglyceride-rich very low-density lipoprotein (VLDL). This mechanism is particularly effective in patients with dyslipidemia characterized by high triglyceride levels.

Fibrates are particularly beneficial in patients who have not achieved sufficient lipid control with statins alone, particularly for those with elevated triglycerides. Gemfibrozil, as a well-studied fibrate, is often used in conjunction with other lipid-lowering therapies but should be approached with caution when combined with statins due to an increased risk of myopathy and rhabdomyolysis.

In contrast, statins lower cholesterol primarily by inhibiting the enzyme HMG-CoA reductase, bile acid sequestrants work by binding bile acids in the intestine, and PCSK9 inhibitors are antibodies that enhance the liver's ability to remove LDL cholesterol from the blood. Each