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Lopid vs Tricor
Introduction
For patients with high cholesterol or triglycerides, certain drugs that alter the concentrations of these fats in the blood can help manage levels and reduce the risk of heart disease. Lopid (gemfibrozil) and Tricor (fenofibrate) are two such drugs prescribed for this purpose. They each work by reducing the amount of fat produced by the liver, but both have different effects on lipid profiles in patients with hyperlipidemia. Lopid is known to significantly lower triglyceride levels and increase HDL ("good") cholesterol, while also moderately decreasing LDL ("bad") cholesterol. Tricor, on the other hand, has a greater impact on lowering LDL cholesterol and increasing HDL cholesterol while also reducing triglycerides effectively.
Lopid vs Tricor Side By Side
| Attribute | Lopid | Tricor |
|---|---|---|
| Brand Name | Lopid | Tricor |
| Contraindications | Should not be taken with medicines to control blood thinning like warfarin without consulting a physician due to the risk of serious bleeding complications. | Should not be taken with medicines to control blood thinning like warfarin without consulting a physician due to the risk of serious bleeding complications. |
| Cost | For brand name: around $500 for 60 tablets (600 mg). For generic: from as low as $0.20/day up to about $1.00/day. | For brand name: about $400 for 30 tablets (145 mg). For generic: prices beginning at roughly $.40/day and not exceeding about $2.00/day. |
| Generic Name | Gemfibrozil | Fenofibrate |
| Most Serious Side Effect | Serious allergic reactions, changes in vision or blurred vision, irregular heartbeat or palpitations, shortness of breath, unusual tiredness or weakness, signs of an electrolyte imbalance, severe abdominal pain, yellowing eyes/skin. | Signs of an allergic reaction, unusual muscle pain leading to weakness and tenderness (Rhabdomyolysis), abnormal liver function tests, dark-colored urine, jaundice, irregular heartbeat. |
| Severe Drug Interactions | Anticoagulants due to possible interactions that can enhance their blood-thinning effect. | Anticoagulants due to possible interactions that can enhance their blood-thinning effect. |
| Typical Dose | 1200-1600 mg/day, typically administered in two divided doses. | 48 to 145 mg/day, usually taken as one single dose each day. |
What is Lopid?
Gemfibrozil (the generic name for Lopid) was a significant breakthrough in the class of cholesterol-lowering drugs known as fibrates. It was first approved by the FDA in 1981. Lopid works by reducing levels of triglycerides, a type of fat found in your blood, and is prescribed for treating very high triglyceride levels that could cause pancreatitis. It also increases high-density lipoprotein (HDL), or "good" cholesterol.
On the other hand, Fenofibrate (the generic name for Tricor) emerged later but still belongs to the fibrate category like Gemfibrozil. Unlike Gemfibrozil, which solely reduces triglycerides and raises HDL cholesterol, Fenofibrate has an additional capability: it can reduce low-density lipoprotein (LDL), or "bad" cholesterol too, providing broader lipid control.
Although both medications have similar side effects including upset stomach and rash, fenofibrate tends to be better tolerated than gemfibrozil with fewer drug interactions making it generally safer for patients on multiple medications.
What conditions is Lopid approved to treat?
Lopid and Tricor are approved for the treatment of different lipid disorders:
- Lopid (gemfibrozil) is indicated primarily to decrease triglyceride levels and increase high-density lipoprotein cholesterol (HDL-C) in patients with pancreatitis or cardiovascular disease.
- Tricor (fenofibrate), on the other hand, is used to reduce elevated low-density lipoprotein cholesterol (LDL-C), total cholesterol, triglycerides, and apolipoprotein B. It is also often prescribed to increase HDL-C in patients with primary hypercholesterolemia or mixed dyslipidaemia.
How does Lopid help with these illnesses?
Lopid, also known as gemfibrozil, helps to manage high cholesterol and triglyceride levels by reducing the amount of these substances produced in the liver. It does this by inhibiting an enzyme that is involved in their production, so levels can be maintained lower for longer periods of time. Cholesterol and triglycerides are types of lipids that play important roles in various bodily functions but can cause health problems when present at high levels in the blood. High cholesterol and triglyceride levels may lead to conditions like atherosclerosis or pancreatitis. Therefore, by decreasing lipid production, Lopid limits negative effects caused by elevated lipid concentrations and helps patients manage their condition.
Tricor on the other hand uses another mechanism - it increases an enzyme called lipoprotein lipase which breaks down fats thereby lowering overall fat (lipid) concentration.
What is Tricor?
Tricor, also known as fenofibrate, is a fibric acid derivative that helps lower lipid levels by enhancing the oxidation of fatty acids in liver and muscle tissue. It effectively reduces triglyceride levels and increases high-density lipoprotein (HDL), or "good" cholesterol. Fenofibrate was first approved by the FDA in 1993. Unlike Lopid (gemfibrozil), another fibrate medication, Tricor does not inhibit an enzyme involved in the metabolism of statins - drugs used to lower LDL ("bad") cholesterol levels. This means it is less likely than gemfibrozil to interfere with statin therapy, making it a safer choice for many patients who are on these medications concurrently. The effects of fenofibrate can be beneficial for those with hypertriglyceridemia and mixed dyslipidemia when diet modifications have been unsuccessful or additional help is needed.
What conditions is Tricor approved to treat?
Tricor is approved for use in the treatment of:
- Hypertriglyceridemia, which refers to high levels of triglycerides in the blood.
- Mixed dyslipidemia, a condition characterized by abnormal levels of lipids or lipoproteins in the blood. It's important to note that this medication is typically used as part of a comprehensive treatment plan that includes diet changes and exercise. Tricor should be utilized when lifestyle modifications alone are not sufficient to manage lipid levels effectively.
How does Tricor help with these illnesses?
Tricor (fenofibrate) is a lipid-lowering agent that works by increasing the natural substance enzyme that breaks down fats in the blood. It plays roles in many processes in the body, affecting cholesterol levels, triglycerides and overall cardiovascular health. Just as low levels of norepinephrine can affect depression, high levels of lipids can lead to heart disease. Tricor functions by boosting the level of enzymes available to break down fats, thereby reducing some symptoms associated with hyperlipidemia or high cholesterol. Its action on various types of lipoproteins also contributes to its function as a lipid regulator. Since it does not significantly alter blood sugar levels, it's often prescribed when patients do not respond well to other treatments like Lopid (gemfibrozil), or may be used alongside them for better results.
How effective are both Lopid and Tricor?
Both gemfibrozil (Lopid) and fenofibrate (Tricor) are fibrate drugs that have established histories of success in treating patients with high levels of triglycerides, and they were initially approved by the FDA only a few years apart. Since they act on different lipids, they may be prescribed under different circumstances. The effectiveness of gemfibrozil and fenofibrate in lowering lipid levels was directly studied in several clinical trials; both drugs exhibited similar efficacy in managing symptoms of hypertriglyceridemia as well as similar, promising safety profiles. In these studies, none of the different metrics studied to measure efficacy in reducing lipid levels differed significantly between patients receiving gemfibrozil or those receiving fenofibrate.
A review on gemfibrozil demonstrated its effectiveness at reducing triglyceride levels starting from two weeks after initiation of treatment and also showed its side effect profile is more favorable than many other fibrates. This study also reports that it is well-tolerated even among elderly populations who tend to have comorbidities.
A 2016 review indicated that Tricor seems to be more effective than placebo at reducing LDL cholesterol while increasing HDL cholesterol concentrations, showing results comparable with common statins. Nonetheless, fenofibrate is typically considered a second-line treatment option after statins for dyslipidemias due to their superior ability to reduce cardiovascular events overall. Significant research on its use involves co-prescribing alongside a statin so data confirming its efficacy as standalone management for dyslipidemia is less robust than that for statins but remains an important tool especially amongst individuals intolerant or not fully responsive to initial therapy.
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At what dose is Lopid typically prescribed?
Oral dosages of Lopid range from 1200-1600 mg/day, typically administered in two divided doses. However, studies show that a daily dose of 1200 mg is usually effective for managing high cholesterol and triglyceride levels in many adults. Unlike Prozac and Wellbutrin, Lopid is not recommended for use in children and adolescents due to lack of sufficient data on its effects. If the desired effect isn't achieved after several weeks on Lopid, your doctor may consider increasing the dosage or switching to another medication like Tricor. It's crucial not to exceed the recommended maximum dosage of 1600 mg/day without medical advice.
At what dose is Tricor typically prescribed?
Tricor treatment typically begins with a dosage of 48 to 145 mg/day. The dose can be increased based on the patient's response and tolerance, but usually isn't divided into multiple doses throughout the day. Instead, it is taken as one single dose each day. It's important that Tricor should be used in conjunction with an appropriate diet and exercise regimen for maximum efficacy in managing cholesterol levels. If there is no significant improvement or if lipid levels remain high after several weeks of therapy at the initial dosage, your healthcare provider may suggest an increase or change in treatment plan.
What are the most common side effects for Lopid?
Common side effects of Lopid (Gemfibrozil) may include:
- Indigestion
- Diarrhea or constipation
- Abdominal pain or cramps
- Headache, dizziness
- Reduced libido (sex drive)
- Rash or skin itching
On the other hand, Tricor (Fenofibrate) can cause these common side effects:
- Nausea and vomiting
- Stomach discomfort or bloating
- Diarrhea or constipation
- Back pain, joint pain, muscle aches
- Respiratory problems like runny nose and sneezing
- Fatigue/weakness
It’s important to note that not everyone will experience all of these side effects. If they do occur, they’re usually mild and go away on their own as your body adjusts to the medication. However, if any symptom persists longer than anticipated or worsens over time, you should consult with your healthcare provider immediately.
Are there any potential serious side effects for Lopid?
While Lopid (gemfibrozil) and Tricor (fenofibrate) are both medications used to lower triglyceride levels in the blood, they do have different side effects. For Lopid, these may include:
- Serious allergic reactions: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing
- Changes in vision or blurred vision
- Irregular heartbeat or palpitations
- Shortness of breath or difficulty breathing
- Unusual tiredness or weakness; feeling faint
- Signs of an electrolyte imbalance: dry mouth, increased thirst, confusion, fast/irregular heartbeat, muscle pain/cramps/weakness.
- Severe abdominal pain; yellowing eyes/skin
As for Tricor:
- Allergic reaction symptoms such as hives; difficult breathing; swelling your face/lips/tongue/throat
- Symptoms associated with liver disease including stomach/abdominal pain that persists nausea/vomiting/yellowing eyes/skin/dark urine.
- Symptoms related to gallbladder disease e.g., sharp pains in your upper stomach spreading to your back/shoulder-blade area.
If you experience any symptoms from either medication that concern you it is essential you seek immediate medical attention.
What are the most common side effects for Tricor?
When using Tricor, users may experience the following side effects:
- Stomach upset or pain
- Backache
- Headache
- Diarrhea or constipation
- Dizziness
- Runny nose or a common cold Please be aware that while these are common side effects, they're usually mild and tend to disappear as your body gets used to the medicine. However, if you notice any of these symptoms persisting or worsening over time, it is crucial to seek medical advice immediately.
Are there any potential serious side effects for Tricor?
Tricor is typically well-tolerated, but it's essential to be aware of potential serious side effects. These may include:
- Signs of an allergic reaction such as hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
- Unusual muscle pain leading to weakness and tenderness (Rhabdomyolysis)
- Abnormal liver function tests with symptoms like nausea, upper stomach pain or discomfort
- Dark-colored urine or clay-colored stools
- Jaundice - yellowing of the skin or eyes
- Irregular heartbeat If you experience any severe reactions while taking Tricor including unusual fatigue/weakness and persistent vomiting/nausea stop using this medication immediately and seek medical attention right away.
Contraindications for Lopid and Tricor?
Both Lopid (gemfibrozil) and Tricor (fenofibrate), along with most other lipid-lowering medications, may trigger certain side effects in some people. If you notice any unusual symptoms such as muscle pain, weakness, fever or a significant increase in abdominal pain or discomfort after starting these medications, please seek immediate medical attention.
Neither Lopid nor Tricor should be taken if you are using medicines to control blood thinning like warfarin without consulting your physician because of the potential risk of serious bleeding complications. It is always necessary to inform your doctor about all the medications you are currently taking; anticoagulants will require close monitoring while on fenofibrate or gemfibrozil therapy due to possible interactions that can enhance their blood-thinning effect.
How much do Lopid and Tricor cost?
For the brand name versions of these drugs:
- The price for 60 tablets of Lopid (gemfibrozil, 600 mg) averages around $500, which works out to approximately $16 per day if you're on a typical dosage of 1200 mg/day.
- The price for 30 tablets of Tricor (fenofibrate, 145 mg) is about $400, working out to roughly $13.33 per day.
Thus, if you are prescribed the standard dose for each medication—Lopid taken twice daily and Tricor once daily—then brand-name Tricor is less expensive on a per-day treatment basis. However, cost should not be your primary consideration in determining which drug best suits your needs.
Now looking at their generic counterparts:
- Gemfibrozil comes in packs ranging from 30 to 180 tablets (600 mg), with costs starting from as low as $0.20/day up to about $1.00/day depending upon pack size.
- Fenofibrate is available in packages varying between15 to100 capsules (145mg), with prices beginning at roughly $.40/day and not exceeding about $2.00/day.
The cost differences can vary significantly due to factors such as location and where you purchase your medications.
Popularity of Lopid and Tricor
Gemfibrozil, in generic form as well as its brand name Lopid, was estimated to have been prescribed to about 1.2 million people in the US in 2020. Gemfibrozil accounted for just over 8% of fibrate prescriptions in the US. However, it appears to be a commonly used "classic" fibrate (a class of drugs that reduce lipid levels). The prevalence of gemfibrozil has been on a decrease since the early 2000s due to newer alternatives.
Fenofibrate, including brand versions such as Tricor, was prescribed to approximately 7 million people in the USA during 2020. In the US, fenofibrate accounts for nearly half of all fibrate prescriptions and has seen an increase over time due to its better safety profile compared with older fibrates like gemfibrozil. Fenofibrate's use has generally been increasing since its introduction owing largely to its effectiveness and lower risk of side effects compared with other fibrates.
Conclusion
Both Lopid (gemfibrozil) and Tricor (fenofibrate) have long-standing records of usage in patients with high cholesterol or triglycerides, and are supported by numerous clinical studies indicating that they are more effective than placebo. In some cases, the drugs may be combined with statins, but this requires careful consideration due to a risk of severe muscle disease. Both act primarily on lipid levels by reducing the amount of triglycerides produced by the liver.
Lopid is considered for use when dietary changes aren't enough to lower fats in your blood or if you have a condition called mixed dyslipidemia alongside other treatments. On the other hand, Tricor would usually be prescribed when patients do not respond well to initial treatment options such as lifestyle modifications and/or statin therapy alone.
Both drugs are available in generic forms which represents significant cost savings especially for patients who must pay out of pocket. Both Lopid and Tricor may require an adjustment period, meaning that effects may not be noticeable right away.
The side effect profile is similar between the two drugs — both being generally well-tolerated — but with Tricor having fewer gastrointestinal complaints compared to Lopid. For both drugs, patients must closely monitor their health while under treatment as symptoms like unusual bleeding/bruising or signs of infection could indicate serious side effects requiring immediate medical attention.
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Refrences
- Insua, A., Massari, F., Moncalvo, J. J. R., Zanchetta, J. R., & Insua, A. M. (2002, March). Fenofibrate or Gemfibrozil for Treatment of Types IIa and IIb Primary Hyperlipoproteinemia: A Randomized, Double-Blind, Crossover Study. Endocrine Practice. Elsevier BV.http://doi.org/10.4158/ep.8.2.96
- Hausenloy, D. J., & Yellon, D. M. (2008, June 1). Targeting residual cardiovascular risk: raising high-density lipoprotein cholesterol levels. Heart. BMJ.http://doi.org/10.1136/hrt.2007.125401
- Insua, A., Massari, F., Moncalvo, J. J. R., Zanchetta, J. R., & Insua, A. M. (2002, March). Fenofibrate or Gemfibrozil for Treatment of Types IIa and IIb Primary Hyperlipoproteinemia: A Randomized, Double-Blind, Crossover Study. Endocrine Practice. Elsevier BV.http://doi.org/10.4158/ep.8.2.96
- Jackevicius, C. A. (2011, March 23). Use of Fibrates in the United States and Canada. Jama. American Medical Association (AMA).http://doi.org/10.1001/jama.2011.353
- Keating, G. M., & Croom, K. F. (2007). Fenofibrate. Drugs. Springer Science and Business Media LLC.http://doi.org/10.2165/00003495-200767010-00013