Drug interactions
Gemfibrozil + Resmetirom
Severity: Major
Gemfibrozil and Resmetirom: major interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Gemfibrozil strongly inhibits CYP2C8, which metabolizes resmetirom, and can substantially increase resmetirom exposure. This raises the risk of dose-related adverse effects such as gastrointestinal effects and liver toxicity.
What this interaction means in plain words
Gemfibrozil and Resmetirom can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Gemfibrozil belongs to Cardiovascular; Resmetirom belongs to Gastrointestinal Tract.
Why it happens
CYP2C8 inhibition reduces resmetirom clearance, with possible OATP1B1 inhibition adding to the increase.
What to do
Avoid the combination and use another lipid-lowering agent if one is needed.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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Other interactions of Resmetirom
- Atorvastatin + Resmetirom Moderate
- Clopidogrel + Resmetirom Moderate
- Pravastatin + Resmetirom Moderate
- Resmetirom + Rosuvastatin Moderate
- Resmetirom + Simvastatin Moderate
- Hydrochlorothiazide-irbesartan + Resmetirom Minor
Other interactions of Gemfibrozil
- Daprodustat + Gemfibrozil Contraindicated
- Elagolix + Gemfibrozil Contraindicated
- Gemfibrozil + Mavacamten Contraindicated
- Gemfibrozil + Metformin-repaglinide Contraindicated
- Gemfibrozil + Ombitasvir / paritaprevir / ritonavir and dasabuvir Contraindicated
- Gemfibrozil + Repaglinide Contraindicated
Frequently asked questions
Can I take Gemfibrozil with Resmetirom?
MediHelp rates the interaction as major. Gemfibrozil and Resmetirom can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Gemfibrozil strongly inhibits CYP2C8, which metabolizes resmetirom, and can substantially increase resmetirom exposure. This raises the risk of dose-related adverse effects such as gastrointestinal effects and liver toxicity.
How serious is the interaction between Gemfibrozil and Resmetirom?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the combination and use another lipid-lowering agent if one is needed.
What other medicines interact with Resmetirom?
MediHelp also lists interactions of Resmetirom with, for example, Atorvastatin, Clopidogrel, Pravastatin. The full list is on the Resmetirom page.
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