Drug interactions
Gemfibrozil + Roxadustat
Severity: Major
Gemfibrozil and Roxadustat: 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 substantially raises roxadustat exposure. This increases the risk of excessive erythropoiesis and adverse effects such as thrombotic events and hypertension.
What this interaction means in plain words
Gemfibrozil and Roxadustat 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; Roxadustat belongs to Miscellaneous.
Why it happens
Gemfibrozil and its glucuronide inhibit CYP2C8 and UGT1A9, key pathways of roxadustat clearance (and OATP1B1 transport).
What to do
Monitor haemoglobin closely and reduce the roxadustat dose as needed. Consider an alternative lipid-lowering agent if possible.
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 Roxadustat
- Probenecid + Roxadustat Major
- Atorvastatin + Roxadustat Moderate
- Calcium acetate + Roxadustat Moderate
- Calcium + Roxadustat Moderate
- Iron + Roxadustat Moderate
- Magnesium + Roxadustat Moderate
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 Roxadustat?
MediHelp rates the interaction as major. Gemfibrozil and Roxadustat 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 substantially raises roxadustat exposure. This increases the risk of excessive erythropoiesis and adverse effects such as thrombotic events and hypertension.
How serious is the interaction between Gemfibrozil and Roxadustat?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor haemoglobin closely and reduce the roxadustat dose as needed. Consider an alternative lipid-lowering agent if possible.
What other medicines interact with Roxadustat?
MediHelp also lists interactions of Roxadustat with, for example, Probenecid, Atorvastatin, Calcium acetate. The full list is on the Roxadustat page.
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