fenofibrate vs gemfibrozil
Side-by-side comparison of fenofibrate and gemfibrozil Data from FDA drug databases (Orange Book, NDC Directory, recalls, shortages) covering 20,000+ approved drugs, plus CMS pricing; see our methodology.
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Fenofibrate is a medicine that helps lower bad cholesterol and fats (triglycerides) in your blood, while raising good cholesterol.
Gemfibrozil is a medicine that helps lower high triglyceride levels in your blood. It can also help reduce the risk of heart disease in some people.
This medicine is used with a diet to treat high cholesterol and high levels of triglycerides (fats) in the blood. It helps adults who have primary hypercholesterolemia or mixed dyslipidemia. It can also treat adults with severe hypertriglyceridemia. However, fenofibrate has not been proven to prevent heart disease in people with type 2 diabetes.
This medicine is used to treat very high triglyceride levels in adults when diet alone doesn't work. High triglycerides can increase your risk of pancreatitis. Gemfibrozil can also lower the risk of heart disease in some people with specific cholesterol problems.
Fenofibrate is a type of drug called a PPAR alpha agonist. It works by activating a protein in your body that helps break down fats and cholesterol. This leads to lower levels of bad cholesterol and triglycerides, and higher levels of good cholesterol.
Gemfibrozil belongs to a class of drugs called fibrates. It works by decreasing the amount of triglycerides your body makes. It also helps to increase HDL (good) cholesterol.
- • Abnormal liver function tests
- • Increased ALT (a liver enzyme)
- • Increased AST (a liver enzyme)
- • Increased CPK (a muscle enzyme)
- • Runny nose
- • Upset stomach
- • Indigestion
- • Abdominal pain
- Feeling sick to your stomach 2,914
- Feeling tired 2,842
- Loose or watery stools 2,681
- The medicine is not working 2,450
- Difficulty breathing 2,100
- Feeling sick to your stomach 882
- Feeling tired 826
- Medicine not working 766
- Loose stools 726
- Aches 692
Fenofibrate can cause liver problems. Your doctor should check your liver function with blood tests before you start taking it and regularly while you are taking it. Stop taking fenofibrate and tell your doctor right away if you have signs of liver problems, such as yellowing of your skin or eyes, dark urine, or stomach pain. Fenofibrate can also cause muscle pain or weakness, especially if you are also taking a statin medicine. Tell your doctor right away if you have unexplained muscle pain, tenderness, or weakness.
This medicine may increase your risk of gallbladder problems, including the need for surgery. Before taking gemfibrozil, tell your doctor if you have liver or kidney problems. You should not take this medicine with simvastatin, repaglinide, dasabuvir, or selexipag.
It is not known if fenofibrate will harm an unborn baby. You should only use fenofibrate during pregnancy if your doctor decides that the benefit outweighs the risk. You should not breastfeed while taking fenofibrate.
Tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. It is not known if gemfibrozil can harm your unborn baby. It is also not known if gemfibrozil passes into breast milk.
How to Read This fenofibrate vs gemfibrozil Comparison
fenofibrate is classified in the Fibrate drug class, while gemfibrozil sits within the Fibrate class. Because both drugs share the same classification, they are often considered interchangeable in theory — but clinical outcomes rarely track that cleanly. Both drugs are prescription-only, so a licensed provider must authorize use.
Adverse event totals above are pulled from the FDA's Adverse Event Reporting System (FAERS). For these top-ranked reactions alone, fenofibrate has 12,987 submissions while gemfibrozil has 3,892. Those figures reflect cumulative reporting volume — not per-patient risk — so older, widely dispensed drugs typically look worse on count alone. No direct interaction between these two drugs is listed in our FDA-derived dataset, though co-prescription still warrants pharmacist review. Serious warnings, pregnancy guidance, and contraindications can differ even when indications overlap.
A table cannot substitute for clinical judgment. Effectiveness, tolerability, drug-drug interactions with your other medications, kidney and liver function, pregnancy status, insurance formulary, and price all feed into a decision that only a licensed prescriber can make responsibly. Data here is sourced from FDA Structured Product Labels (SPL) and FAERS, both of which update as manufacturers and clinicians submit new information. This page is for educational purposes only, is not medical advice, and should not be used to self-switch between fenofibrate and gemfibrozil — always consult your physician or pharmacist first.
Important: This comparison is for informational purposes only. Drug effects vary between individuals. Always consult your doctor or pharmacist for personalized medical advice.